Assessment and Intervention, Theories and Methods.
This essay will explain and evaluate the theoretical bases and influences of two methods of intervention, namely Systems Theory and Attachment Theory. It will show how both approaches might be implemented in work with a service user, drawing on the contrasts and comparisons in how they would be applied as an intervention. Using research, the effectiveness of both approaches will be evaluated as well as the potential for discrimination within two particular areas, those being gender and power.
The term Systems emerged from the early studies of social systems by the sociologists, Emile Durkheim and Max Weber, as well as Talcott Parsons. Drawing from the natural sciences, psychology, sociology and in particular biology, the Austrian philosopher and theoretical biologist, Ludwig Van Bertalanffy (1971) developed General systems theory/ Bertalanffy discovered ‘that the whole was greater than the sum of its parts and that using this theory we could observe patterns and the way relationships were organized in any living system’. (Walker, S, 2012. p2 ).
Bronfenbrenner's Ecological System Theory (1979) superseded Bertalanffy's general systems theory. Bronfenbrenner felt that ‘systems theory did not fully capture the complex dynamics that occur within social systems’ (Friedman, B, D, Neuman Allen, K, System theory). Bronfenbrenner began to focus on human biological systems within an ecological environment, i.e. the impact the environment has on an individual’s development.
From the mid-twentieth century, the main theoretical basis for social work focused more on the sociological rather than the psychological. Hollis (1964 ) encouraged social workers to recognize both the social and psychological aspects of intervention and the ways in which systems theory can be related to human beings.
Jane spent most of her childhood in care, as a result of sexual and emotional abuse from her family members and had several abusive relationships. Her current partner, Karl, has mental health issues that are exacerbated by the use of illegal drugs. Due to the growing concerns around Karl’s erratic behavior and his increasingly violent behavior towards Jane, the children are now subject to Child Protection Plans. Jane has a child from a previous marriage, Jordon, who was taken into care aged four after it was found that Jane’s then partner, Mick, was a ‘Person who Poses a Risk to Children’ (PPRC) and that Jane was unable to protect the children whilst in the relationship. Jane is currently 12 weeks pregnant. She does not believe that Karl is the father and disclosed that she had a one-night stand whilst out with friends. Karl is unaware of the pregnancy. Mabel, Jane’s mother, has recently been diagnosed with dementia. Jane and her mother have always had a fractious relationship and Jane believes that her Mother was complicit in the abuse she suffered as a child.
The use of a genogram (Hartman 1975) would provide, a snapshot of how that person or family is structured.’ and ‘an immediate visual representation of the individual or family being assessed’, in this case, Jane and her family. (Parker, J, Bradley, G, 2004. p40). Using an ecomap (Hartman 1975) would help to identify Jane’s current social context and dissect both the positive and negative factors in her relationships within the family.
Systems theory is used as an intervention and puts emphasis on the consequences of one person’s actions on another. An advantage of using this theory as an intervention is that ‘individuals are not seen as isolated, unconnected beings but social and affected by and influencing others around them, the organizations with which they have contact and, indeed, wider society” (Parker, J. Bradley, G,2004, p86). ‘Which is often explained as ‘person in the environment, (Teater, B, 2014. p16).
According to Coulshed and Orme, a substantial element of system theory intervention requires, ‘interviewing skills, assessment skills and counseling skills,’ and suggests that assessment helps to establish, ‘what needs to be done to maintain, improve or bring about change in the person, environment or both. (Coulshed and Orme, 2012. p22). The ecological theory identifies five environmental systems in which an individual interacts, meso, eco, macro, and Chrono systems and is akin to Thompsons’ PCF model (1997) of human development and fits with the framework for assessment.
Assessment is a continuing process that changes according to circumstances. It is used as a tool to gather information and knowledge about Jane, her family, and the environment in which they live. Germain and Gitterman’s life model talks about establishing an ‘active relationship based on mutuality and reciprocity.’ (Healy, K 2005.p 138). One of the first stages is to build a positive, empathetic relationship based on respect, trust, and honesty. Effective communication is an essential part of both the assessment and intervention process. Smith (2010) discusses the unequal dynamics of power between the social worker and the service user and suggests that in terms of practice, developing credibility and congruence will support the professional in gaining relational power.
