INTRODUCTION TO SOCIAL WORK The Book Reading and the Assessments & the Client Treatment Plan Paperwork for Completion in these Assignments is also Attached

INTRODUCTION TO SOCIAL WORK The Book Reading and the Assessments & the Client Treatment Plan Paperwork for Completion in these Assignments is also Attached

Lesson 7 Discussion

Josephine is a 45-year-old, female who has been admitted to the hospital after her husband found her passed out in bed with an open medication bottle next to her. You receive a referral to meet with this patient for an assessment. You are advised that she been depressed for some time and has limited social supports.

Using the above vignette, please create a substantial discussion post considering the following question(s) in your post.

1) What type of assessment questions would you consider asking this client?

2) Are there any risk factors you would want to consider assessing?

Lesson 7 Assignment

For this assignment, please use the vignette from this week’s discussion and complete the “Agency Assessment.”(FIND ATTACHED).  You can role play this assessment with a family member or friend as the client.

Lesson 8 Assignment

For this assignment, please use the vignette from the Lesson 7 discussion post and complete the “Client Treatment Plan.” (FIND ATTACHED). Please select 2-3 treatment goals for this client.

Objectives:
To learn about the treatment planning process and how to complete a client treatment plan.

RESOURCES

Readings and Videos

Introduction to Social Work Textbook Read Chapter 4

Please review Chapter 12: Models of Assessment by Janine Bolger and Patrick Walker

Lishman, J., Yuill, C., Brannan, J., & Gibson, A. (2014). Social work: an introduction. (1 st ed.). New York: Sage Publishing.

Reviewing Suicide Prevention Skills:

https://www.socialworktoday.com/news/enews_1016_1.shtml (Links to an external site.)

Suicide Prevention:

https://www.samhsa.gov/find-help/suicide-prevention (Links to an external site.)

Suicide Prevention is Every Social Worker’s Business:

https://www.socialworktoday.com/archive/JF19p10.shtml

Assessing for Depression in a Mental Health Appointment:

Vignette 5 – Assessing for Depression in a Mental Health Appointment (Links to an external site.)-  https://www.youtube.com/watch?v=Gm3FLGxb2ZU

YMH Boston. (2013 May 22). Assessing for depression in a mental health appointment. . YouTube: Vignette 5 – Assessing for Depression in a Mental Health Appointment. 12
Models of
Assessment
Janine Bolger and Patrick Walker

Key Themes
●● Assessment is a core activity of social work practices, which should be a process

capable of responding to dynamic factors in the lives of service users.
●● Assessment is underpinned by a series of principles that serve to guide and

direct practice.
●● The legal and policy context of assessment is essential to understand as this

sets a mandate for appropriate social work practice.
●● Models and frameworks for assessment provide guides for practitioners and are

underpinned by the skills and knowledge to inform the ‘what’, ‘how’ and ‘why’ of
assessment.

●● Assessment is founded on partnership with service users, but may be undertaken
in both voluntary and involuntary contexts.

INTRODUCTION

The concept of assessment is generally associated with notions of appraisal, making
judgements, forming opinions or calculating the value of something. Whilst these
provide a helpful starting point, they require much further examination when applied
to a social work context, where assessment is a discrete, core activity and a key skill.
This chapter will introduce you to elements of social work assessment, incorporating
principles, context, models, frameworks, skills and practice issues. It will draw reference
from across the range of service user groups and invites you to reflect on and critically
explore the material.

To begin to understand the meaning of assessment in social work, consider your
understanding of assessment in your day-to-day life. Everyone makes numerous
assessments every day in order to navigate their way through the daily interactions
and situations that they face. In making these day-to-day assessments you will use a
wide variety of perspectives that give meaning to the information that is presented,
or help sift the information that is presented or found. Perhaps personal experience

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Assessment170

helps you, or perhaps your own cultural beliefs offer a way of interpreting situations or
environments. Some of these factors will have relevance to assessment in social work
and highlight the importance of being self-aware.

