Engagement

1. Engagement Chapter 5

2. LEARNING OBJECTIVES • Understand the meaning of engagement • Understand the difference between conversation and building a professional relationship • Develop skills in listening and for identification of problems, needs, emotions, reactions, and strengths and resources and goals as expressed by client systems • Acquire awareness of how the professional relationship is progressing 5. Understand how engagement may take place at micro, mezzo, and macro levels of practice

3. Engagement Time and processes used in establishing a professional relationship with a client or action system that is directed toward goal-oriented change

4. Engagement Phases Establish Professional relationship boundaries Identify problems, needs, strengths Recognize feelings and reactions Increase client investment Determine goals Make initial plans Monitor engagement phase

5. The Relationship Boundary

6. According to the NASW Code of Ethics… …Social workers--not their clients, their clients' relatives, or other individuals with whom the client maintains a personal relationship--assume the full burden for setting clear, appropriate, and culturally sensitive boundaries.

7. Boundaries… • Our sense of how we are different from others • Exist for our protection • Ensure appropriate behavior and keep us from offending others • Enable us to get close to others without becoming overwhelmed

8. As a social worker… You have your our own personal boundary issues as well as professional boundary concerns. You will see people who have no boundaries, rigid boundaries, partial boundaries, and healthy boundaries.

9. Boundary Sensor Personally assessing the following list of situations can help alert you to the kinds of boundary issues that might risk interfering with your ability to work most effectively—and ethically--with your clients. If your answer to any of these brief statements is “yes,” it is highly likely you are in jeopardy of abusing professional boundaries.

10. The client feels more like a friend than a client, or you want to be friends with the client when their therapy ends. You feel sexually aroused in response to a client. You would like to be lovers with the client when their therapy ends. You have sexual contact with a client. You often choose your clothing with a particular client in mind. The client’s sessions frequently run overtime. You reveal a lot about yourself with a particular client, perhaps telling stories or engaging in friend-like conversation. You share personal problems with a client. You allow a client to comfort you. YES or NO

11. Without discussing it with the client ahead of time, you attend a social event at which you knew the client would be present. You accept gifts or favors from a client without reviewing why the gift was given or why the client chose that particular time in their therapy. The client owes you a lot of money and you are unsure how to handle it. You find it difficult to refrain from talking about a particular client with people close to you. You accept valuable gifts from a client. You do so much on behalf of one particular client, you feel exhausted. You invite a client to a public or social event. You sometimes feel like punishing or controlling a particular client. Yes or No

12. What are Some Examples of Boundaries?

13. Clear Boundary Areas: • Planning social activities with clients • Having sex with clients • Having family members or friends as clients

14. A Client Should Not Be Your: • Lover • Relative • Employee or Employer • Instructor • Business Partner • Friend Strictly prohibited by the Social Work Code of Ethics

15. Areas Where Boundaries May Blur: • Self disclosure • Giving or receiving significant gifts • Dual or overlapping relationships • Becoming friends • Physical contact

16. What Are Some Other Areas Where Boundaries May Be Blurred?

17. Danger Zones • Over-identification with client’s issues • Strong attraction to client’s personality • Strong physical attraction to client • Clients who can potentially reward you with their influence • Transference and counter transference

18. Something to think about… People new to the helping field try to cross boundaries in a safe manner. People who have more experience set firmer boundaries because they know there is no safe way to cross boundaries.

19. On the NASW Top Ten Ethical Violations List

20. 1997

21. 2003 Study: New York Social Workers Many reported engaging in nonsexual multiple role relationships Many confused regarding what constitutes an ethical violation when it comes to multiple role relationships

22. Keep professional boundaries between you and your client and/or systems by… • Apprising clients of rights • Serving clients with professional skill, loyalty and determination • Not practicing, condoning or collaborating with any form of discrimination towards clients • Seeking advice and consultation from colleagues and supervisors when in the best interest of clients • Withdrawing services promptly and make service referrals appropriately and cautiously only under unusual circumstances, giving careful consideration and minimizing possible adverse effects to me

23. Keep professional boundaries between you and your client and/or systems by… • Terminating service to clients when such services and relationship are no longer required or no longer serve my needs. Making referrals • Not exploiting clients for your personal advantage; i.e. don’t use my valuable time to share my own frustrations, grief or loss • Not engaging in sexual activity with clients • Avoiding relationships that conflict with the interests of clients, i.e. don’t ask me to take care of your pet while on vacation

