Social Case Work

Section- I
Social case work, a primary method of social work, is concerned with the adjustment and
development of the individuals towards more satisfying human relations. Better family life, improved
schools, better housing, more hospital and medical care facilities, protected economic conditions and
better relations between religious groups help the individual in his adjustment and development. But
his adjustment and development depends on the use of these resources by him sometimes due to
certain factors, internal or external, he fails to avail existing facilities. In such situations, social case
worker helps him. Thus, social case work is one to one relationship which works in helping the
individual for his adjustment and development.
I. Definitions of Social Case Work
Social case work has been defined by following thinkers:
Richmond (1915)
Social case work may be defined as the art of doing different things for and with different people
by cooperating with them to achieve at one and the same time their own and society's betterment. 1
Richmond (1917)
Social case work is the art of bringing about the better adjustments in the social relationships of
individual men, or women or children.2
Richmond (1922)
Social case work means, "those processes which develop personality through adjustment
consciously affected, individual by individual, between men and their social environment." 3
Hollis (1954)
Social case work is a method employed by social workers to help individuals find a solution to
problems of social adjustment which they are unable to handle in a satisfactory way by their own
efforts.4
Hamilton, Gordon (1956)
In social case work the client is stimulated to participate in the study of his situation, to share
plans, to make an active effort to solve his problems, using his own resources and whatever
community resources are available and appropriate.5
Perlman (1957)
Social case work is a process which is used by certain human welfare agencies to help
individuals to cope more effectively with their problems in social functioning. 6
The credit goes to Mary Richmond for defining the social case work scientifically. In 1915, she
said that social case work is an art through which help is provided to people for their betterment as
well as for the betterment of society. It means that social case work is essential if any country wants to
improve and develop society and community. But this definition was not clear and, therefore, she
defined it again in 1917, in which she emphasized its specific purpose i.e. better adjustment in the
social relationships. Again in 1922, she told that social case work brings about change in the
personality of the individual for proper social adjustment.
Hollis talks of finding a solution to the problems of individual client. According to Perlman, the
case worker's task is to restore or reinforce the client's ability to deal with the problem rather than to
deal with the problem for or with him.
Perlman, while defining the social case work process, has indicated the four-essential
components of social case work in their relationships to one another. A person with a problem comes
to a place where social worker helps him through a well defined process. The person is a man,
woman or child, anyone who finds himself, or is found to be, in need of help in some aspect of his
social emotional living, whether the need be for tangible provisions or counsel. As he begins to
receive such help, he is called a client.7 The problem arises from some need or obstacle or
accumulation of frustrations or maladjustments, and sometimes all of these together, which threatens
or has already attacked the adequacy of the person's living situation or the effectiveness of his efforts
to deal with it.8 The place is a social service agency or a social service department of another kind of
human welfare agency. It is a particular kind of social agency and department in that it is set up to
deal not with social problems at large but with human beings who are experiencing such problems in
the management of their own personal lives. Its purpose is to help individuals with the particular
social handicaps which hamper good personal or family living and with the problems created by
faulty person to-person, person-to-group, or person-to-situation relationships.9
The process, names 'social case work' to denote its centre of attention and its individualized
aspect, is a progressive transaction between the professional helper (the case worker) and the client. It
consists of a series of problem solving operations carried on within a meaningful relationship. The
end of this process is contained in its means to influence the client person that he develops
effectiveness in coping with his problem and/or to so influence the problem as to resolve it or vitiate
its effects.10
Evolution of Social Case Work
The social case work as a method of social work has emerged from the processes of
industrialization and its concomitant urbanization. It is the offspring of Charity organization societies
movement, which was introduced in the late 1870s. But the first theoretical formulations of the social
case work are associated with the publication of Mary Richmond's book 'Social Diagnosis' in 1917.
Case work has gone through several discernible stages. These are (i) the exploratory and
disciplinary, (2) the sociological, (3) the psycho-social11 and (4) the synthetic or integrated.
i) The Exploratory and Disciplinary Stage
Josephine Shaw Lowell, founder of the New York Charity Organization Society, and many other
social workers believed that the unworthy poor should be provided financial assistance. These
workers were motivated by desires to:
1. Deal kindly but firmly with individuals in need, primarily the self- respecting and working poor,
the public agencies to deal with others by repressive methods.
2. Reduce duplication in relief administration as between agencies.
3. Conduct careful inquiries into the extent of personal needs.
4. Help people with certain types of personal problems contributing to poverty such as sickness,
and to deny help to others, who were lazy, intemperate and extravagant.
5. Give their time and effort without remuneration to the alleviation of suffering and to the
diminution of extravagant relief administration.12
ii) The Sociological Stage
In 1901, Mary Richmond presented a chart showing the environment forces influencing the
family and argues for the analysis of social situation before providing any help. She wrote a very
valuable book 'Social Diagnosis' in 1917, which reflects sociological point of view of social case work.
In 1922, she published another book 'What is Social Case Work? in which she defined the social case
work as: "Social case work consists of those processes which develop personality through adjustments
consciously effected, individual by individual, between men and their social environment." 13
iii) The Psycho-social Stage
World War I was a major turning point in the practice of the social case work. The Psychiatric
Wave forced the social case work away from its appropriate concern with social issues towards an
inappropriate preoccupation with mental phenomena. Influence of Freudian Concept spread and the
social case work became a psycho-dynamic case work. Valuable contributions were made by Towle,
Bibring, Turner, Austin, Bandler, Parad, Hollis, Smalley, Garrett, etc.
