The Nature and the Features of Case Work

Social case work has its own history evolved from different institutions of civilization, religion
and culture. But it has developed a preferential leaning towards the principles of democracy, the
fundamental rights, and human growth and development. Social Case work stands on the basic
belief that human beings are born with innate capacities and these capacities need to be enhanced
with new knowledge and skills, and experiences gained through everyday life. Moreover, human
beings need to learn to cope with the new challenges that result from the rapid changes in
society. They need to acquire new competencies to achieve the milestones of growth and
development. Social case work involves a process of social treatment. This implies that social
treatment is the sum total of all activities and services directed towards helping the person with a
problem. The focus is to relieve the immediate problem and if possible, to modify any basic
aspects of the person that have precipitated.

Human beings take to different patterns of interaction with other human beings. These patterns
may be classified as:

a. Primary level
b. Secondary level c
c. Tertiary level

Primary level: When a child is born, the basic institution of family is responsible for the child’s
initial interaction. The child develops certain skills required to interact with the society at large in
an appropriate manner. The family prepares the child to face the challenges in human
relationships. In this context the case worker has to assess the level of interaction within the
family and ensure the quality of the foundational skills for healthy interaction with one another.
Both the parents and the child come into the process of case work in order to improve the innate
skills and build up new capacities for solving any immediate problem and meeting the future
challenges in intra and inter relationships.
Secondary level: Institutions such as schools, religious structures, and so on which can make a
great impact on the child’s growth and development as a human being come under this level.
These institutions aim at imparting knowledge and skills and assist in the mature growth of the
person. At this stage the person’s problems may become more manifest. He/she may tend to
develop behavioral and attitudinal problems, as new dimensions of life unfold themselves at the
physical, psycho-social, and faith levels. The case worker has a significant role to play at this
juncture in the life of a person as a child, or teenager or young adult. He/she needs to understand
the complexity of the problem efforts to enable the person to solve the problem as well as to
proceed further in his/her life’s journey through the dissemination of suitable knowledge and
skill

Tertiary level: The tertiary level of human interaction begins in the community and develops in
the society at a wider level. The person who obtained the skills at the primary and secondary
levels demonstrates the learning in the society through his/her interactions. In this process the
individual may face conflict situations that may affect his/her wellbeing. Hence the intervention
of the case worker assumes importance in helping the individual with problem-solving skills and
suitable support, so that the individual is able to understand the reality and increase his/her
adaptive and adjustment capacity to solve the problem and enhance the quality of his/her life.
The process of intervention in case work enables individuals to build up their innate and acquired
capacities to find solutions to their problems, and improve their level of functioning in the family
and society to the optimal level. Thus, the existing gap between the issues and the potentialities
of the individual is reduced or removed, and the quality of life of the individual increases
through proper adjustment and adaptive mechanisms. The individual is now able to positively
contribute to the welfare of the society in which he/she lives through appropriate human
relationships that are reciprocal in nature or the growth process and support the person, parents
and teachers.

Crisis Intervention Case work

(CIC): Gerald Caplan (1964) describes a crisis situation as involving a “relatively short period of
psychological disequilibrium in a person who confronts a hazardous situation that for him
constitutes an important problem which he can for the time being neither escape nor solve with
his customary problem-solving resources”. Case work interventions that address such instances
and individuals are known as crisis intervention casework.

Crisis Intervention Case Work is relevant in situations such as the following

1. Accident
2. Death of a loved on
3. Natural disaster like Tsunami/ Floods/Volcanic eruption/ Famine/ cyclone/rain /fire
4. Serious Health related issues /illness
5. Financial crisis
6. Unemployment

CHARACTERISTICS OF SOCIAL CASEWORK PRACTICE

All that you have learnt now needs to be applied to specific clients – in specific situations with
similar or different problems and concerns – being served by different organizations. It will help
you perform more effectively if you keep in mind the following features that characterize social
casework practice, wherever you may be located: Let me start by stressing the fact that
casework help is not standardized. As we go along, we shall talk about different factors that may
determine caseworker’s differential response to a similar situation. The individual, the client, is
seen as a whole – as a thinking, feeling, acting being -- in continuous interaction with his total
social environment. You as the Social Caseworker, represent not only the agency which has
employed you but also your profession – Social Work. That you have to practice