DEFINING ASSESSMENT IN SOCIAL WORK

Despite the large body of literature regarding assessment in social work, it remains a
much debated area, not least because of the variety of approaches, perspectives and
frameworks that are available. There is certainly agreement that assessment is a core
activity but less consensus on what actually constitutes a good assessment and whether
assessment is separate or integral to intervention. Coulshed and Orme (2012) describe
assessment as an ongoing process, which is participatory, seeks to understand the service
user and his/her situation and sets a basis for planning how change or improvement can
be achieved.

In a similar vein, Payne (2008) identifies assessment as something that is continuous
and ought to be part of a cycle. In this respect assessment is seen as a process rather than
an event; although Payne highlights that practice reality often does not reflect this.
Emphasising the process aspects, Milner and O’Byrne (2009) put forward a framework
for assessment with five key stages:

1 Preparing for the task.
2 Collecting data from all involved.
3 Applying professional knowledge to analyse, understand and interpret the informa-

tion gathered.
4 Making judgements.
5 Deciding and/or recommending.

For our purposes we would propose to define assessment in social work as a structured
activity with the characteristics shown in Figure 12.1.

PRINCIPLES OF ASSESSMENT

The purpose of this section is to offer some principles, or core common features, of
assessment. The discussion here cannot be prescriptive, but rather is indicative, for
reasons that will become apparent. Assessments are frequently context-specific and
consequently are shaped by the inclusion of particular elements and influenced by the
manner in which the assessment is undertaken.

Case Study
Consider the following three different types of assessment that may take place
under the auspices of services for children and young people:

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Models of Assessment 171

1 An assessment in a family centre may focus on elements of parenting capacity,
or parent–child interaction.

2 A comprehensive assessment for a Children’s Hearing (in Scotland) may require
capturing a much wider picture of the child in the context of his/her family,
school/community and social setting.

3 An assessment in a Youth Justice team may employ a standardised, structured
assessment focusing on specialised areas related to offending.

As a consequence, we need to be very clear about our role, remit and the context of any
assessment.

Guiding principles help clarify and direct practice in all areas of assessment. They
may be drawn from ethical frameworks, theoretical perspectives, legal obligations and
practice guidance and are important because, although various frameworks can be

Assessment

Purposeful
and appropriate

Dynamic and
responsive

Based on
engagement
and inclusion

Ethical and
skilled

Grounded in the
legal and policy

context
Empowering

and outcomes
focused

Highlights
protection and
safe-guarding

Holistic and
comprehensive

Involves
judgement to

support
decision-making

Leads to
planning and
future action

Figure 12.1 Structure of assessment in social work

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Assessment172

used in assessment, it should be remembered that, as Statham and Kearney point out,
‘social work can never be a purely technical activity based simply on assessment formats,
models or methods’ (2007: 102, emphasis added). This suggests that some underpinning
and orientating principles are required when beginning and undertaking the assessment
process. Five key principles are presented here.

Principle 1: Understanding Need
Daniel (2007: 116) states clearly that need ‘can offer a guiding principle for the social
worker’; it orientates the practitioner towards exploring and understanding the service
user’s situation. In some cases, need will be immediate, for example in situations of child
or adult protection. In other cases, need may emerge over a longer period and relate to
support and quality of life, for example befriending to address social isolation.

Horder (2002: 117) notes that ‘good assessment in social work has always been needs-
led’, although he alerts the reader to the fact that need can be understood differently
by people and can become a ‘contested’ concept. Horder goes on to suggest that need is
’in most cases defined by others rather than as perceived by the person being assessed’.
This is the practitioner’s dilemma: how to understand, take into account and respond to
the service user’s view of their needs, whilst also acting within employers’ requirements,
using professional theories and with normative concepts of need in mind.

Spicker (2012) offers the following:

The idea of need refers to:

●● the kinds of problem which people experience;
●● requirements for some particular kind of response; and
●● a relationship between problems and the responses available. A need is a claim for

service …

and points the reader towards Bradshaw’s (1972) taxonomy of need, summarized as:

●● Normative need, which is identified according to a norm (or set standard); such
norms are generally set by experts. Benefit levels, for example, or standards of unfit-
ness in houses, have to be determined according to some criterion.