The other contributors are Miss Robinson, who wrote a book 'A Changing Psychology in Social
Case Work', Taft who wrote a book 'A Functional Approach to Family Case Work.'
In this phase, the following contribution was made to the philosophy and practice of social case
work;
1. Interest in the cause of human distress conceived of as deriving from the social situation or
physical environment. Interest in the family as the social unit having most importance in the
 development of human adjustment but with little appreciation of the nature of psychological
interactions within the family.
2. Efforts to find the most scientific way of doing things and the development of a methodology for
social diagnosis.
3. Belief that most people will make adjustments to life if their environment was favourable. If it is
unfavourable, the social worker has the function or removing or of having removed the
disrupting condition.
4. Interest in the effect of social environment upon human personality but without much
understanding of causation and mechanisms of behaviour.
5. Belief in the values of friendly contracts and their effects upon personality but with little
awareness of what in the net period was so energetically studied-psychological relationships
and the dynamics of interaction.
iv) The Synthetic or Integrated Stage
The Milford Conference in 1925 appointed a committee under the Chairmanship of Porter Lee to
define the nature of generic social work. Milford Conference accepted the report of the Committee
which recommended. "Social case work deals with the human being whose capacity to organize his
own normal activities may be impaired by one or more deviations from accepted standards or normal
social life. The use of norms is essential because without use of norms purposeful activity is difficult.
Social history of the client is significant for the particularization of the care. The purpose of social case
work is to assist the individual to develop his capacity to organize his own normal social activities."
Since the publication of the Milford Conference Report 1929, a number of books on social case
work theory and practice have been published, Lowry edited Reading in Social Case Work: 1920-1938
in 1939. Hallis brought out Social Case Work in Practice in 1939. Hamilton published, Theory and
Practice of Social Case Work in 1940.
II. Basic Assumption of Social Case Work
Hamilton has described the following main assumptions of the social case work:
1. Individual and society are interdependent.
2. Social forces influence behaviour and attitudes, affording opportunity for self-development and
contribution to the world in which we live.
3. Not only are all problems psycho-social inner and outer but most case work problems are
interpersonal, that is, more than one person is likely to be involved in the treatment of the
individual, and particularly in case work the family unit is involved.
4. The client is a responsible participant at every step in the solutions of his problems;
5. At the center of the case work process is the conscious and controlled use of the worker-client
relationship to achieve the ends of treatment.14
III. Purpose of Social Case Work
The basic purpose of social case work is to enable the client to enjoy with some degree of
permanency, more satisfying, effective and acceptable experience in the social situation in which he
finds himself. To achieve this goal, efforts are made to bring effective changes in the client's
environment or social living situation, through clarifying the clients possibly distorted perception of it
or strengthening his capacities for coping with it.15 Its essential task is the facilitation of social
relationship. According to Witmer 'the chief aim of social case work is that of helping people to
mobilize their capacities for the solution of the problems that brought them to the attention of social
agencies.'16
In general, the purpose of social case work is to help an individual client to solve his psycho-
social problems in such a way so that he finds himself capable of dealing with these problems at
present and also may solve in future if such problems arise. Thus social case work has the following
objectives:
1. To understand and solve the internal problems of the individual.
2. To strengthen his ego power.
3. Remediation of problems in social functioning.
4. Prevention of problems in social functioning.
5. Development of resources to enhance social functioning.
IV. The 4Ps, 4Rs, and 4Ms of Case Work17
For many years, Perlman's (1957) 4 Ps (person, problem, place, and process) have proven useful
to social workers as a way of organizing their thoughts about a client, his or her situation, and the
agency context of social work intervention. Doremus (1976) suggests the 4 Rs (roles, reactions,
relationships, and resources) as a way of conceptualizing assessment in health care settings. In
addition, the authors offer the 4 Ms (motivation, meanings, management, and monitoring) as further
reminders of important elements in social work intervention.
A blending of the 4 Ps, 4 Rs, and 4 Ms results in a 12-item, easily remembered conceptual tool
that can help a worker sift through available data, organize it, and begin formulating an intervention
plan. As used here, the word client refers to an individual. However, the underlying ideas that make
up the 4 P/4 R/4 M can be applied to work with other client systems, including couples, families, or
small groups.
The 4 Ps
1. Problem
  What is the nature of the client's problem or concern? Its cause, intensity, frequency, and
duration?
  How does the client define or describe it? How do others who know the client define it?
How does the worker define it?
  Can this problem or situation be changed? What aspects of the problem can feasibly be
addressed in a change effort by the worker and client?
  How effective have previous efforts by the client, agency, or worker been n dealing with
this problem or concern?
  Is the problem or situation an emergency that requires as rapid response?
  What would the consequences be if the worker or agency does nothing for or with the
client?
2. Person
  How are the various dimensions of the whole person (e.g., physical, emotional social,
economic, and spiritual) related to or affected by the client's problem, concern, or situation?
  What client strengths or assets can be used as a foundation on which to build an effective
intervention plan and change process?
  How might the client's usual ways of thinking and behaving become barriers to dealing
effectively with the problem or concern?