(use knowledge and skills & techniques) within the professional value-system ethics and
principles but at the same time be responsible for achieving the goals of the employing agency.
While you generally work within the service delivery systems devised by the organization you
have a commitment to performing the role of a change – agent in case these systems are
dehumanizing or degrading for the clients. You have to be constantly aware of your personal self
and make sure that it does not interfere in your social casework practice. It is all the more
important in Social Casework because its clients’ problems and concerns have heavy emotional
component. Human problems of living are complex and multidimensional and require sensitive
handling. Therefore, Social Casework Practice may very often require interagency
collaboration.! You will very often be a part of a team of professionals. In primary settings you
are likely to be the main professional for service delivery, whereas, in secondary settings, you
may have an ancillary status. It is important for you to communicate your contribution as a social
work professional to other professionals in the team. Social Casework service may be offered for
prevention, promotion, cure/ remedy, rehabilitation, placement, reformation, palliative care, or
for modification of social environment.

DETERMINANTS AND FIELDS OF PRACTICE

Fields of social casework practice are broad areas or settings in which casework method is
utilized to help individuals and families. Various fields can be determined on the basis of the
following components:

a) Person-in-context – The context here includes the total social environment of the client -- a
male adult with visual impairment, a middle-aged woman abandoned by her husband, an
orphaned child in a Foundling Home.

b) The concern or the problem requiring help – Destitution, chronic illness requiring major
changes in life-style, drug dependence, rehabilitation, trauma caused by riots or serious accident,
bereavement, role conflict, displacement.

c) The human service organizations that provide the location for providing help, like, schools,
hospitals, childcare institutions, short stay homes, institutions for the elderly and juvenile homes.
The first two dimensions can be analyzed further from two perspectives:

The needs perspective

a) Common human needs – beside survival needs, every individual has needs for affection, for
security, for achievement and for belonging (to a group).

b) Special human needs – needs that arise because a person has a disabling impairment, is
suffering from a chronic illness requiring major changes in life style, has deficit of coping or
social skills, needs arising due to traumatic experiences like accident, riots, natural calamities or
needs of very young or old persons. c) Societally caused needs – those that arise due to certain
conditions in society itself, for example, discriminatory practices, oppression, deprivation, or
displacements due to large developmental projects. The needs perspective helps the worker in
understanding the source and extent of the problem as it applies in each case. It helps in knowing
about the impact of the unfulfilled need on the client and his social environment. The worker is
able to help the clients decide upon the action plan for dealing with their problematic situation by
fulfilling the unmet needs. ! The life-span perspective An individual experiences a number of life
changes as he/she goes through his life cycle, that is, from birth to death. She/he is seen as
moving in life through a series of developmental stages, each stage requiring the individual to
successfully complete some tasks before he/she moves on to the next one. In most cases, human
beings move through this cycle without major unsettling stresses. But if the person is not able to
achieve this transition smoothly, he/she may find life changes stressful and is thus unable to
adapt to the new demand

FIELDS OF SOCIAL CASE WORK PRACTICE

As we have already stated that any discussion of fields of casework practice needs to look at two
components: client groups with some problem or concern and the setting where the clients get
help with their concerns. Let us first describe in brief the client groups and some of their
characteristics.

The Individual: Person and his/er interaction with social environment are influenced
significantly by a number of factors. These factors determine as to how different clients react to a
similar situation /problem/concern differently. Their expectations from the caseworker may also
vary accordingly.

Some of these factors are:

Age: The needs and concerns, problems and difficulties faced by a child are invariably different
from those of a young adult or an elderly person. Again, how the individual--- of any specific age
group --- looks at the situation under study, feels about it and wants it to be handled may differ
according to the age of the individual.