When applying system theory, it can be difficult to know where to intervene due to the multiple and complex needs of the family. It is difficult to address Jane’s individual needs when using system theory as all issues are all interrelated within a system, therefore it's essential to work with the family as a whole.
There is an immediate power relationship when both the social worker and service user initially meet. With this in mind, the social worker must ensure they are not using their professional power to become the expert in peoples’ lives but to empower Jane and other individuals within the family to become, ‘the authors of their own lives. (Coulshed, V, Orme, J, 2012. p226). ‘System theory uses a strength-based approach and focuses on supporting the family to identify the positives that exist within their systems. Once strengths are identified they can be developed into a set of ’SMART’ goals which can be used to empower the family to encourage change. Change and power are intertwined’ and ‘people have to experience themselves as having some power if they are to bring about changes. (Beckett, C, 2010. p131).
Another advantage is the unifying force that promotes partnership working with organizations and agencies. Referrals to specialist agencies will provide Jane with additional support to address specific issues. Power and status dynamics are an integral part of multi-agency working. Working within a multi-disciplinary setting, professionals will have to make judgments about the service user. However, professionals must remain ‘both congruent and non-judgemental in doing so.’ (Musson. P, 2017. p107). Ensuring that Jane and her family have equal opportunities to be involved in decisions regarding their lives is crucial to anti-oppressive practice.
The strength of systems theories is in its adaptability, and exchange of resources and energy from the different systems. The theory talks about all systems having boundaries within which energy is exchanged. General systems theory (1950) states that this interaction has two parts, closed systems, i.e. boundaries that do not interact with the outside world, and open systems, those where the boundary is permeable. All families have roles and in a healthy family, these roles are flexible. Each role is a way for each individual to feel like they have some control and power. When change occurs, boundaries become blurred and families often find interaction and communication difficult as each individual struggles with their own issues. Dysfunctional family systems leave the individual, i.e. Jane questioning what role they have/had in the family.
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Social work has always had a focus on understanding the individual within their environment, and the impact of wider social factors on people’s lives ( Deacon, L, Macdonald, S, J, 2017. p82). Pincus and Minahan (1973) were amongst the first to apply systems theory to social work practice at a time when the theory was looking to provide social workers with a ‘ unitary model of practice, ‘one that could offer a holistic framework’ (Walker, S, 2012. p3). Its links to the family began to develop during the nineteen fifties and was an approach used to provide the understanding that ‘many human situations are more helpfully understood in terms of the interaction between individuals rather than in terms of individuals in isolation ( Beckett, C, 2006, p84).
Systems Theory is only a short-term intervention that avoids dependency. Families can return to healthier relationships and interactions known as, homeostasis, by changing the way in which they communicate and interact which each other. Whilst the theory used in social work practice ‘involves bringing about change through manipulating the systems, their relationships with individuals and others ’ (Musson, P, 2017. p60), one of its limitations is the concept of homeostasis. It only agrees with changes that stabilize the system and using this only allows for slow and steady change. Abrupt changes to the status quo can disrupt the macro systems which are reliant on particular parts of society remaining the same. This can prove to be oppressive when dealing with issues relating to inequality and diversity as, ‘such structural understandings see power, not as an entity to be possessed (and perhaps redistributed), but as an antagonistic social relation of power. Lipsky 1987 suggests that, ’structural relations of social oppression maybe internalized,’ and that, ’people may take on the attributions of inferiority that are imposed onto them by dominant groups. (Journal of social work. p37). Jane has been abused by males throughout her life which reflects the societal constructions of gender, that place men in the dominant role. As a result, Jane may have been left feeling powerless.
One of the advantages of systems theory is that it is broad and able to integrate with other interventions to effect positive outcomes. In order to address Jane’s relationships with her family, attachment theory can be used as a model of intervention.
Attachment theory was first developed by the British psychoanalyst, John Bowlby (1969) who with ‘insights garnered from evolutionary theory, ethology, systems theory and developmental’ (Aldgate, J, Rose, W, Jeffrey, C (2006). p68) created the theory of attachment. Bowlby examined the way in which relationships are formed and believed that human beings are predisposed to seeking attachments and that attachment to another individual is instrumental in emotional development. Although Bowlby was focused on the early childhood experiences of attachment, he also, ’assumed that it is active over the entire life span and is manifested in thoughts and behaviors related to seeking proximity to attachment figures .’( Mikulincer, M, Shaver, P, R , (2007). p12).