3. Place
  What meaning does the client assign to his or her involvement with the agency (e.g.,
hopefulness, stigma, fear, humiliation, etc.)?
  Can the agency provide the services needed by the client? If not, is referral to another
agency likely to be effective?
  Are the agency's own procedures, policies, or methods somehow contributing to the client's
problems?
4. Process
  What type of helping approach, method, or technique is the client likely to find acceptable?
  What approach, method, or technique is likely to be effective?
  How will the requirements of the helping process (time, fees, scheduling, etc.) affect the
client's current roles and responsibilities?
The 4 Rs
1. Roles
  What roles and responsibilities does the client have in life (e.g., parent, spouse, employee,
etc.)?
  What do others (e.g., family, employers, etc.) expect of the client?
  How satisfied is the client with his or her role performance?
2. Reactions
  What are the client's reactions (e.g., physical, behavioral, and emotional) to his or her
problems, concerns, and situation?
  How do these reactions compare to his or her usual patterns? Is the client in a state of
crisis?
3. Relationships
  What people are significant and meaningful parts of the client's life (e.g., family, peers,
friends, etc.)?
  How are they being affected by the client's problem or situation?
  How is the behavior of significant others contributing to the client's current problem or
situation?
4. Resources
 What formal and informal resources has the client used in the past to cope with similar
problems? Are these resources available to the client?
  What new or additional resources are now needed by the client? Are they available? Is the
client willing to use them?
  Is the client eligible for or able to pay for needed services and programs?
The 4 Ms
1. Motivation
  What does the client want to do about his or her problem or situation?
  What discomfort or aversive factors are pushing the client toward action?
  What factors of hope are pulling the client toward action?
  What can be done to increase client motivation?
2. Meanings
  What meaning does the client assign to his or her situation, and problems?
  What ethnic, cultural, and religious beliefs and values are important to the client and
relevant to the current problem or situation?
3. Management
  How can the worker best use his or her limited time, energy, and resources to help the
client deal with the problem or situation?
  What overall plan or strategy will guide the worker's activity with the client?
  How will work with this client affect the worker's other responsibilities? Stages of Team
Development Stage 1:
4. Monitoring
  How will the worker monitor his or her impact on the client and evaluate the effectiveness
of the intervention?
  How can the worker use peers, supervisors, or consultants to monitor and evaluate
intervention?
V. Client-Case Worker Relationship
The term 'relationship' in social case work was used for the first time by Miss Virginia Robinson
in her book: 'A Changing Psychology in Social Case Work' in 1939. Relationship is the case workers
responsible and disciplined use of himself in working with a client. The relationship is the channel
through which the mobilization of the capacities of the client is made possible. The relationship is the
medium through which the client is enabled to state his problem and through which attention can be
focused on reality problems, which may be as full of conflict as emotional problems. 18 A case work
relationship is the professional meeting of two persons for the purpose of assisting one of them, the
client, to make a better, a more acceptable adjustment to a personal problem. 19 Within the democratic
frame of reference, the professional relationship involves a mutual process of shared responsibilities,
recognition of other's rights, acceptance of difference, with the goal, not of isolation, but of socialized
attitudes and behaviour stimulating growth through interaction. 20
Characteristics of Case Worker-Client Relationship
Perlman21 has described the following characteristics of case worker- client relationship:
1. Vital relationships between people rise out of shared and emotionally charged situations.
2. All growth-producing relationships, of which the case work relationship is one, contain elements
of acceptance and expectation, support and stimulation.
3. The identifying mark of a professional relationship is its conscious purposiveness growing out of
the knowledge of what must go into achieving the goal.
4. The case work relationship begins as the client shares some part of his problem and as the case
worker demonstrates that he feels with the client at the same time that he has professional
competence to being to dealing with the problem.
5. The case worker relationship may have several therapeutic values.
6. Relationship needs and difficulties from outside the case work situation may intrude into and
complicate the case work relationship and may have to be death with.
7. The case worker, too, has relationship reactions, and part of his professional skill in the
management of them.
Purpose of Relationship
The case work relationship is the dynamic interaction of attitudes and emotions between the
case worker and the client, with the purpose of helping the client to achieve a better adjustment
between himself and his environment.22 Thus, the purpose of establishing relationship is to help the
client with his psycho-social needs and problems. Its other purposes are:
1. Better solution of client's problem.
2. Exploitation of means for solving problem.
3. Stating reality and emotional problems.
4. Solution of the personal problem.
5. Development of personality.
The Principles of Case Worker and Client Relationship
Biestek23 has described 7 principles of case work relationship. These are:
1. Principle of Acceptance
Acceptance is a principle of action wherein the case worker perceives and deals with the client as
he really is, including his strengths and weaknesses, his congenial and uncongenial qualities, his
positive and negative feelings, his constructive and destructive attitudes and behaviour, maintaining
all the while a sense of the clients' innate dignity and personal worth. The purpose of acceptance is
therapeutic: to aid the case worker in understanding the client as he really is, thus making case
worker more effective; and to help the client free himself and look at himself as he really is, and thus
to deal with his problem and himself in a more realistic way.
2. Principle of Individualization
Individualization is the recognition and understanding of each client's unique qualities and the
different use of principles and methods in assisting each towards a better adjustment.
Individualization is based upon the right of human beings to be individuals and to be treated not just
as a human being to be individuals and to be treated not just as a human being but as this human
being with his personal differences.