Sex: The experiences and conditions of male and female persons in a given society are socially
and culturally determined. The status in society (rights, privileges and power within the family
and society at large), division of tasks, role expectation, role transitions, and role conflicts affect
men and women differently. The stereotyping of image and roles tend to become oppressive and
discriminatory for women specially.
Caste: In Indian society, caste-based discrimination affects individuals and families across age
and sex divisions, although females suffer the most. The low status because of belonging to
lower castes results in deprivation, oppression, and lack of opportunity, depression, apathy and
inertia.

Class: The income group an individual belongs to determine the life goals and motivation for
striving for change. Outlook towards life and problems of living are likely to affect persons
belonging to:

 lower income groups

 middle income group
 affluent groups
 those who are below poverty line.

Residential Institutions

There are situations when individuals have to be removed from their natural environments and
placed in residential institutions. Some of the institutions where social casework is practiced are
as follows:

a) Children’s Homes

Children who are destitute, orphans, or have run away from home and can not be sent back
home; those who are violence, risk to health (e.g., healthy children of leprosy patients) or moral
danger are generally placed in children’s homes. Most of these Homes operate under the
provisions of Juvenile Justice Act and, therefore, provide custodial care. Children are committed
for specific periods. There is sometimes a feeling among inmates that they are under detention.
Only in a small number of cases adoption and foster care services are or can be offered. Homes,
run by the Govt. or voluntary organizations, are expected to provide custody and care to the
children. Social Worker is an important professional here. Living arrangements may be
dormitory or cottage types. Social Caseworker is expected to help each inmate adjust to the life
within the Home and achieve psychosocial development. As the children have often gone
through traumatic experiences before they are placed in Homes, it is very important for them to
come to terms with their life, talk about it and get over the pain and the sense of betrayal. The
worker is expected to provide pastoral care, liaison with schools where the children go for
education, help children develop positive relationships within the institution, and prepare for life
after the stay in the Home is over

b) Correctional Institutions: These include homes/special schools for the delinquent, prisons,
remand/observation homes, beggar homes etc. The main task of the Social Caseworker is to help
those in conflict with law by enabling them to understand themselves and their relationship with
others. They need to understand what is expected of them as members of society. The aim is to
rehabilitate these persons – to help them in such a manner that they can engage in socially
constructive activities once they go back to their homes. The worker helps the clients change
modify their values (so that they are in line with the social values); change their behavior and
response patterns. The residents of these institutions often have a feeling of hostility towards
society or they suffer from a sense of inferiority and inadequacy. Social Casework aims at
correcting these attitudes and feelings by modifying the clients’ immediate environment,
working with their families and maintaining a supportive professional relationship with them.
The Caseworker works as a member of a team of professionals like, probation and parole
officers, psychologists, psychiatrists, and vocational counsellors and educators.

SOCIAL WORK WITH INDIVITUALS

Homes for the Aged: The number of old age homes have been increasing in cities. The stresses
and constraints of urban living have often led to adult children opting to send their aging parents
or relatives to residential institutions. The residents in these homes need nursing care,
understanding and emotional support. The caseworkers in these institutions help the reside, lack
of energy, loneliness, loss of economic independence and the thought of approaching death. The
caseworker enables the client maintain his/her self-esteem. He/she also helps the family deal
with suppressed or open feelings of guilt so as to encourage them to maintain cordial relation
with the client. The worker needs to identify and mobilize community resources like motivating
and orienting volunteers to spend time with the residents, talk to them and attend to their simple
errands.

Residential institutions for women: Short stay homes, rescue homes, widow homes etc. are
some of the settings where casework practice takes place. Most of the inmates are those women
who are destitute, abandoned or battered by their husbands, widows with no relative to give
them support, victims of crimes including prostitution or kidnapping.
 These residents need to build their skills – vocational and social – to become independent
persons capable of taking care of their lives. The caseworkers try to bring about conciliation
between the client and her family, if any. Where marriage is indicated, pre-marital counselling is
provided.

