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

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Preparing for Resolution

• Anticipate the end even from the beginning

• Remind clients of the transitory nature of the practice relationship

• Provide convenient exit points


Discussing Readiness

• Reviewing progress

• Signal - reaching goals

• Evaluate what worked and what didn’t

• Discuss transferable strategies


Evaluating

• Evaluate what worked

• Clarify effective strategies

• Review information useful for future challenges

• Bring a sense of completion to the work


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


Generalizing Outcomes

• Stabilize successes achieved

• Ensure access to – Social supports – Environmental resources

• Contract for closure


Completing Contracts

• Firming Up Social Supports

• Celebrations and Ritualized Endings

• Looking to the Future

• Following Up


Closing With Referral

• Reasons– Limited resources in current setting– Workers take new positions – Legal mandates

• Strategy: Recognize interim success


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


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


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


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


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


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


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


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


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


chapter 16 intervention integrating gains. social work endings types of endings –completing...

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