●● Comparative need concerns problems that emerge by comparison with others who
are not in need. One of the most common uses of this approach has been the com-
parison of social problems in different areas in order to determine which areas are
most deprived.

●● Felt need, which is based on the perspective of the people who have it.
●● Expressed need, which is need people say they have. People can feel need that they

do not express and they can express needs they do not feel.

Need, as a principle, can determine what the social worker may require to explore in
assessment. If children need, for example, a secure relationship with their parent or
caregiver, to grow and develop, then the absence of it becomes a risk to them. Similarly,

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Models of Assessment 173

if an adult with mental health problems needs support and counselling to manage
auditory hallucinations, then an absence of such support may significantly impact on
the person’s health and well-being. By understanding need and drawing on broader
knowledge and theory, the practitioner is able to consider the person’s situation and to
explore approaches to relieving the unmet need.

Exercise
The word ‘need’ is used commonly by everyone, so the expression ‘needs-led’
should be fairly straightforward. However, think about when you and others use the
word and substitute the word ‘want’ in place of ‘need’. How often is ‘want’ a more
appropriate term, and how often is ‘need’ the correct description of the situation?

Principle 2: Working with Systems and Ecology
Like most people, users of social work services very rarely live in a vacuum. Most of
us are part of systems, networks and connected relationships that serve to shape and
influence our lives in complex and multifaceted ways.

Bronfenbrenner’s Ecological Systems Theory (cited in Daniel, 2007: 116) suggests
that individuals are situated ‘within layers of systems from immediate family up to wider
society’ and any assessment is required to take account of these layers of connections and
influences. Although this theory was developed in the context of child development,
the levels and systems identified are just as applicable in work with other service
user groups. The central aspect to draw on here is an understanding of how different
factors influence and are influenced by the individual. The ripple model proposes four
interconnected levels surrounding the individual:

●● Micro-system: the family, school, workplace etc.
●● Meso-system: the interaction of two different micro-systems
●● Exo-system: the community/external environment
●● Macro-system: the sociocultural context.

Bronfenbrenner later added a fifth level, the chrono-system, this being the dimension of
time relating to an individual’s life events and environment – for example the influence
of time in relation to reactions to the death of a parent, relocation, a relationship
breakdown and so on.

See the article by Hill (2002) on the Companion Website (www.sagepub.co.uk/
SocialWork) which reviews the social network approach to social work assessment.

Principle 3: Building on Strengths
If social workers are to work collaboratively with individuals and families the assessment
process must take account of capacities, strengths and protective factors. In doing so
social workers will take an assets-based approach which seeks to recognise resilience

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and capacity for change (Daniel et al., 2010). An assessment that explores strengths
can reveal an individual’s or family’s ability to resolve their difficulties using their own
skills and expertise without becoming disempowered through service involvement. The
very process of assessment can help individuals or families to identify and utilise latent
strengths and thus reduce dependency on professionals.

This principle is relevant when working with all service users and in all domains of social
work, whether the practice base is termed ‘Children and Families’, ‘Learning Disability
Services’, ‘Social Work with Older People’ and so on. Assessments that purely focus on
deficits are not only likely to be demoralising and incomplete, but also run the risk of
being oppressive, result in inappropriate labelling and potentially limit an individual’s (and
their network’s) abilities to resolve their difficulties themselves. Compensatory strengths
need to be explored, identified and added in to the equation whenever they are present.

Principle 4: Being Person-centred
We have outlined above the principle of systems and ecology and believe that such a
perspective is important. Whilst there is a requirement to keep this ecological perspective,
it must be emphasised that no assessment should lose sight of the fundamental needs
of the child or adult at the centre. Taking a person-centred or child-centred approach
sharpens the focus of social work practitioners to their primary concern. It can be, in
practice, all too easy to become side-tracked into the needs of others. It is a reality
that social workers are often engaged in working in complex situations where the
voices of these ‘others’ are stronger and more articulate. A person-centred approach to
assessment should involve direct interaction with the adult or child and be informed by
the theoretical and knowledge base underpinning practice.