Organizations Working with the Differently Abled There are residential and non-residential
organization’s offering variety of services to the differently abled. The main task of the
caseworker is to fulfill the objectives of the organizations such as

a) Care:
b) rehabilitation -vocational training, education (depending upon their capacity).
c) Employment:
d) offering services according to governmental provisions and special concessions;
e) Advocacy: to reduce or remove social discrimination against the differently abled; and
facilitating the client’s acceptance and understanding of his/her situation and also
recognition of his/her potential. Giving support to the client – both emotional and action
oriented – is an important intervention offered by the caseworker. The caseworker also
works with the family to help them cope with the situation, to understand the needs of the
client, and to learn to take care of the client when he or she is at home. The worker very
often acts as a broker, linking the client and or his/her family with the available community
resources and networks of other organizations working in this area. Organizations Working
with Victims of Disasters There is increasing recognition of the need for individualized help
for the victims of disasters – whether natural or man-made. Victims of natural calamities are
victims of floods, earthquake’s.

HOSPITAL BASED CASEWORK

Referral The attending doctor refers a woman patient admitted in the female surgical ward
to the medical social worker of a government hospital. She is reported to be unwilling to
undergo operation, which she has postponed twice before. The Casework Process Study The
social worker, Sangeeta met the patient, Mrs. K. in the ward and told her about the doctor’s
referral. Sangeeta learnt that Mrs. K was 35 years old married woman. Theirs was a nuclear
family. She had three children, aged 14, 10 and 5 years. All the children went to a school
nearby. Mrs. K. was a housewife. A part-time maid servant helped with a few of household
jobs. Her husband’s job required him often to be away from home. Mr. K had brought his
wife to the hospital because of severe pain in her knee. The doctor had advised surgery.
Sangeeta explored further to enquire the reasons for the client’s resistance to surgery by
interviewing the client in the ward and her husband, both in the ward and during a home
visit. The worker also spoke to the nurse on duty in case the client had shared any Fields of
Social Casework Practice
Social Work with Individuals of her concerns with the nurses (using the collateral sources
for information). She spoke to the doctor concerned to understand the client’s medical
problem and the chances of the client’s recovery
The worker considered the following probable reasons (there could be even more than the
ones listed):
a) Was it because of her anxiety as to who would look after her children during her long
period of hospitalization?
b) Was she scared of the process of operation, as Sangeeta, the medical social worker, knew
from her experience that surgery very often created panic in the patients and even their
relatives?
c) What was her husband’s reaction to the doctor’s advice? Did he offer any support to her
operation?
d) Who will attend to her during the post-operative period, because, according to hospital
rules, only female attendant is allowed in the female wards? Assessment Sangeeta, the
worker, shared with Mrs. K, her understanding of the likely reason(s) for the latter’s anxiety
about the operation. Sangeeta believed that it was important that Mrs. K confirmed the
worker’s definition of the client’s problem before some solution could be worked out.
(Communicating empathy and ensuring client’s participation in the process.) Depending on
the reason/s, Sangeeta and Mrs. K could consider one or more of the following solutions:

