Systemic Approach

Annamaria Campanini

Can Social Workers Work Therapeutically With Families in Italy?

Legally, therapeutic work (in the psychological sense) is the domain of doctors and psychologists and social workers are not allowed to work as therapists

No, BUT…The Italian Position – Using the Ideas of Boscolo and Cecchin

focusing on:TrainingSecond order changeRecognising the impossibility to be “objective”Paying attention to the culture and the language of the family

The way the problem creates the systemChanging the thinking, not the behaviourThe significant system, which includes all the people and institutions which are activated to alleviate problems brought to the social worker for a solution

No, BUT…The Italian Position – Using the Ideas of Selvini Palazzoli group on

the “family games” through researches they found:Getting parents out of the lives of young peopleCouple stalemateChildren’s involvement in parental businessThe advent of the first symptomThe symptom’s power

No, BUT…The Italian Position – Systemic Thinking in Social Work

Social workers tend to adopt one of five ‘positions’ when working with families

The absent family – The relationship between the client and his/her own family is ignored or not considered relevant for the intervention

Separated closeness – The social worker thinks of him/herself and the client family like two, separated subjects, everyone having significant relationships with the client in different and parallel contexts

1. Unilateral co-operation – The social worker considers and recognises the family relevance for the client, but uses it as a ‘means’ to empower his/her own intervention project

Substitution – The family is considered by the social worker in a negative way, likely to oppose the professional intervention, which is seen as an alternative or corrective to the influence of the family

Co-evolution – Social work is seen as a constitutive part of a wider relationship system that includes the family and others

OrganisationServiceservizio Social

Worker

Politica Variable

s politiche

Economic Variables

economiche

Cultural VariablesCultural variables

culturali

Extended Family.estesa faFamil;FFamily

Client

Other Services Volunteers

schoolWork

Friends

SOCIAL ENVIRONMENT

It will be possible to observe :the individual within the family, the family within the familial network or the social context

BUT ALSO the social worker within the service, the service within the institution or the social context,

AND FURTHERMOREthe social worker and the family as systems in relation to the service and the social context and so on.

Couple ----- Marriage or co-habitation Family with children ----- Birth of

childrenFamily with adolescents ---- Children’s

adolescence Springboard family ---- Children’s

leaving Family in late age ---- Retirement, illness and death

Multiproblematic familiesIn relation to the material environment of life, it has been identified a setting characterized by precarious situations that emerges as one of the most sensible indexes of social vulnerability of these groups; bad working condition, underemployment, under the table job, income derived from illegal activities or social security benefits.

Multiproblematic families Besides, living into a deprived and economically and culturally marginal area, , the multi-problematic family is often been uprooted from a cultural setting completely different from the one it is embedded;

The adults are likely to have little education, poor professional skills and working instability. The relationship the children have with the scholastic institution is characterized by little motivation, misbehaviour and learning difficulties, together with a lack of interest of the parents in the problems experienced by their children or by the collusion between these and the educational system;

The family experiences a strong social exclusion accompanied by a lack of cohesion into the familial system. In such a context, each single member is inclined to look for points of reference in people or groups that share their same organisation, language, and ways to attribute meanings and that refer frequently to values deviating from those social norms shared in the setting the family belongs to;

The familial system seems to stand on foundations that are weak and basically unable to face new issues: for example, every stage during the life cycle can generate a serious crisis needing of support from the outside;In this type of family there is a series of particular configurations which are disorganized or under-organised due to the weak structure and the difficulty in identifying precise functional roles (chaos);

The inner communicative styles are characterized by a poor propensity to listen with an inclination to react automatically and instinctively. «The relationship parents-children takes place within a situation where roles are confused and the intergenerational boundaries are blurred. The children’s growth happens against a background of lack of care, poor stimuli and incoherent and confusing attitudes»

The handling of the familial ménage, in fact, is discontinuous and therefore there is not regularity in the pace of the familial life (meals, sleep etc.), nor guarantee of having the primary needs fulfilled with continuity.

Collecting informationFollowing the proposed theoretical model, the situation analysis will be conducted to gather information rather than news. The term “news” means an objective language offering contents that reconstruct chronicle elements, while the word “information” is here referred to a meta-language because it comments the relationships facilitating a better organisation.

The focus is turned to the present time and to those relationships the user is experiencing within the system they belong to or other significant systems. From the past are considered relevant those events which changed the personal or systemic history distinguishing actual from relational facts.