24. Identifying Problems, Needs, and Strengths

25. UP TO HERE FOR THURS. OCT. 11/07

26. What are some of the most common problems/issues people seek mental health services?

27. Common problems/issues for which people seek mental health services • Significant or chronic emotional and/or physical pain • Relationship problems • Skill acquisition • Recent Loss • Victim of trauma or abuse • A clinical disorder or condition • Personal Growth • Major Life transitions (i.e. new job, marriage) • Gender Identity

28. How do you get at the heart of the issues or problems for which services are being requested or sought?

29. Know how problems are operationally defined and what they entail Problems arise out of disequilibrium between persons in their environments. Problems relate to and include: • Needs • Issues • Concerns, desires, feelings • Contextual environmental factors • Risk factors • Protective factors, resiliencies • Resources • Assets

30. Good morning, Mrs. B. I am Mary Costello, the school social worker. I would like to talk to you about your son Johnnie and how he’s doing at school. Good morning. I am Mary Costello, the school social worker. I understand you wanted to talk with me. Yes, I’m Johnnie’s mother. His teacher said that maybe I could talk to you about the problems I’ve been having at home with my son lately. Identifying Problems Concern in Service Concern in Client

31. Getting to the Problem Generalist Social Worker listens to the client system: • Present the breath and depth of the problem • Express verbal and nonverbal reactions and feelings about the problem • Discuss what has been tried and with what success to resolve this problem • Consider hopes and wishes for solving the problem

32. KEEP IN MIND How the client THINKS about a problem significantly influences what the client DOES about the problem

33. The engagement process should answer these basic questions. • For what problems is the client seeking or being referred help? • How have these problems affected the client’s life? • What is maintaining these problems? • What does the client hope to gain?

34. In Practice…Identifying Feelings and Reactions Is a process that requires: 1. Purposeful expression of feeling 2. Controlled emotional involvement

35. Purposeful Expression of Feelings • Recognition of clients need to express feelings freely • Purposeful listening without discouraging or condemning expressed feeling • Where beneficial – stimulate and encourage free expression of feelings.

36. Here is a listing of words A-L that describe feelings. This list may help you build your feeling vocabulary.

37. Here is a listing of words M-Z that describe feelings. This list may help you build your feeling vocabulary.

38. Controlled Emotional Environment

39. Controlled Emotional Involvement • There are three components to a controlled emotional response to a client's situation: • Sensitivity to expressed or unexpressed feelings • Understanding based on knowledge of human behavior • Response guided by knowledge and purpose. • Careful: • Not to respond in a way that conveys coldness or lack of interest • Not to over identify with the client.

40. Goal Recognition • What does the client system really want? • Goal is an end-point toward which all practice efforts are directed……. “an attainable wish” • Examples: • Learn a skill • Make a decision • Increase competence • Resolve conflictual relationship • Secure and use resources

41. Objectives for Goals • What specific objectives need to be completed in order to meet the identified goal? • What specific tasks and activities need to take place to meet the objectives? • Who will carry out which tasks and activities? • What time frame will be used for carrying out the tasks and activities? • What benchmarks or criteria shall be used to know that objectives of tasks and activities have been met?

42. Example of Goal and Objectives Goal: To improve parent – child relationship Objective 1: Mother and child will spend more time together Task 1: After coming home from school, two-times a week, mother will spend about 1-2 hours with child listening and talking about child’s day Task 2: Every two weeks, mother will take child out for a fun activity of child’s choosing Objective 2: Mother and father will clarify their roles and responsibilities for caring for their child Task 1: Within next two weeks, mother will approach father to set time for discussion Task 2: Within next month, mother and father identify time and activities they wish to do with child

43. Decision Making Process Setting the tone of the working relationship • Start with the client system’s problem presentation • Begin defining this problem in person-in-environment context • Identify client system’s needs in this problem • Uncovers client system’s strengths and assets • Prioritize problems based on client system’s preference • Select the problem that has the most chance of success • Identify client system’s goals and objectives in problem prioritization • Assist the client system in considering consequences of resolving the problem and/or selecting particular goals • Establish initial agreement for working relationship

44. Assessment Worksheet

45. Case Planning Worksheet