Exercise
Consider your own situation now. What are the positives and negatives in your own
situation? How do you interact with your family and how does your family interact
with neighbours, friends, work and the wider community? How much of this is relevant
to your current situation?

Principle 5: Taking an Interprofessional Approach
An interprofessional approach to assessment highlights the importance of recognising
that different professionals have particular areas of expertise. No one professional can
have the whole picture that makes up the lived existence of an individual. Given that
each profession will have unique insights and understandings, it is important to pull
these together and to make sense of them. The value of interprofessional practice is
brought into sharp relief through the following quotation from Bronstein (2004, cited
in McLean, 2007: 339). In it she describes interdisciplinary collaboration as:

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Models of Assessment 175

an effective interpersonal process that facilitates the achievement of goals that can-
not be reached when independent professions act on their own …

Interprofessional assessment therefore brings together professional perspectives, and,
when these are collated and acted on, offers potential for a more comprehensive,
coherent and relevant approach to assessed need across multiple, but connected, areas
of people’s lives.

Of course, when we speak about taking an interprofessional approach (see Chapter
14) there is a tendency to focus on the contribution of professionals, but this is not the
whole story. By no means should service users and their families be excluded from such
an approach – they are experts on themselves.

THE LEGAL AND POLICY CONTEXT OF ASSESSMENT

Across the four jurisdictions of the United Kingdom there is a raft of legislation and
policy concerned with social work and social care. Much of this legislation and policy
impacts directly on the assessment process, and consequently it is essential to acquire this
knowledge and learn to use it effectively. We shall address some of the broader points that
you need to be aware of, but for more detail you should also refer to Chapters 2 and 3.

One of the characteristics of assessment we identified earlier was that it should be
grounded in the legal and policy context. It is vital when undertaking assessment that
you are aware of what you can do, what you must do and what you may not be allowed
to do. In a legal context ‘powers’ are what you can do in specific circumstances; ‘duties’
are what you must do in specific circumstances; and ‘restrictions’ refer to any limitations
placed on the worker (Thompson, 2009). Whatever your field of practice, you need to
establish the legislative and policy framework within which your work takes place.

Given that the law generally regulates the activities of social work practitioners and
the organisations those practitioners work for, it is essential to recognise that the law
also holds those practitioners and organisations to account for the work undertaken.
This may seem on the one hand intimidating, but it is the natural companion of having
legislation and policy that gives you a mandate for practice, particularly in the context
of social work in statutory settings.

The third general point is that legislation and policy can act as a powerful tool in
empowering service users and promoting their rights. Often you will work with service
users who have a limited understanding of their rights and are not fully aware of the
options that are available to them. By understanding the law and what can and should
be done, you can assist service users to improve the quality of their lives, achieve their
outcomes and protect their interests ( Johns, 2011).

Lastly, it is important to be aware that whilst the law may appear prescriptive it is
applied in the context of individual lives, with all the complexity that brings. In this
sense, social workers still need to be able to make judgements and ‘negotiate tensions
between legal principles and processes and the values and approaches that underpin
social work practice …’ (Gordon and Davis, 2011: 1).

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MODELS AND FRAMEWORKS OF ASSESSMENT

The increased emphasis on assessment in social work, particularly of risk, has created
more theories about the purpose, process and practice of assessment. Increased focus on
recording has resulted in the production of a number of proformas, many of which are
used by a range of professionals, including those in health, social work and education.
These standardised formats are supported with social work values and theories and so
can be viewed as value-based. The information gathered is from the worker’s perspective
and, therefore, the outcome of the assessment can be influenced by the attitudes and
values of the assessor. The social worker has a responsibility to the service user to be
both reflective (consciously looking backwards) and reflexive (using innate skills in the
moment) on their practice.

