Looking At The Hierarchy Of Need When Designing
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Looking At The Hierarchy Of Need When Designing

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Finding a different way to Case Manage by looking at the psychological state of the client.

Finding a different way to Case Manage by looking at the psychological state of the client.

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  • Read the introduction
  • Abraham Maslow (1908-1970), a personality theorist (also known as humanistic psychology) “was most systematic in describing the structure of personality, and postulated a hierarchy of needs”. The watchword during Maslow’s time was “self-actualizing”. It was believed that we could all reach our highest potential. However, things could get in the way and block this progression. Maslow believed that, “Difficult living conditions or stressful life or interpersonal experiences may move you away from your true self” and that “we cannot progress up the hierarchy until we have satisfied the needs at lower levels”, (Barlow & Durand, 2005). The hierarchy consists of five levels…..
  • The face of the homeless is not what we once thought it to be. Anyone can be homeless…single parents, 2-parent families, the disabled, the mentally ill (including depression), the drug/alcohol addicted, children, teens, the once employed…It could be you! It could be me!
  • It has been shown that the homeless population presents with multi-axial issues. In the study by Best, et. al, (2008), it was found that many homeless individuals are dealing with, “multi-axial problems such as substance abuse, instability of employment, health problems and problems with family and/or relationships”. Toro, et al (1995) was consistent with most findings, “suggesting high rates of pathology of all types among the homeless, including mental illness, substance, criminal behavior and health problems”, and Fischer, et. al (1986), found that one-third of the homeless subjects were identified as likely psychiatric cases, and diagnosed with disorders such as schizophrenia, affective disorder …and particularly substance abuse.
  • Here we take a look at what a program may ask of its clients, those who are dealing with multi-axial problems/issues. The goals listed here are more in line with what stable, average people are trying to do. An individual whose basic needs have not been met, will have a difficult time at adhering to these program standards. Take employment for example. In this economy, a person with an education and job history has a difficult time finding employment. Now, add substance abuse, no formal education and lack of stable housing. How easy will it be for that person to find employment?
  • Let’s take a look at a fictitious client. This client presents with a lifetime of instability; and no two clients are the same. With that in mind, the Individual Service Plan & Goals set by programs need to address the unique issues facing each client. How likely to do think it is that this client is ready for employment within 90-days? The chances are slim. Programs must look at the overall picture of the clients life in determining the likelihood of success in their programs. Programs should rethink timelines on “requiring work” or “going to school” and focus closer on what the “client says that he/she needs” and if those needs are realistic. This woman may say that she wants to work and will actually look for work. However, her limited education, limited job history and long-term abuse of drug/alcohol, will present as barriers to this goal. Think of realistic goals when clients come in for service and address those immediate needs before pushing higher level needs onto clients.
  • The next several slides will outline how Maslow’s Hierarchy of Needs model can be used in designing services for homeless individuals and families. First, there are the Biological & Physiological Needs, where clients are functioning in “survival mode”. This level must be addressed before clients can move on to higher level needs. Programs may want to look at extending the timeline out to about 6-months to work with clients and their primary concerns. It may not be easy to figure out what those needs are but it is safe to assume that many of the clients will have multiple issues preventing them from moving on to employment or school.
  • (Read from slide)—Clients may not be able to address these issues at the start of the program so the timeline should be pushed out to 6-12 months.
  • (Read from slide)---Once the client has addressed those pressing, primary issues, he/she may be ready for this level during the 2 nd half of the program.
  • (Read from the slide)---By the end of a 24-month program, clients may just be settling into “normal” living, where they are working and depending less on programs for everyday living.
  • By the time a client reaches this level, he/she will have long left your program and it is unfortunate that you may not see the “fruits of your labor”. But the lives that enter your programs do not belong to you. Clients have the right to make decisions for themselves. Just keep in mind that you planted the seeds; and the client has the right to nurture and maintain those seeds or let those seeds die. But many clients will go on to reach this level in their lives. The tree that sprouted from the seeds you planted are now blooming with the successes of that client….family & marriage, a new home, a college education, a new car, happiness.
  • Read conclusion.

