(Withdrawn) Intervention with Families in Extreme Distress - the Perspective of the Social Workers and the Clients

Background and Purpose: Multi-problem families have always been at the core of the social worker's profession. These families are among the most difficult populations to work with and continue to be a challenge for social workers' intervention as well as for social policy. Multi-problem families defined as "Families in Extreme Distress", and a set of factors characterized these families: Poverty (e.g. debts); housing (e.g. physical neglect); health problems (e.g. chronic diseases); couple functioning (e.g. violence); parental functioning (e.g. lack of boundaries); children (e.g. learning difficulties); substance abuse (e.g. drugs); anti-social behavior (e.g. arrests); support systems (e.g. no family system).

The purpose of the study was to learn about the two points of view: (a) of the clients of welfare departments who are characterized as Families in Extreme Distress, according to a scale for assessing such families, and (b) of the social workers who treat them.

Methods: After receiving ethics approval, we asked social workers of the welfare departments in Israel who agreed to participate in the study, to choose their clients that meet the criteria of Families in Extreme Distress. After receiving the clients’ consent, 13 pairs (dyads) of the clients and their social workers were interviewed using identical questions based on a semi-structured interview. The questions related to the client's main difficulties and the needs of the family, the strengths and resources of the family, and the kinds of help given to the family.

Results: Content analysis revealed several common themes: Difficult economic situation; coping with illness; methods of intervention and help for the families; therapeutic relationships; the strengths of the clients; improvement suggestions.

The comparison between the answers of the clients and the social workers shows three patterns: (1) The same phraseology used by the client and by the social worker. (2) Different wording of the client vs. the social worker. (3) Differences in the perceptions in assessing the situation.

For example, the theme: Difficult economic situation.

The same words - The client: "We needed baby's food, clothing, diapers." The social worker: "They had no money even to buy food for the child".

Different wording - The client: "Sometimes we get stuck without bread, without shopping for Saturday". The social worker: "Lack of resources".

The difference in perceptions -The client: "The economic situation is difficult." The social worker: "Problematic parental functioning".

Conclusions and Implications: It is necessary to create a dialogue which means providing an equal place for social workers and clients to express their ideas and feelings. It is always important to listen to the point of view of the clients, how they phrase their problems and what is important to them. The practical implication is to recommend that social workers enable clients to express themselves about what kind of services they wish to receive and to evaluate the treatment given to them throughout the process. Evaluation of intervention programs can improve social services.