Agreement is required between ‘what to do’, ‘how’ it can be done and ‘why’ it needs to
be done. Above all the purpose of assessment must be clear (Doel and Shardlow, 2005).
Assessment frameworks do not ensure effective practice in their own right as they only
provide us with a framework to assist what is a complex activity. The process of assessment
must be underpinned by knowledge around ‘current policy trends, professional codes of
practice, the attitudes of the workers, their managers, the organisations involved … and
should be supported by good assessment skills’ (Statham and Kearney, 2007: 102).

The purpose of carrying out an assessment is usually to identify levels of need or
risk or to form an understanding when making first contact with the service user.
Depending on the kind of information we need to gather, Smale et al. (1993) offer
us three models – the Procedural, the Questioning and the Exchange – to guide us in
carrying out assessments.

●● The Procedural model, often associated with guidance related to legislation, involves
using systems that are devised to ensure consistency and thoroughness in data col-
lection. Consequently, eligibility for and allocation of services is often decided upon
as a result of the collection of such data. This can provide only a snapshot assessment,
directing the assessment away from examining the individual’s strengths and abili-
ties, and can divert from individual rights or concerns over quality of life (Milner and
O’Byrne, 2009). The concern is that such systems can replace rather than support or
inform judgements made by professionals (Barry, 2007 cited in Milner and O’Byrne,
2009), and may be viewed as rigid, time-consuming (lots of forms) and one-way,
in that it meets the needs of the worker and agency rather than that of the service-
user. The difficulty arises when information is collected on an individual by different
professionals with a different focus (i.e., health, housing etc.) but stored separately.
This results in an inadequate understanding of the total experience of any individual
by any one professional. Workers can become caught up in the process of gathering
information rather than in trying to understand what the service user needs. On a
more positive note, this systematic manner of collecting large amounts of data has
also contributed to the evidence base for social work practice.

●● The Questioning model of assessment focuses on the nature of the questions and how
the information is used. Using this approach problems and solutions reside with the

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individual and the social worker’s task is to identify the problem and highlight the
most appropriate approach to resolve the issue. A criticism of this model is that it
can be seen as oppressive given that the social worker takes on the role of expert and
makes the final decision. However, if questions are asked in order to try to under-
stand what is impacting on the current situation, and if a range of perspectives are
sought, then this does not have to be the case.

●● When adopting the Exchange model the service user becomes the expert with regard
to their own needs and through their involvement in their own assessment becomes
empowered. It acknowledges that the worker’s expertise lies in their problem-solving
abilities. The aim, through development of trust, is to seek a compromise between
choices and needs through involvement of all parties. The worker takes on responsi-
bility for managing the process of assessment. The focus is on a holistic assessment
of the context in relation to the individual over time (Coulshed and Orme, 2012).

Specific frameworks have been outlined in the Case Study to demonstrate how models of
assessment can support particular frameworks or approaches to information gathering.

Case Study
1. The Common Assessment Framework (CAF) in England and Wales, the
UNOCINI Assessment Framework in Northern Ireland and the GIRFEC (Getting it Right
for Every Child) approach in Scotland focus on how practitioners across all services
for children and adults can work together to ensure that children and young people
have their needs met with reference to a range of outcomes and indicators that
can be applied in any setting and circumstance. The approach is underpinned by
a set of common values and principles. The success of such approaches depends
on a standardised assessment and the application of shared tools and models. All
approaches require a lead professional.
The five outcomes of CAF concern being healthy, staying safe, enjoying and

achieving, making a positive contribution and achieving economic well-being
(Children’s Workforce Development Council, 2009). It consists of a pre-assessment
checklist to decide who would benefit from an assessment (focusing on the
development of the child/young person, parents and carers, and family and
environment); a standard recording format; and a process to enable practitioners in
the children and young people’s workforce to undertake a common assessment and
to move forward on the result through the development of an action plan.
In sharing information with other professionals, recording information on a single

system, identifying needs and services, establishing a plan and reviewing both the
plan and provision, it would appear that a Procedural model is being employed.
2. The Single Shared Assessment (SSA) in Scotland, the Single Assessment Process

(SAP) for older people in England, the Unified Assessment in Wales and the
Northern Ireland Single Assessment Tool (NISAT) combine elements of both
Procedural and Questioning models. SSA is the ‘streamlining of the assessment
process to enable the needs and outcomes for the individual to be identified and
subsequent interventions and services put in place’ (Scottish Government, 2009b: 1).