Looking At The Hierarchy Of Need When Designing Presentation Transcript

  • 1. Looking at the Hierarchy of Need When Designing Program Services: More Accurately Meeting the Needs of the Homeless Population Shavona D. Parker Argosy University Psychology 492 Katina Clarke, Professor June 6, 2010
  • 2. Introduction
    • Studies show that the needs of the homeless are unique. The uniqueness of the population include the face of gender differences (Hagen, 1987; Fatimah, Aziz, & Ibrahim, 2008; Walsh, Rutherford & Kazmak, 2009 ), homeless young people (Taylor, Stuttaford, Broad & Vostanis, 2006), entire families (Bassuk, Rubin & Lauriat, 1986); older female adults (Washington, 2005), as well as those dealing with addiction (Best, McCarthy & Darlingon, 2008).
    • Because this population presents with multi-axial problems such as “drug abuse, instability of employment, health problems…”, (Best et. al, 2008), they generally have difficulty in meeting the program requirements set by the programs that provide services to them. It is suggested that program developers use Maslow’s Hierarchy of Needs model when designing their services, more specifically to the case management process in developing the Individual Service Plan (ISP), as it is the roadmap to the success of the client.
  • 3. Abraham Maslow
    • Who is Maslow? What is the Hierarchy of Needs model?
  • 4. Faces of the Homeless
    • Who do you see?
  • 5. Studies Multi-Axial Issues
    • Addiction, Disability, Mental Health, Physical Health, Unemployment, Violent Behavior, Crime
    • Best, et. al, (2008)
    • Fischer, et. al, (1986)
    • Toro, et. al, (1995)
  • 6. What Programs Expect
    • Social Service programs are designed with well-intent in mind. They want to provide services that help those in need. Listed here are some of the client expectations in 2-Year Homeless Transitional Programs:
    • EMPLOYMENT—Client will seek out and find employment within 90-days
    • -or-
    • EDUCATION—Client will enroll in a Vocational Program or other program that will lead to employment; complete GED, Apprenticeship leading to employment
    • -and-
    • MONEY MANAGEMENT—Client will save 30%-60% of income while in program
    • -and-
    • CREDIT REPAIR—Client will work on repairing credit issues
    • -and-
    • SOBRIETY—Client will maintain sobriety; and submit to random drug testing
  • 7. Case Management: The Client Intake
    • Name: Jane Doe
    • Age: 42-Years old
    • Gender: Female
    • Highest Level of Education: 9 th grade (partial)
    • Children:
      • 16-year old female living with family
      • 7-year old female with paternal grandparents
      • 5-year old male with Foster Care family
    • Income: None
    • Employment History: Sporadic, some part-time work
    • Housing Status: Homeless, living on street, with family/friends for past 15-years. No permanent address
    • Substance Abuse History: Meth & Alcohol
      • Last Use: Over 3-years ago (just quit)
    • Mental Health History: Reports none
    • History of Domestic Violence: Yes
    • Criminal History: Possession, Prostitution, Check Fraud
  • 8. Biological & Physiological Needs (0-6 months) Shelter, food, drink, air, warmth, sleep, sex
    • Clients with multi-axial problems are functioning at this level. They are likely not to reveal what these problems may be. They may appear to do what is necessary to keep shelter, food, etc.; they may present unrealistic objectives/goals; may start to avoid meetings. Some clients will work through this level faster than others; while others may be stuck at this level for longer durations than programs will allow. However, clients need some time to acclimate themselves to a more stable environment, as most are coming from chaotic environments and lifestyles. Case Manager’s should first address areas that are barriers to employment such as drug use, mental health or no work history or high school diploma/GED.
  • 9. Safety Needs (6-12 months) Protection from the elements, security, order, law, limits, stability
    • Many of the clients are victims of crimes, are perpetrators of crime, have lost their children to Child Protective Services, have many crises over their lifetime and have not had stability. At this level they may or may not be in a position to address these things. But if left unaddressed, things in this area can get in the way of gaining employment, housing, etc. Readdress areas that are barriers to employment such as drug use, mental health, no work history or high school diploma/GED .