2. Principle of Purposeful Expression of Feelings
 Purposeful expression of feelings is the recognition of the client's need to express his feelings
freely, especially his negative feelings. The case worker listens purposefully, neither discouraging nor
condemning the expression of these feelings, sometimes even actively stimulating and encouraging
them when they are therapeutically useful as a part of the case work service.
3. Principle of Controlled Emotional Involvement
The controlled emotional involvement is the case worker's sensitivity to the clients' feelings, an
understanding of their meaning, and a purposeful, appropriate response to the client's feelings.
5. Principle of Non-Judgmental Attitude
The non-judgmental attitude is a quality of the case work relationship, it is based on a conviction
that the case work function excludes assigning guilt or innocence, or degree of client responsibility for
causation of the problems or needs, but does include making evaluative judgments about the
attitudes, standards, or action of the client, the attitude which involves both thought and feeling
elements, is transmitted to the client.
6. Principle of Client Self-determination
The principle of client self-determination is the practical recognition of the right and need of
clients of freedom in making their own choices and decisions in the case work process. Case workers
have a corresponding duty to respect that right, recognize that need, stimulate and help to activate
that potential for self-direction by helping the client to see and use the available and appropriate
resources of the community and of his own personality. The client's right to self-determination,
however, is limited by the client's capacity for positive and constructive decision making, by the
framework of civil and moral law, and by the function of the agency.
7. Principle of Confidentiality
Confidentiality is the preservation of secret information concerning the client which is disclosed
in the professional relationship. Confidentiality is based upon a basic right of the client; it is an ethical
obligation of the case worker and is necessary for effective case work service. The client's right,
however, in not absolute. Moreover, the client's secret is often shared with other professional persons
within the agency and in other agencies; the obligation then binds all equally.
Friedlander24 has mentioned two types of principles.
A. Generic Principles
(i) The principle of acceptance
(ii) The principle of communication
(iii) The principle of individualization
(iv) The principle of participation
(v) The principle of client self-determination
(vi) The principle of confidentiality
(vii) The principle of case worker self-awareness
B. Differential Principles
(i) In a stressful situation, involving a client who presents evidence of inadequacies in current
role functions, whose current mode of adaptation to this loss seems appropriate (not
markedly regressive) and who demonstrated the possession of a clear perception of the
problems and what may be needed for their solution-which is evidence of effective ego-
functioning- the goal and techniques of environmental modification and ego support are
applicable.
(ii) In a stressful situation, involving a client who presents evidence of inadequacies in current
role functions and whose mode of adaptation seems either (a) appropriate (not markedly
regressive) or else, at the other extreme, (b) markedly in appropriate and regressive, and
who demonstrates the possession of either (a) a clear perception of the problems and what
may be needed for their solution-evidence of effective ego-functioning or (b) markedly in
accurate or distorted perception of the problems- evidence of grossly ineffective ego-
functioning-the goals and techniques of environmental modification and ego-support are
applicable.
 (iii) With a diagnosis of relatively strong ego-functioning, of some but not marked regressive
modes of adaptation, and of rather satisfying and effective performance in key social roles,
the case worker may engage with clients in the goals and techniques of clarifying the effects
and meaning of the clients' behaviour.
(iv) When problems in role fulfilment are bases primarily in intrapsyschic hindrances to
effective and satisfying modes of adaptation and the client's potential and satisfying modes
of adaptation and the client's potential level of ego-functioning is a high one, the goals and
techniques of uncovering the "forgotten causes of behaviour are applicable."
VI. Social Case Work Process
There are three phases of social case Work practice: Social investigation or psycho-social study,
diagnosis and treatment or management.
First Phase
1. Social Investigation (Psycho-Social Study)
Nothing happens on this earth without any reason. In other words, every happening has a
definite cause. Definite cause does not exist in vaccum rather in a natural phenomenon. It is very
interesting to note that today man is not just considered the creature rather a creator as well. This
particular change in the status of man has tempted him to quench his thirst of knowledge not only
about the natural phenomena rather today's man is much interested to understand human behaviours
in a very scientific and precise way. Social case worker is also interested in gaining this knowledge for
its successful functioning.
Before conceiving the term social investigation, Mary Richmond herself toyed with such terms
as "social-evidence" "learned seeking", "social inquiry" and ultimately shifted her choice upon the
term social investigation. Social investigation is the foundation upon which the various helping
processes, actions and treatment techniques are built. For every social work activity- whether it is at
individual level of family level or community and societal level, the social investigation is
indispensable. Social Investigations helps to find out the social realities of the clients and their
families, to identify the problem areas and to formulate treatment, rehabilitation and after care
strategies.
It is rightly pointed out by Hamilton that social investigation is a psycho-social process. It
transcends much beyond the assessment of the individual client or family. The Intra-psychic forces
are inseparably linked with social forces. To understand the individual as psycho-social entity, the
analysis of his relationship with others and others related with him is equally important.
Contents of Social Investigation
Perlman25 has given the following contents of the case work study in the beginning phase.
(1) The nature of the presenting problem
(2) The significance of this problem
(3) The cause (s), onset and precipitants of the problem
(4) The efforts made to cope with problem solving
(5) The nature of the solution or ends sought from the case work agency
(6) The actual nature of this agency and its problem solving means in relation to the client and his
problem.