(Continued)

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The sharing of information across agencies is crucial and so the process encourages
joint working.
In a SSA a ‘lead professional’ coordinates the gathering of information for the

assessment and ensures that a plan is made and reviewed and that the identified
services are delivered. Care Management is the name for this process, and it is
focused on the needs of individuals with complex or changing needs. Three different
types of assessment (Simple, Comprehensive or Specialist) can be carried out,
depending on the needs of the service user, and assessment is undertaken by
different professionals depending on their levels of training and expertise. The legal
context for Care Management is provided through the National Health Service and
Community Care Act 1990 and in Scotland is augmented by the Regulation of Care
(Scotland) Act 2001 and the Community Care and Health (Scotland) Act 2002. The
process of a SSA involves service users and carers and is intended to be person-
centred. However, for older people information is also gathered through an Indicator
of Relative Need questionnaire which consists of 12 multiple choice questions under
section headings: activities of daily living; personal care; food/drink preparation;
mental well-being and behaviour; and bowel management. The answers to each
question are scored and the totals for each section are calculated. The scores are
intended for planning purposes and not to determine eligibility for services.
3. Motivational interviewing (see Chapter 23), used in substance misuse counselling,

is both client-centred and semi-directive. The approach attempts to increase the
service user’s awareness of the consequences of their behaviour and to encourage
reflection on the benefits that might be achieved through change. The approach is
non-judgemental, non-adversarial and non-confrontational. The eight key interviewing
techniques: asking leading questions; reflecting resistance; acknowledging the
advantages of behaviours; raising awareness of discrepancy between the present
and the desired situation; elaborating on self-motivational statements; offering non-
dogmatic information; voicing the service user’s doubts and summarising selectively
(Miller and Rollnick, 1991) fit well with the Exchange model of assessment.

Having chosen a specific model and framework for assessment the social worker must
also consider the knowledge that underpins assessment. The range of knowledge used
to support the assessment should include an awareness of developmental theories,
social systems theories, policies, organisational knowledge and knowledge of research.
The point is to bring together information and resources in order to personalise the
provision (Statham and Kearney, 2007).

THE ASSESSMENT RELATIONSHIP

The task of assessment should be underpinned by skills that convey ‘genuineness, warmth
and acceptance, encouragement and approval, empathy, responsiveness and sensitivity’
(Lishman, 2009: 76). Cowager (1994) suggests that the strengths that the service user
brings are key to developing the helping relationship. Strength-based assessments may

(Continued)

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Models of Assessment 179

support the service user to draw on their own resources to examine alternative ways to
improve their situation and to build their confidence. As previously outlined, assessments
focusing on deficits may serve only to disempower the service user and reinforce
inequalities between them and the social worker. The social worker’s role is to develop
the service users’ capability to assist themselves. This is known as empowerment.

A good assessment relationship involves the social worker in:

●● examining the personal and environmental strengths of the service user and carrying
out a multidimensional assessment of such strengths

●● utilising meaningful and appropriate language
●● negotiating mutual agreement over the assessment
●● apportioning no blame. (Cowager, 1994)

In addition, we would add:

●● discovering the uniqueness of the service user by understanding an individual’s iden-
tity and life choices which are formed by their life experiences, culture and ethnicity
and the way in which others have responded towards them.

Any attempt to form a genuine partnership will involve good skills of listening and
interviewing and will focus on the individual rather than the procedure.

REFLECTION ON SELF IN ASSESSMENT

Social workers must be aware of how their own attitudes, values and power based on
their …

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