Casharo ku saabsan social work

1. GROUP 5
• Abdirahim Hussein Ibrahim
• Ayuub Hasan
• Ikraan dahir adar
• Eyman Abdi Karim
• Ismahan Hasan Mohamed

2. CHAPTER 5
ASSESSMENT OF ADULTS

3. INTRODUCTION
In order to provide effective evidence-based interventions with adult
clients, a thorough assessment is essential. Although fundamental in
planning and providing effective treatment for adult clients,
assessment is a challenging endeavour. Although there are a variety
of definitions of social work assessment, this chapter is based on the
following definition from the Social Work Desk Reference.

4. CONT...
• Assessment is the process of systematically collecting data about a
client’s functioning and monitoring progress in client functioning on
an ongoing basis.
• Assessment is defined as a process of problem selection and
specification that is guided in social work by a person in
environment systems orientation. Assessment is used to identify and
measure specific problem behaviours as well as protective and
resilience factors, and to determine if treatment is necessary.

5. CONT...
Information is usually gathered from a variety of sources (e.g.,
individual, family member, case records, observation, rapid
assessment tools and genograms).
Types of assessment include bio-psycho-social history taking,
multiple dimensional crisis assessment, symptom checklists,
functional analysis, and mental status exams.
—(Roberts & Greene, 2002, p. 830)

6. CONT...
Using the social work framework of person in environment, a successful
assessment involves understanding the individual not only as a physical and
psychological entity but also as one engaged in a relationship with both
micro- and macro-environments. In looking at the intersection of this
person in an environmental matrix, the social worker is in the best position
to complete a comprehensive client assessment. Although many regard
social work assessment as focusing on problems and diagnosis, the
assessment of strengths and resilience is as important in completing a
comprehensive assessment of the client. Other common features of current.

7. CONT...
• social work assessment models outlined by Jordan and Franklin (2003) include the
following:
• Social work assessment models are eclectic and integrative and are not based on
one underlying theory.
Long history taking is deemphasized, and there is a focus on seeking
only relevant history that is related to the function of service. For
example, a social worker in a medical setting might be most interested in past and
present physical health, whereas a social worker in a family-therapy agency might
focus on past and present history of family relationships.

8. CONT...
Social work assessment involves a collaborative process between client and worker.
Using an evidence-based practice (EBP) approach, the client is actively involved in
sharing information with the goal of deciding on the best possible treatment.
Involving the client in a short-term active participatory approach to diagnosis is the
best way to ensure that the client continues to participate in treatment.
A comprehensive client assessment includes many factors, both in terms of the
individual (appearance, developmental history, past and current physical health,
cognitive ability and style, intellectual capacity, mental status, psychiatric diagnosis,
and cultural/racial identity).

9. CONT...
as well as the individual relationship to environment (role within
family, family history, physical environment of home and
neighbourhood, and relationship to the outside community). An
important part of the assessment process involves focusing not only
on the deficits that a client presents but also on the client’s strengths
and resilience.
There are many challenges to completing a comprehensive
assessment of a client. First, with the current focus on short-term
treatment models, a thorough assessment is often not possible.

10. CONT...
Clinicians frequently focus only on information needed to complete
forms or to select an intervention. In fact, many EBP models look
primarily at the client’s participation in the choice of intervention and
minimize the assessment process. Yet a thorough assessment is most
helpful in making the best intervention decision. Another challenge
has been that assessment is often accomplished with a singular focus.
Some assessment models favor an individual.

11. CONT...
Historical Background
Psychosocial Diagnostic Assessment From the birth of the social
work profession, many different assessment models have been
used. Perhaps the most well known is the psychosocial or
diagnosis approach first developed by Hollis. This model relies
heavily on family and developmental history to reach a psych
diagnostic assessment of the client. An ego-psychology framework
(Goldstein, 2002) is fundamental to this approach.

12. CONT...
the assessment process has the following steps:
(a) assessing the client’s interactions with his or her
environment in the here and now and how successfully he or she is
coping effectively with major life roles and tasks;
(b) assessing the client’s adaptive, autonomous, and conflict-free areas of ego
functioning as well
as ego deficits and maladaptive functioning;
(c) evaluating the impact of a client’s past on current functioning; and
(d) examining environmental obstacles that impede a client’s functioning (Goldstein,
2002; Hollis &

13. CONT...
According to a psychosocial diagnostic approach, information for client assessment was
collected in a variety of ways, including
(a) psychiatric interviews to determine a diagnosis,
(b) the use of standardized and projective testing to support diagnostic assessment,
(c) current psychosocial assessment and study of prior development and adjustment to
identify problem areas,
(d) use of standardized interviewing to assess problem areas and current functioning,
and
(e) study of the client-social work relationship to ascertain client’s patterns of
interactions (Jordan & Franklin, 2003).

14. CONT...
Problem-solving Assessment
Another major assessment model was a problem-solving assessment originally developed by
Helen Harris Perlman 1957.
This model is based on the psychosocial diagnosis model described earlier and functional.
Cognitive-Behaviour Assessment
Cognitive-behaviour assessment models have made a major contribution to current practice and
research about assessment.
Jordan and Franklin (2003) identify four attributes of cognitive-behaviour assessment that are
particularly useful in today's practice:

15. CONT...
1. Because much today's practice focuses on short-term intervention, the focus
on rapid assessment and treatment is particularly useful.
2. Much research has been conducted on outcomes of cognitive behaviour
approach.
3. Many assessment and manuals for use with assessing a number of identified
client problem, such as depression, substance abuse, personality disorders,
and posttraumatic stress disorder, have been developed using cognitive-
behavioural approach.
4. Ongoing assessment has been stressed as essential in evaluating the
effectiveness of treatment.