Social case worker attempts to investigate the following facts:
(1) Nature of the Problem
He tries to know major complaints, beginning of the problems, the nature of the problem,
severity of the problem, implications of the problem, location of the problem, causation of the
problem, scope of the problem (who are other affected persons) etc.
(2) Client's Feelings and Reactions
Case worker attempts to find out attitude of the client towards his problem, the analysis and
interpretation made by him about his problem, the relationship between client and problem,
capacities, competencies and weaknesses of the client.
(3) Client's Efforts to Solve Problems
Social case worker acquires knowledge about the efforts made by the client to deal with his
problems, the help taken so far, help taking organization and agencies, effects of help, client's
evaluation towards these help receiving agencies and the time spent in these agencies
(4) Social Conditions
He investigates the clear picture of family, its environment and its impact on the client. He also
gains knowledge of schools and its effect on the client. Apart from these social agencies, he makes
attempts to know the impact of neighbour, working place and religious, economic and political
institutions.
(5) Psycho-social Development of the Client
In this area, case worker gets information about the pre and post natal care of the client, his early
development, childhood, schooling, socialization patterns, home environment, marital history,
occupational history, habits and relationship with others.
(6) Personality of the Client
For the proper diagnosis, the case worker gives much emphasis to gather information regarding
personality characteristics of the client i.e. knowledge, feelings, wishes, temperament, ego-strength,
sensitivity, adaptability, communication patterns, cooperation, sympathy, tolerance, responsibility,
expression of emotions, devotion to work, motivational state and level of aspirations and weaknesses
in his personality.
Techniques of Social Investigation
There are two fundamental techniques of social investigation, i.e. (i) Interview and (ii)
Observation.
The process of social investigation is initiated and carried through by the process of interview.
Professional skill in this area requires not only theoretical knowledge about the psychology of human
behaviour but also considerable case work experience in which the worker's technique is repeatedly
analysed. The interview is used for securing information about the client as well as his problems
including his relationships with other persons in his social and personal environment. Through the
interview situation, the case worker attempts to instruct and guide both the client and others who
play significant roles in his life and attempts to manipulate the environment for the benefit of the
client.
Observation is always coupled with interviewing. It makes possible to record behaviour of the
client as it occurs. It yields clues as to the pathological patterns of communication, pathogenic relating
and defective role playing and polarization of power and authority among the family members which
are of etiological significance.
Tools of Social Investigation
The following tools are used by social case worker in collecting the relevant information for
diagnosis and treatment:
(1) Interview guide and schedule
(2) Life Chart
(3) Video recording of family interaction
(4) Tape recorded interview
Second Phase
2. Social Diagnosis
Diagnosis, like treatment, begins with the first glance between the help giver and help-seeker.26
Social diagnosis is the attempt to arrive at an exact a definition as possible of the social situation and
personality of a given client. It is a search for the causes of the problem which brings the client to the
worker for help. Diagnosis is (i) an explanation formulation in the light of known facts (both tangible
fact items and psychological fact items): (ii) an explanation made in the knowledge of other possible
explanations; and (iii) subject to change or revision whenever subsequent material warrants a
different explantion.27 Diagnosis is, therefore, concerned with understanding both the psychological
or personality factors which bear a causal relation to the client's difficulty and the social or
environmental factors which tend to sustain it.28
Content of Social Diagnosis
Content of the case work diagnosis falls into a triangular pattern. It consists of:
1. Nature of the problem brought and the goals sought by the client, in their relationship to;
2. Nature of the person who bears the problem (his social and psychological situation and
functioning) and who seeks (or needs) help with his problem, in relation to;
3. Nature and purpose of the agency and the kind of help it can offer and/or make available. 29
Process of Making Diagnosis
A diagnosis has been broken down into a number of stages: gathering the data, the diagnostic
study, the diagnosis itself or the evaluation and the diagnostic product.
(1) Gathering Data
Data are gathered from the interview of the client, repeat, agency's records, reports from other
members of the team, other agencies, schools, relatives. Home visit is also an important source of data
collection. The accuracy of data depends on worker's skill of interviewing, individualization,
acceptance, communication and involvement.
(2) Diagnostic Study
The study attempts to identify the problem areas which are important for social case work
involvement.
(3) Diagnosis or Evaluation
This means finding the nature of the problem, its organization and extent and who is going to be
affected. Factors responsible for the problem may be one or more than one of the following:
(i) Physical-physical illness or disability, how the sufferer feels, how his family and others feel.
Effect of physical illness-dependent, tired, irritable, depressed, self image lowering, distort
relationship, disrupt communication.
(ii) Psychological- The assessment is made of the quality of libidinal relationship, dependency,
narcissistic tendencies, sexual identification, quality of aggressiveness, channelization of
aggressiveness, nature of super ego, consistency of ego and superego, defense, used degree of
discomfort the problem cause him, the nature of desire to change it, the effect that change may
have upon other members.
(iii) Social-The following facets of social environment generally come within the diagnosis:
1. Income level-high, low, consistent, uncertain, effect on the present problem.
2. Housing-loan taken, rented, adjustment with landlord/tenant, overcrowding, basic
facilities lacking/sufficient.
3. Neighbourhood-tolerant/intolerant/supportive/conflict, views toward client etc.
4. Employment-job availability, prospects, remuneration, level, security, status, condition of
work, job satisfaction.