  • 10. Belonging and Love Needs (12-24 months) Work group, family, affection and relationships
    • At this level, the client is actively looking for and qualified for employment or may be employed. Client may even be interested in attending school or training in order to gain better employment. Client has taken responsibility for actions and relationships with other are mending and on a positive progression. Client attends church or other religious activity Maintains sobriety with some issues or concerns.
  • 11. Esteem Needs (2+ Years) Self-esteem, achievement, mastery, independence, status, prestige, managerial responsibility
    • Maintaining employment and doing well in the workplace, on-target with school/training, relies very little on program/case manager, more confident in making own decisions. Able to maintain sobriety with no issues/concerns.
  • 12. Self Actualization (5+ Years) Realizing personal potential, self-fulfillment, seeking personal growth and peak experiences
    • The seeds were planted at earlier levels over the client’s lifetime. It is up to the client to nurture and maintain those seeds. A client may complete college, purchase a home, etc. These may occur 10+-years out. A program will likely not be around to be a part of this level.
  • 13. Conclusion
    • Setting goals that stable individuals are likely to accomplish cannot be set for individuals whose basic needs have yet to be satisfied. Program developers can assist the case management process by helping to accurately capture the level of need of the client when designing the ISP and goals. A more realistic way of looking at how to provide services to homeless individuals means revamping the timeline in which goals must be met. Closer attention must be given to the present state of the individual (their level on the Hierarchy of Need pyramid). Programs will then have better affects on the individual’s future performance.
  • 14. References
    • Barlow, D. H., & Durand, V. M. (2005). Abnormal psychology: An integrative approach. Belmont, CA: Thomson Wadsworth.
    • Bassuk, E. B., Rubin, L., & Lauriat, A. S. (1986). Characteristic of sheltered homeless families. American Journal of Public Health , 76 , 1097-1101.
    • Best, D., Day, E., McCarthy, T., & Darlington, I., Pinchbeck, K. (2008). The hierarchy of needs and care planning in addiction services: What Maslow can tell us about addressing competing priorities? Addiction Research and Theory , 16 (4), 305-307.
    • Chapman, A. (2001). Maslow's Hierarchy of Needs, Original Five-stage Model. Retrieved May 10, 2010, from Businessballs Free Work and Life Learning, Washington, DC. Web site: http://www.businessballs.com/maslow.htm.
    • Dreamtime (2010). Photos on slides #1, #4 and #5. Retrieved June 17, 2010, from http://www.dreamstime.com/
    • Fatimah, P. R., Aziz, J. A., & Ibrahim, K. (2008). Women-family in quality perspective. Social Indicators Research , 88 , 355-364.
    • Fischer, P. J., Shapiro, S., Breakey, W. R., & Anthony, J. C., Kramer, M. (1986). Mental health and social characteristics of the homeless: A survey of mission users. American Journal of Public Health , 76 (5), 519-524.
    • Hagen, J. L. (1987). Gender and homelessness. National Association of Social Workers, Inc. , 312-316.
    • Taylor, H., Stuttaford, M., Broad, B., & Vostanis, P. (2006). Why a 'roof' is not enough: The characteristic of young homeless people referred to a designated mental health service. Journal of Mental Health , 15 (4), 491-501.
    • Toro, P. A., Bellavia, C. W., Daeschler, C. V., & Owens, B. J., Wall D. D., Passero, J. M. (1995). Distinguishing homelessness from poverty: A comparative study. Journal of Consulting and Clinical Psychology , 63 (2), 280-289.
    • Walsh, C. A., Rutherford, G. E., & Kuzmak, N. (2009). Characteristics of home: perspectives of women who are homeless. The Qualitative Report , 14 (2), 299-317.
    • Washington, O. (2005). Identification and characteristics of older homeless African American women. Issues in Mental Health Nursing , 26 , 117-136.