Giving Information Sangeeta could explain the exact problem Mrs. K was suffering from. It
was possible that the patient might not have felt free to ask the doctor or the doctor never
explained the problem in detail. Worker could also explain the complete process of surgery
and the chances of recovery. (Based on facts gathered from the doctor himself.) Here she
performed the role of a mediator between the patient and the medical staff. 2
Identifying and Mobilizing Family Support System
Some female relative could be requested to be with children during the period of
hospitalization;
Husband could apply for leave from his office. Sangeeta could provide opportunity to Mr. K
to express his anxiety. She could have sessions with the husband and children to provide
them emotional support. The family, then, could provide the necessary emotional support to
the client. (Counselling sessions with the family members.) The eldest child could be helped
to share some responsibility at home in the mother’s absence. With the support of the
worker, this experience could become a source of positive learning for children --- to learn to
tackle difficult situations and to become independent.
Using Hospital Resources
The medical social work department could arrange for an attendant for the client.
Any other Fields of Social Casework Practice Any other help that the client may need or any
other suggestion that Mrs. K or Mr. K may now think drought. Victims of man-made
disasters include victims of communal violence (riots), serious accidents, mega projects of
development etc.
Some of the common experiences of most of the victims of disasters are trauma:
 loss of loved ones;
 loss of livelihood or assets
 Homelessness
 feeling of helplessness
 feeling of anguish or hostility (desire for revenge)
loss of community feeling; despair and a sense of fatality or sometimes high/unrealistic
expectations from the worker. Despite this commonness, the clients need individualized care
to overcome debilitating impact of the crisis. Organizations Working with Women Social
caseworkers are employed in family counselling centers, crime women cells, legal aid cells,
family courts and women resource centers.
The aim of the professional interventions is to enable women become empowered,
confident, and independent and also utilizes available legal provisions and safeguards for her
protection. There are increasing number of cases of rape victims. The worker has to help link
the family with police, courts, hospitals, schools, and agencies working for rehabilitation of
these victims. Special techniques are used to help the victim come out from trauma, and
restore her self-confidence and self-esteem. The family also needs understanding and
support
of the worker in dealing with this situation. The sensitivity towards the discrimination
women face in families and society is vital in arriving at accurate assessment of the
condition under study. For illustrating Social Casework Practice two cases are presented

FAMILY WORK IN THE COMMUNITY

We shall now discuss a case where the social worker identified the client herself. The case
also demonstrates proactive approach, that is, the worker did not wait for the client to seek
help. Rather she offered her service to the client at the latter’s own home. Referral Renu, a
young trained social worker recently qualified, is working in a community-based
organization. She recently organized a women’s group around weekly kirtan (Devotional
music and worship day organized by women themselves. A Brahmin woman conducts the
worship. The residents of the Basti belong to low-income groups, and mostly of lower
castes. After one such session, Renu asked Mrs. G about her daughter-in-law Kala. Renu told
Mrs. G that though Kala had arrived some time back, she had not been seen in the present
group. Mrs. G invited Renu to visit their home and meet her daughter in-law. During the
home visit, Renu found that Kala was looking very ill, was obviously anemic, and did not
talk to Renu at all. Sensing Renu’s concern, Mrs. G took Renu outside and started
complaining about Kala. She informed Renu that Kala was very lazy, did not know how to
cook or do other household work, and that Kala always pretended to be ill to escape work.
Renu decided to take up the case to help the family. As the family had not asked the help,
Renu had to explore the particulars of the family and gather other relevant information very
slowly and discreetly (quietly) so that no member of the family felt offended. She learnt the
following details about the family. The Social Casework Process Renu realized the
importance of applying different principles of casework to be able to establish positive
relationship not only with Kala, who Renu identified as her client, but also with Mrs. G and
Mohan, Kala’s husband. Only then could she hope to help Kala. She accepted Mrs. G Kala
and Mohan; adopted a non-judgmental attitude; created an atmosphere in which the persons
concerned could share their experiences and feelings freely.
(Principle of purposeful expression of feelings) She was careful not to allow her initial
sympathetic attitude towards Kala and anger against Mrs. G to bias her and affect her
exploration work. (Controlled emotional involvement) She had to keep an open mind to
gather and interpret information Empowerment Proactive Rehabilitation Dehumanizing

According to Barker’s Social Work Dictionary, empowerment is “the process of helping

individuals, families, groups, and communities increase their personal, interpersonal, socio
economic, and political strengths and influence towards improving their circumstances.”
Empowerment counters powerlessness and oppression. Reaching out to the clients without
waiting for them to first seek help. It is opposite to the clinical approach. Rehabilitation for
persons with physical or mental disability means ‘restoration to the fullest physical, mental,
vocational, and economic usefulness of which they are capable. Degrading; not considering
service users as human beings, worthy of respect irrespective of their status in life Fields of
Social Casework Practice Multidimensional: having many layers and aspects.