Psycho-social interventions

Social Work interventions are very much based on working with the person in the context of their environment, and I have found it useful to conceptualise this by using the diagram below:

Psycho-social assessments

This assessment is more than just collecting information about the client’s social context and personal functioning. It is an important part of rapport building and needs to be enabling for the client, helping them to develop insight and make more sense of their world. It is also a work in progress that evolves and is revised as new information is added and circumstances change.

We only need to gather information that is relevant to this client and their unique circumstances, rather than obtain information about all the aspects listed below.

Psycho

The Psycho aspects include:

•  Cognitive functioning – ability, ability to process information, style of thinking, insight/ level of wisdom from experiences.
•  Belief systems – self-labels, level of comfort with self, how defines self.
•  Behavioural functions – coping skills, ability to sustain selves, ability to self-soothe, level of resilience, ability to cope with challenges, strengths and skills.
•  Affective functions – emotions and moods, defences, how regulate emotions.
•  Health – medical conditions and symptoms, medication (impacts/ side effects and how view), physical pain.
•  Holistic resources/ needs – needs, what would like to change, expressed needs.
•  Personality characteristics
•  Willingness and ability to change – power blocks, are they a customer, complainant or enquirer, why they are here (agenda), barriers to change, preparedness to engage in counselling, client’s level of comfort (moving back and forth between unsafe/uncomfortable and safe/ comfortable).
•  Developmental life stage

These are often present as symptoms (and in the diagram above would be listed under the figure of the person).

Social 

Here we could include:

• Significant relationships
• Family  -- role in family, family history, relationships with family members.
• Social networks – community engagement.
• Primary and secondary supports
• Available resources and support deficits – housing, transport, legal, financial etc.
• Negative or unpleasant environmental factors/ living conditions
• Cultural factors
• Challenges – physical and emotional safety and security, trauma, loss etc.
• Interactions with other services and past history of interventions
• Education/ work/ recreation/ leisure
• Possibilities for the future

Causes are often found in this area (and in the diagram above would be listed under Context/ Environment).

Interaction between psycho and social

The interactions from the client to their environment include:

• Social skills/ how they relate to people.
• Level of social participation.
• What they have already done to address issues.
• Access to resources.
• Coping strategies/ how they deal with life challenges.
• Behaviour/ reasons for behaviour/ purpose served by behaviour.

The interactions from the environment to the client include:

• How they are defined by others (including family).
• Sources of stress.
• Labels and diagnoses.
• Role modelling.

And the interactions that flow both ways include:

•  Reactions to attachments
• Security, safety and protection

Our interventions are usually related to changes in these areas (and in the diagram above would be listed under the two-way arrow).

Some aims of intervention

In our interventions with clients we are assisting them to:

• enable change to occur (including in thinking and/ or behaviour).
• increase insight.
• manage symptoms and/ or increase appropriate coping strategies.
• target the interactions between "psycho" and "social".

I hope that this helps to make some sense of the multiple complexities we are working with when counselling clients.