5. Religion- believes in values, offering support-consolation, expressive, outlets, sublimation,
reinforcing problems - guilt, tension.
6. Availability/quality/attitude and attitudes (client) to social organization and services :
medical facilities, courts, credit organizations, legal advice centers, Post office, social
security,
7. Prejudice, tension etc.
8. Educational problems.
Types of Diagnosis
Perlman30 has described three types of diagnosis that is carried on in social case work process.
These are: Dynamic diagnosis, Clinical diagnosis and Etiological diagnosis.
(1) Dynamic Diagnosis
 Dynamic diagnosis gives an understanding of the current problem of the client and the forces
currently operating within the client, within social environment and between him/his environment. It
gives the answers of the question- what is the trouble? What psychological, physical and social factors
contribute to it? what solution is sought? What are the means available within the client and his
environment? What are organized? The nature of such diagnosis is changeable because it is the
beginning phase of social work practice.
(2) Clinical Diagnosis
Under clinical diagnosis, the case worker attempts to classify the client by the nature of his
sickness/problem. He identifies certain forms and qualities of client's personality, maladaptation and
malfunctioning in his behaviour. The clinical diagnosis describes both the nature of the problem and
its relation to the client and the helping means and goals. Such type of diagnosis is useful only when
it becomes apparent that a disorder of personality accompanies the social disorder, creating and
complicating it.
(3) Etiological Diagnosis
Etiological diagnosis is concerned with the explanation of the beginnings and life-history of
problem of the client, basically that problem that lies in the client's personality make up or
functioning. The history of his development as a problem encountering, problem-solving human
being may provide the case worker with an understanding of what his client suffers from and what
the extent of his coping ability is likely to be.31 Etiological diagnosis is more useful in explaining or
rigid reactions. When inspite of the fact that the client's present problems are in the centre of
attention, the clients responses are not in accordance with, the past history and its appraisal in the
light of client's current capacities, goals and problems are used for the treatment. This type of
diagnosis contributes to understanding the nature of the problem to be dealt with, the person who
has the problem, and the ways and means that can be anticipated as helpful.
Data for Diagnosis
The data for diagnosis can be collected by at least three primary means:
(1) Interviews
Interview guides are used for collecting information. There are number of standard guides
prepared by psychologist but most recent guide is of Goldfried and Davison 32 having the categories of
information: client's behaviour during the interview and physical description, presenting problem (s)
(nature of problems, historical setting, events, current situation determinants, relevant organizmic
variables, dimensions of the problem, consequences of the problem): targets for modification,
recommended treatment (s), motivation of treatment, prognosis, priority for treatment, client
expectation, other information, comments, or observations.
(2) Checklists and Inventories
The following inventories may be used: Survey Schedule Questionnaire on client's perception of
himself, family functioning, marital functioning, sexual functioning and instruments for assessing
environments.
(3) Direct Observation
Observation in those situation in which the behaviour actually occurs, e.g., home or place of
work makes the work of diagnosing very easy.
Steps in Diagnosis
The following steps are taken while diagnosing a problem:
(1) The worker begins to focus on problematic behaviours. He begins with the survey of both
functional and dysfunctional behaviours in his environment. He classifies various complaints
and problems in terms of excesses and deficits. He evaluates client's personal strength as well as
of his environment.
(2) He specifies the target behaviours. This involves an attempt at breaking down complex
behaviours into their component parts, being as clear and precise as possible about them.
(3) Baseline data are collected to specify those events that appear to be currently controlling the
problematic behaviours.
(4) The collected information is summarized in an attempt to anticipate any major problems in
treatment and as a way of beginning to establish objectives for treatment.
(5) Selecting priorities for treatment is the final step of the diagnosis.
(6) Concentration on one problem at one time makes treatment process more manageable and
allows both client and worker to channel their energies into one area. It is the best of handling
and proper use of available resources.
Third Phase
3. Social Treatment
Social case work consists of those processes which develop personality through adjustments
consciously affected between men and their social environment32. Generally, two types of efforts are
required for social adjustment-environmental modification/and/or change in behaviour and
attitudes. Early case work treatment was placed on modification through the environment. Later on
the development of ego psychology helped social case workers to use intensive and direct treatment
techniques. Now the aim of social case work treatment is to restore the individual to social
functioning or to help him develop this capacity in order that he may achieve at one and at the same
time his own and society's betterment.33
According to Hamilton, treatment is the sum total of all activities and services directed towards
helping an individual with a problem. The focus is the relieving of the immediate problem and, if
feasible, modify any basic difficulties which precipitated it36.
The objectives of social case work treatment are as follows:
(1) To prevent social breakdown;
(2) to conserve client's strength;
(3) to restore social functioning;
(4) to provide happy experiences to the client;
(5) to create opportunities for growth and development;
(6) to compensate psychological damage;
(7) to increase capacity for self-direction;
(8) to increase his social contribution.
Thus, the objective of social case work treatment is to alleviate the client's distress and decrease
the mal-functioning in the person-situation system. It is to enhance the client's comfort, satisfaction,
and self- realization. This may require enhancing the adaptive skills of his ego and the functioning of
the person-situation system.37
V. Social Case Work Treatment Process
Social case work treatment process begins with the initial contact with the client. The process of
treatment passes through many phases, i.e. (i) Initial phase, (ii) Motivation and role induction, (iii)
Primary contract, (iv) Diagnosis and assessment, (v) Establishing treatment goals, (vi) Developing
treatment plan, (vii) Preparation for actual treatment, (viii) treatment in practice (ix) Monitoring and
evaluating the effects of treatment, and (x) Planning of follow up termination of the therapeutic
relationship.