16. CONT...
Life-Model Assessment
The life model Assessment (German & Gitterman, 1996) uses an ecological
framework that focuses on the client's interaction with the environment in three
main areas-life transitions, environmental pressures, and maladaptive interpersonal
processes.
Task-Centered Assessment
The task-centered assessment model developed by Reid (1988) focuses on
specific target problems and their desired outcomes.
Major steps in this model include planning, implementation, and review.

17. CONT...
Solution-focused Assessment
A major new assessment model is the brief solution solution-focused therapy assessment
developed by De Jong and Berg (2001) for work with mandated clients.
Identified the following methods for conducting a solution-focused assessment:
■Tracking solution behaviours or exceptions to the problem.
■Scaling the problem.
■ Using coping and motivation questions.
■ Asking the miracle question.

18. CONT...
Strengths-prespective assessment
A final perspective that has had a major influence on current
assessment practice is the strengths perspective developed by
Saleeby (1997). This perspectives is fundamental to the values-based
perspective of social work in that all people are seen as having dignity
and worth as individuals as well as the right to self-determination.
Using this approach, the practitioner looks for knowledge,
competencies, hidden resources, and resilience in each and every
client who comes for treatment.

19. CONT...
Summary of Current Evidence-Based Assessment for Individuals. There are a
number of sources of information that a social worker can Usain completing
assessments on individual clients. These sources include:
●Background information on clients from case records.
● Verbal reports from clients about their feelings, history, and problem.
●Direct observation of nonverbal behavior.
●Observation of interaction with family members and others in clients'
environment.
● Collateral information from families, relatives, physicians, teachers, employers,
and other professionals
●Tests or other assessment instruments.

20. CONT...
thorough assessment usually includes the following categories
1. Identifying information
2. Referral source
3. Presenting problem.
4. History of the problem
5. Family background

21. CONT...
Assessment Scales and Tools
One of the earliest and most well-known scales is the Wechsler Adult Intelligence
Scale (WAIS), first published in 1955 and now in its fourth edition (2007). The
current version, which is used to measure adult intelligence of people between 16
and 90 years of age, consists of 10 core subtests and 5 supplemental subtests.
Cultural assessment
One area of much importance in today’s practice is that of cultural and ethnic
identification. Understanding a client’s cultural background is very important in
completing an assessment.

22. CONT...
• Suicide Assessment
Suicide assessment and prevention is an important part of any
comprehensive assessment process. The number of suicide attempts
is on the rise, especially among adolescents. The following factors
• Feelings of despair and hopelessness.
• History of previous suicide attempts.
• Concrete, available, and lethal plans to commit suicide.
• Family history of suicide.

23. CONT...
• Ruminations about suicide.
• Lack of support systems.
• Feelings of worthlessness.
• Belief that others would be better off if one were dead.
• Age—very old or adolescent.
• Substance.

24. CONT...
• DSM-IV Assessment
• In behavioural-health settings, social workers are frequently expected to
understand and make a DSM-IV-TR :
• Disorders usually first diagnosed in infancy, childhood, or adolescense.
• Delirium, dementia, and amnestic and other cognitive disorders.
• Mental disorders due to a general medical condition.
• Substance-related disorders.
• Schizophrenia and other psychotic disorders.

25. CONT...
• Mood disorders.
• Anxiety disorders.
• Somatoform disorders.
• Factitious disorders.
• Dissociative disorders.
• Sexual and gender-identity disorders.
• Eating disorders.
Sleep disorders.
• Impulse-control disorders not otherwise classified.
• Adjustment disorders.
• Personality disorders.

26. CONT...
These diagnoses are descriptive in nature and not tied to any
theoretical framework. A DSM-IV diagnosis has five axes:
• Axis I: Primary clinical disorder.
• Axis II: Personality disorder or mental retardation. Axis III: Medical
problems.
• Axis IV: Psychosocial issues.
• Axis V: Global Assessment of Functioning.

27. CONT...
Assessment of Older People
Because social workers often encounter older people in their practice,
assessment issues for older people need special attention.
Evidence-Based Assessment
There have been some attempts to provide evidence about the use
and effectiveness of different evidence-based assessments.

28. CONT...
Implications for Social Work on Micro-, Mezzo-, and Macrolevels
The importance of a comprehensive assessment for individual clients
is evident. No treatment intervention can begin before there is
assessment about the nature of the problem and what strengths the
client brings to resolving the problem.
Mezzo level practice is designed to change the systems that most
directly affect the client-namely, the family, peer group, and classroom
.

29. CONT...
Conclusion
Individual assessment of adults continues to be as important for
social workers as in the early days of psychosocial diagnostic
assessment. The assessment process is much shorter and focused on
the problem at hand. Often, assessment is not separate from
interven- tion. Although we have developed well-documented
specific tests to assess the presence of specific mental disorders,
general-assessment instruments have not been subject to such
empirical investigation.

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