The target proposed by this research is to discover the relationships structured between individual and context, highlighting those ones which are functional or dysfunctional and in relation to what they assume this characteristic. The data gathering is therefore aimed to understand the single situation: as stated by Cirillo ( 1986, p. 15) «[…] nothing can be done (pay bills, find a job, speak with teachers, apply for council housing, etc.) without understanding the origin of the crisis experienced by the family». That implies to comprehend the specific peculiarities of difficult conditions (cultural, social, economic) the familial unit is experiencing which are nevertheless common to others.

The decision to ask an external help is indicative of the fact that one or more members of the family consider the system not sufficiently functional to allow them to maintain the kind of relationships they like with the other members of the family. This view can lead to behaviours that will involve therapists or social advisors into a relationship with the familial system

first contactbuild a meaningful relationship with the client;allow the client to explicate the requests;define whether it pertains to social services;understand possible implicit requests;

first contactdetect the minimum number of people significantly involved in the problem (in order to decide whom to talk to after the first contact with the client);formulate a general hypothesis about the game that is taking place in the family.

Important informationpersonal data of the client and his/her family;information about the environmental and social context;the referrer information concerning the problem;request analysis

QUESTIONS CONCERNING THE PROBLEM

How long are you experiencing this problem?Whom this situation is a problem for?, what does it entail?Who is involved, as part of a wider context (relatives, friend, institutions and other relevant systems) in the problem?What has been done to solve it? By whom?

QUESTIONS CONCERNING THE PROBLEM

Which effects have these attempts had? If not effective, especially in case of chronic situations, why the attempted solutions have not had the expected results?Which are the relational networks the family generally access to?Who is considered as resource?

AssessmentWho has defined this condition, it is a perception/belief of the family, it is the social contexts to define it, there is a formal labelling (e.g. forwarding of TM), or it is the social professional themselves who have connoted the situation that way since the first meeting;Which are the areas where this condition is particularly evident and explicit;What does impede the correct functioning (the pathology in the single person, in the relationships, in the social context is part of, the chronicity, etc.);

Which are the elements that could help the family to function correctly; which aspects can be used; who can be a resource within the family or within the relevant systems where the family is embedded;Through which stages it is possible to obtain a good functioning; are these stages coherent with the family’s resources and system of meanings;How can the system be attracted to start a communication able to promote its evolution.

Which are the elements that could help the family to function correctly; which aspects can be used; who can be a resource within the family or within the relevant systems where the family is embedded;Through which stages it is possible to obtain a good functioning; are these stages coherent with the family’s resources and system of meanings;How can the system be attracted to start a communication able to promote its evolution.

Hypothesis of the family’s functioning.

The information that the social worker has gathered about the crucial areas of the situation permit to elaborate a hypothesis of the family’s functioning by analyzing:the system’s history, accomplishing the operation defined by Bowen (in Haley, 1980) as «to make the calendar speak»;the history of the problem looking at the change undertaken by the system when the problem arose;the history of possible relationships between family and services, where the latter are agencies the family turned to without any success.

instructive perspectiveis based on the idea of unilateral control of the intervention and provides for a strategic approach where, starting from theory, social workers act following a linear logic and where the efficacy of the intervention derives from carrying out technical tools whose scientific validity was previously verified and that are, therefore, considered suitable to produce results if the process is implemented correctly

methods, procedures, tools and techniques are emphasized neglecting the relational and interactive nature of the context, in the second one it is highlighted how «the final outcome does not result from single systems of representation or from the behaviour of single individuals but, rather, from the way these two are coordinated when interactive dynamics are performed» (Fruggeri, 1997, p.185).

social construction perspective

is based on the assumption that «interpersonal relationships and relationships between individuals or groups and environment are mediated by the symbolic activity of the people involved which, in turn, is influenced by those interactions and social memberships characterising the subjects themselves» (Fruggeri, 1997, p.183).

The social worker «will pursue the aim to help, facilitate, modify, educate, and support a person or a familial group, but also these latter will interact pursuing the aims that made them to turn to social agencies». Both of them will start a «communicative process through which negotiate definitions of themselves, of their relationship and of the situation they are involved in» (Fruggeri, 1997, pp.184 -185).

Special attentionTargets and activities must not be confused (e.g. the domiciliary care is an activity whose target is to let the elderly person to remain at home; the professional integration can aim to increase the economic independence, the sense of fulfilment or the self-esteem; the foster care is an intervention whose target is to provide a proper environment for minors). Sometimes the agency, that has requirements of development or of performance quantification, uses the term “target” to address internal activities to implement, but it means implicitly that these activities have always an external recipient, the client, towards whom interventions are planned coherently with the organisational mission.

