Chapter 16 Intervention Integrating Gains. Social Work Endings Types of endings –Completing...
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Transcript of Chapter 16 Intervention Integrating Gains. Social Work Endings Types of endings –Completing...
Chapter 16
Intervention
Integrating Gains
Social Work Endings
• Types of endings– Completing contracts– Client discontinues– Closing with referral
• Dynamics vary with size of client system
• Requires individually tailored processes to end in ways that benefit clients
© 2013 Pearson Education, Inc. All rights reserved.
© 2013 Pearson Education, Inc. All rights reserved.
Preparing for Resolution
• Anticipate the end even from the beginning
• Remind clients of the transitory nature of the practice relationship
• Provide convenient exit points
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Discussing Readiness
• Reviewing progress
• Signal - reaching goals
• Evaluate what worked and what didn’t
• Discuss transferable strategies
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Evaluating
• Evaluate what worked
• Clarify effective strategies
• Review information useful for future challenges
• Bring a sense of completion to the work
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Feelings about Endings
• Sharing Feelings– Feelings about closure; Endings can be
positive events; Celebrate successes
• Factors that influence feelings– Personal experiences with transitions – Sense of competence as professionals – Feelings toward clients
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Generalizing Outcomes
• Stabilize successes achieved
• Ensure access to – Social supports – Environmental resources
• Contract for closure
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Completing Contracts
• Firming Up Social Supports
• Celebrations and Ritualized Endings
• Looking to the Future
• Following Up
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Closing With Referral
• Reasons– Limited resources in current setting– Workers take new positions – Legal mandates
• Strategy: Recognize interim success
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Making Referrals
• Ensure clients remain in control even in transition processes
• Refer clients to specific persons rather than programs
• Collaborate with clients on how to transfer information
• Arrange for follow-up to track progress
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Clients' Discontinuation of Services
• Recognize clients’ privilege to discontinue
• Treat each session as if it could be the last
• Be alert for messages of pending departure
• Resolve unplanned exists
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When Clients Die
• Feeling loss of clients is genuine
• Dimensions of grief: denial, anger, bargaining, depression, and acceptance
• Influences on experience of grief – Age; Gender; Cultural background– Religious beliefs; Experiences with death;
Access to social support
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End-of-Life Care
• Support for “dying well”
• Advance care planning– Planning for end-of-life care– Patient Self-Determination Act – Advance directives
• Living wills• Durable powers of attorney for healthcare
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Grieving the Death of a Client
• Resources for resolving grief– Self-awareness – Collegial and personal support
• Clients’ death by accident or intention– Potential for feeling guilt
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Small Group Endings
• Closed-ended groups– Members resolve relationships with the
worker, with each other, & with the group itself
• Open-ended groups– Workers deal with collection of members at
various stages in their work in the group
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Resolving Intermember Relationships
• Structured endings– Workers plan final meetings with larger client
systems• Provide members with opportunities to share their
thoughts and feelings about the work completed• Consider the future
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Endings with Organizations and Communities
• Stabilize the functioning of the organization or community itself
• Consider implications of ending for relationships within the group
• Maintain the stability by targeting changes in policies and practices
© 2013 Pearson Education, Inc. All rights reserved.
Endings are Beginnings
• Effective endings are beginnings – Stabilize the progress – Integrate the skills learned
• Benefits for workers and clients– Clients: empowerment to continue to function
competently– Workers: practice wisdom for future work
© 2013 Pearson Education, Inc. All rights reserved.