Attachment Theory can be used to explain how Jane’s childhood relationships with her parents/caregivers/family have impacted on her adult relationships and the relationships with her children. Research has found that ‘Early attachment patterns become deeply embedded in the neural pathways of the brain and the central nervous system.’ https://www.communitycare.co.uk/2016/12/06/attachment-theory-social-work-adults/
Ainsworth (1978) developed a three-category model of attachment styles; secure, anxious, and avoidant. Maine (1995) added a fourth attachment known as the disorganized attachment style which states that, as adults, individuals will seek co-dependent relationships which are dominated by a fear of abandonment. It also suggests that adults can choose who they attach to, normally partners who confirm their beliefs about attachment.
Jane had a difficult childhood stemming from the sexual abuse by her father and having spent most of her childhood in care in residential homes. Her adult life has been cataloged with a history of abusive relationships. Jane’s lack of attachment during childhood has left her feeling unworthy and unloved. Research by Henderson, Bartholomew, and Dutton (1997) has identified that insecure adult romantic attachment has links to intimate partner violence and is associated with shorter and more frequent relationships. Research indicates that ‘around one in five adults aged 16 to 59 (an estimated 6.2 million people) had experienced some form of abuse as a child, according to the Crime Survey for England and Wales (CSEW) for the year ending March 20162.’ https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/peoplewhowereabusedaschildrenaremorelikelytobeabusedasanadult/2017-09-27.
Jane has endured a significant amount of change personally, structurally, and culturally throughout her life much of which has been beyond her control. The level of degree in which she will engage with services may depend on issues regarding experiences of attachment and rejection. The lack of services that are available to victims of domestic abuse may also be a barrier to accessing services. This has the potential for the social worker to perceive Jane as ‘difficult’ and dismiss her as refusing support. As a child, Jane has learnt strategies to keep herself safe which she has continued in her adult life. However, ‘as social workers, we must never think that we are “treating” a strategy or set of behaviors. ‘Our role is to help them over-applying that strategy in adult life, while also helping them add different strategies.
- https://www.communitycare.co.uk/2016/12/06/attachment-theory-social-work-adults/
The intervention itself has the potential to be oppressive. Keeping within the law and balancing the scales between keeping people safe and respecting individual rights can prove problematic. ‘Dominant groups in society use their position of power to influence subordinate groups’ (Frameworks for clinical practice).
It is important for social workers to develop a framework for understanding human behavior. Therefore, it is fundamental for the social worker to identify and understand the attachments Jane has had in her life and the impact they have had on her relationships in adulthood. As Any unresolved conflict or trauma will inhibit the intervention work.)
Initially, it is, as with system theory, necessary to create as Bowlby describes a ‘safe haven’ and ‘secure Base’, in order to work with Jane.
Attachment-aware practice helps the social worker to understand the client's behavior and also the coping strategies employ in times of crisis. Professor Munro stated in her child protection report that all social workers should be trained in attachment theory and in the 2014 report on education for social workers, Sir Martin Narey advised that a newly qualified social worker should have a comprehensive understanding of attachment theory.
- (Payne, M, 2005. p143. Modern Social Work Theory. Palgrave Macmillan).
Payne describes the theory as a “generalized set of ideas that describes and explains our knowledge of the world around us in an organized way” (Payne, 2014. p5). The Professional Capabilities Framework, states that applying social science theory to social work practice is a professional requirement. Capability five specifically indicates “Apply knowledge from a range of theories and models for social work intervention with individuals, families, groups, and communities, and the methods derived from them”. A theory draws insight by gathering evidence through the scientific model in an attempt to understand the root cause Alongside this Jane is also trying to cope with her past traumas, including the impact of domestic abuse and sexual abuse which has affected her emotionally, social, and intellectual well – being. ‘Abuse and violence can have a serious impact on the way a woman thinks and interacts with the world around her and ‘may impair a woman's ability to function in the ‘real’ world,’ ‘including finding it really hard to look after children as well as she would want.
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