The project is embedded into a relational context characterized by a prevalent connotation. A project can be developed within a counselling, assistance or control context but that does not mean that different interventions cannot be planned into the project (e.g. within the control context, counselling or assistance interventions can be undertaken as well)

The more the target is generic the more it will be difficult to evaluate its achievement and indicators. It is therefore helpful to articulate with precision the targets into different levels and the recipients. Some targets can derive from the stage in the life cycle that the family is experiencing (to redefine the distances among generations, to assume new roles, to meet the tasks of development), others will be more related to the problem’s typology.

Each target has to be assigned the activities that are necessary to achieve it, the people who will implement these activities, the timing and the indicators.It is important to plan intermediate stages to evaluate the implementation of the project and to make modifications if necessary.

When asking the client to perform some specific tasks, it is necessary to pay particular attention to understand that to modify someone’s behaviour (have a new job or a better accommodation, develop a different relationship), to undertake a task to achieve a target, to fear and/or not to stand possible negative answers, are situations whose logical and complexity levels differ. Therefore, before proposing targets and their respective interventions, it is fundamental to follow a certain criterion of graduality analysing carefully which of these levels the client can find difficulties in, and including particular interventions of clarification and support to help the client to overcome these aspects of the problem.

TO FORMULATE A PROJECT…

Clear definition of the problem in concrete terms;Analysis of the tried solution;Clear definition of the change to be pursued;Formulation and application of a project to obtain the wished change.

Agent of change system

meaning with that the institution or organisation where social workers undertake their activity and that influences with its social mandate as well as with its restrictions and resources the project hypothesis;

Client system

is the person who asks for intervention, who agrees a contract with the social worker and benefits from the undertaken efforts;In the systemic approach is always the all family

Target systemconcerns those people who have to be influenced in order to realize the target of change defined for the client system. It is a variable system including individuals, groups or institutions in relation to the specific case. It can include, sometimes, the organisation social workers belong to when internal changes are necessary to solve the need of the client system; it can also be someone that in a different situation would be considered a useful resource to integrate into the action system (e.g. school, neighbourhood, GP etc.). A proper situation analysis will help to interpret which are the significant interactions within the subjects’ life environment and, in particular, will make it possible to identify the system defined by the problem to differentiate which system has to be considered within the target system from those ones that can be considered as partner of the project within the action system;

Action systemincludes all those people social workers work with in order to reach the targets of change. It is necessary in this case, to identify precisely into the intervention project “who does what and when” defining clearly the relationships and developing collaboration, synergies and interdependence in order to reduce a possible exportation, from the family to the action system, of dysfunctional games with a concrete possibility to introduce, as a result, chronicity into the family/service relationship (cfr. Malagoli Togliatti, 1987). All this requires an adequate ability to work in group, to negotiate and mediate, but also a clear definition of each other roles as well as the use of techniques to raise barriers around the interventions.

Facilitating interventionsThere belong to this class those services that families can access during the transition phases related to the developmental tasks expected within their life cycle. The facilitating intervention is used to integrate or amplify the internal resources of families that are facing a critical event in their history. Day centres for vulnerable people, summer centres, health camps, and family centres are examples of this class of intervention.

Support interventions Their aim is to respond to unpredicted critical events compensating for a lack of resources when facing transitions caused by the events themselves. The lack of resources is only partial and is accompanied by resources existing into other sectors and, therefore, by the chance to activate these latter. Benefit, foster care, domiciliary care, residential care, and day care can be included in this class.

Mediation interventions

In this case families receive the intervention when they are unable to deal successfully with conflicts, especially during a separation. It is supposed that the family owns resources that the intervention aims to reactivate as they are temporarily stuck.

Control and protection interventions

These are interventions provided when violence, abuse or serious incapacity of a family to take care of its members occur. Usually the intervention project provides for a report to the judiciary authority and sometimes the intervention itself results from the request of this latter assuming, therefore, a coercive nature. It is important to consider the complexity of this kind of intervention whose goal is not only to break situations of violence but also to reactivate evolutionary processes for those people who are involved assuming, as a result, a therapeutic nature as well. Because of their complexity and difficulty, these interventions should be developed through multidisciplinary assessments and planning, especially when minors are involved.

Therapeutic interventions They respond to psychopathological discomforts, both in young and in adult people. Like the previous kind of intervention, the therapeutic intervention is embedded into complex projects where usually many services are involved, especially when facing serious psychopathologies such as those related to drug addiction. The target is to modify the relational and interactive dynamics which caused the pathology creating new relational conditions where the family can develop new resources. Since into the Italian context the social worker is not qualified to perform psychotherapeutic activities, their intervention will be of psychosocial counselling to prepare the client to enter into a therapeutic setting, or to integrate and support the activities performed by psychologists and psychiatrists.