(I) Initial Phase
The main task of social case worker in the initial phase is to examine how the problem was
brought to his attention. He would attempt to focus on aspects of the problem that seem fit to case
work treatment. Here the decisions of the worker are tentative. The initial phase of social case work
treatment will be thought completed when the case worker meets the following conditions.
1. The issues have been sufficiently identified so as to substantiate that they are appropriate to the
purposes and goals of the service.
2. The participants understand the nature and meaning of the problem with enough explicitness to
permit engagement and participation.
3. The problem is appropriate to the programme, resources and services of the setting.
4. The problem fits the practitioner's skill and capabilities.
 The social case worker develops a preliminary understanding of the problem and the client. He
also provides psychological support and help to the client and engages him in a therapeutic
relationship. It is quite possible that through this initial process of treatment, client may learn that he
really does not need further help as the problem has been sufficiently clarified and explained. It is
also possible that the agency may not have concrete service to the client and the case worker may
become bound to refer the case to the particular agency. If the case is to be continued with the case
worker, he takes a decision whether to move system-oriented treatment or towards person centred
treatment.
(II) Motivation and Role Induction
One of the most important tasks of social case worker at the beginning of the treatment process
is to build and develop the therapeutic relationship between himself and the client. Worker's
empathy, warmth and genuineness feelings are highly motivating forces for the client to take part in
the therapeutic process. The objective of this phase is to minimizing premature terminations and
enhance motivation to continue the treatment. At this phase the worker finds the resistances of the
client and its genuineness. He explores client's perception of why he is involved in the treatment and
how he feels about being in the agency. He also encourages client to specify his expectations of
clarifying the roles and responsibilities of both himself and the client. He also clarifies the type of
services agency can offer and tells the boundaries to those services. These activities and role of the
social case worker help to engage the client in therapeutic planning.
(III) Primary Contract
The objective of this phase is to develop a preliminary contract with the client. This contract may
be oral or in writing. The case worker, thus making psychological contract (relationship), sets the
stage to move towards more formal assessment.
(IV) Diagnosis and Assessment
Diagnosis and assessment process is ongoing throughout the entire treatment. The social case
worker provides detailed information about the problem situation that will help in establishing the
treatment goal, a strategy of treatment and selection of specific procedures of treatment. The case
worker assesses the client's ego strength, skillness, capabilities and capacities in relation to his
problem. He classifies the excesses and deficits in his behaviour and selects the specific treatment
procedures to be used to overcome the problem. He assesses whether the client needs advice, counsel,
behaviour modification, crisis intervention or consultancy services like teaching, consultation,
interpretation, supervision or provision of adult services i.e. material help; resource location and
referral.
(V) Establishing Treatment Goals
The social case worker, after diagnosis and assessment of the problems of the client, establishes
goals for the solution of the problem. He selects any one or more goals out of the following: (i)
prevention of break down, (ii) ego strengthening, (iii) restoration of social functioning, (iv) creation of
opportunities for growth and development, (v) self direction experience, (vi) social participation
experience, (vii) change in the environment. The social case worker along with this work, points out
the negative and positive results that may come due to change in the behavioural patterns of the
client or due to environmental manipulation. Though the client has the major say in deciding on
goals, the case worker plays an important role by clarifying, a variety of alternative goals for his
consideration.
(VI) Developing Treatment Plan
Treatment plan involves three major dimensions: formulating of strategy, selection of specific
treatment procedures and developing a method for evaluating the impact of the treatment
programme. The social case worker decides whether the primary thrust of the invention or treatment
will be system centred, person-centred or both. He, then, makes a judgement as to which of the key
roles of the case worker is most suited to the particular problem. The entire process of formulating a
treatment strategy may be depicted like this.38
Assessment and Establishment of Goals
 Formulate intervention Strategy

System centred Person centered

Direct Environment

Increase behaviours Decrease behavours Change cognitive Patterns

Cognitive Problem solving Self-Control

Restructuring and Decision Making
(VII) Preparation for Actual Treatment
Preparation for actual treatment phase involves several specific steps such as collecting all
possible information, formation of action system, preparation of mediator (s) if needed, change of
significant elements in the client's environment to increase the probability of getting desired result,
make attempt to make the new behaviour acceptable to the client and to provide high level of close
relationship with the client.
(VIII) Application of Treatment Methods
In order to achieve the goals set by the case worker, conventionally the following methods of
social treatment have been mentioned:
1. Administration of Practical Services
2. Indirect Treatment (Environmental Manipulation)
3. Direct treatment
1. Administration of Practical Services
The client is helped to choose and use the social resources afforded by the community. Porter
Lee39 was the first social worker who emphasized and classified such resources into executive and
leadership Administration of practical services means to help the client in such a way that he could
select and use the resources available in the community. The social case worker helps the client with
adequate knowledge of available resources through the techniques of discussion, information,
clarification and direction. The use of services is essential to solve any kind of problem and if the
problem is of social nature, then it becomes more essential for the worker to help the client in this
direction. These services take the form of treatment as they satisfy his needs and give satisfaction. The
client knows what type of services he needs but he does not know how to reach to these services. It is
the job of the case worker to take the client to the resources. Money, medical care, nursery schools,
scholarships, foster/homes, legal aid, recreational facilities, etc. are such type of services that any
person may need in order to resolve a given problem in his daily living.
2. Indirect Treatment (Environmental Manipulation)
Environmental manipulation means to bring change in the social conditions of the client so that
he may be relieved from excessive stresses and strains. The case worker suggests as to what steps
may or may not help the client to cope better, with his problems. He plans with him as to his
emotional, professional and recreational activities. He gives appropriate advice to members of his
environment and modifies their attitude favourably. Though interview is used in this method but the
main emphasis is given to change in his conditions. When social resources and systematized social
conditions are used as main sources for the solution of the problem, it becomes social treatment.
Home services camps, Group experience activities, training and employment for livelihood and other
activities of adjustmental nature are such types of programmes. The purpose of such activities is
always to minimize the load of tension in the client.
The social case worker organizes such types of activities through which the client's experiences
help him in his personality growth and adjustment in the society. Though practical services are also
made available but the focus is always on change in conditions. Attempts are also made to change
and modify the attitude of parents, teachers, spouse, employer, friends and relatives in accordance
with the needs of the client.
 In general, environmental modification (manipulation) is under taken by the case worker only
when environmental pressures upon the client are beyond the latter's control but can be modified by
the case worker.40
3. Direct Treatment
Perlman sees direct treatment as the provision of a systematic but flexible way in which the
client can work over his problem, his relation to it and possible solutions. Here the case worker exerts
his influence directly on the client. Direct treatment techniques are used where the client needs
direction because of his ignorance, anxiety and weaknesses of his ego strengths. The degree of
influence that the case worker is able to exert may depend on the relationship between himself and
the client.
Modes of Direct Treatment
Direct treatment is given through counselling, therapeutic interviewing, clarification and
interpretation leading to insight. Supportive treatment for the direct benefit of the client is provided
through guidance, externalization of interests re-assurance, suggestion, persuation and advice.
(1) Counselling
Counselling is a personal help directed towards the solution of a problem which a person finds
that he cannot solve himself and on which he, therefore, seeks the help of a skilled person, whose
knowledge, experience and general orientation can be brought into play in an attempt to solve the
problem. It is a psychological help in which information and clarification is used for making the client
aware about the problem. It is always used for some particular purpose like marriage counselling,
occupational counselling, family counselling, school counselling, etc.
(2) Therapeutic Interviewing
Therapeutic interviewing is used where intra-psychic conflict is projected to the environment or
neuroses or behaviour disorders are acted out. The purpose of such interviewing is that of purpose of
psychotherapy which aims towards personality growth in the direction of maturing, competence and
self-actualization. For the analysis of the unconscious, the social case worker applies the techniques of
free association, dream interpretation, analysis of resistances and transference. For behaviour
modification, the social case worker makes use of the techniques of positive enforcement, negative
enforcement, positive punishment, negative punishment, systematic desensitization and covert
desensitization.
Sometimes faulty communication and faulty interaction play basic role in developing
maladaptive behaviour. For the improvement of interpersonal relations and correct the
communication, the social case worker practices marital and family therapy techniques and
Transactional Analysis.
(3) Clarification
It is also a kind of counselling through which clarification of the client himself, his environment
and the public with whom he is associated, is made. The social case worker gives such understanding
to the client so that he becomes capable of understanding himself, his environment and his social
network. The clarification may consist of giving the client information about the environment or
people in the environment, which he does not possess and without which he cannot see clearly what
steps he ought to take.41
(4) Interpretation and Insight
Sometimes conflicting feelings and strong emotions lead the individual to distort reality so
seriously or react to it so inappropriately that understanding is impossible without a deeper
perception. The social case worker interprets the factors of the problem, related facts, attitudes of
client and unconscious feelings in relation to the reality situation. He helps the client to an awareness
of his strong projection of his inner needs and his subjective responses upon the outer world. Insight
development is always accompanied by some degree of clarification and psychological support.
(5) Psychological Support
Psychological support is useful in decreasing tension and guilt, increasing self confidence,
encouraging healthy functioning or a way of functioning that maintains the client's equilibrium and
in helping him to build up compensatory strengths and satisfactions. 33 The following help is provided
to the client. He is encouraged to express his feelings. The case worker accepts him and his feelings
and shows keen interest in him. He clarifies the problem and encourages to take his own decision.
The social case worker, through psychological support, does not develop understanding in the client
but applies reinforcement for his ego strength through the techniques of guidance, reassurance,
suggestion, precaution and advice.
(IX) Monitoring and Evaluation
Monitoring provides the crucial feedback to the case worker and the client regarding whether
established goals have been achieved, whether modifications in the programme are necessary and
whether the client is being helped in the real sense. The social case worker evaluates the content of the
programme and its effectiveness and inner strength gained by the client and success of himself in
helping the client.
(x) Planning Follow Up and the Termination of Therapeutic Relationship
It is neither wise nor necessary for the termination to be an abrupt one. The frequency and
amount of contacts should be gradually decreased. Particularly, the follow-up should be planned on a
progressively diminishing basis, first, perhaps after two weeks, then a month, then three months, six
months and a year following the termination of the formal programme.