Study Questions

1. Modernism, postmodernism, structuralism, post-structuralism, critical realism

2. Enlightenment thinkers believe that reason could help people break free from the
structures of the church and state and in doing so, achieve personal liberation,
societal order, and social progress.
3. ???

4.
a. Reconciliation of social work values
b. Places value of social justice at center stage
c. Does not blame the individual for their difficulties
d. Encourages us to adopt a multi dimensional analysis
e. Ensures social workers recognize the effects of cultural and social
structures on service users lives
f. Values the contribution of local change processes can make in achieving
on social change
5.
a. Collaborative, highly structures, time limited, problem focused
b. Crisis intervention is a form of problem solving used for the treatment of
trauma
c. Joint effort between social worker and service user
d. Develops clients capacities
6. Parton: structures of knowledge, claims and practices through we understand,
explain and decide things. They are frameworks of social organization that make
some actions possible while precluding others.
a. Sets of language practices that shape our thoughts, actions and words
b. Ex. Biomedicine, economics and law

7. What is theory:
• Devised to analyze, predict, or explain the nature or behaviour of a phenomena
that could be used for the basis for action

• It is socially constructed

• Often overlap (Payne)

• Prone to fashion, influenced by forces

 • Informs what we value, do, fund and evaluate as “successful”

8. What is the difference between grand theory and practice theory:

• Grand theories are the philosophical underpinnings that have influence and guide
our practice theory

• Practice theories guide our actions as social workers

9. What would the development of Healy’s “framework of practice” involve for you?
What does yours “look” like now?
• Framework of practice: refers to the combination of formal knowledge and skills
and informal knowledge and skills developed by the social worker in practice

• So basically, how does theory impact your everyday practical work, living, and
view?

10. what are three markers of structuralism

• Power, inequalities, marginalization, class & gender, advocacy, community

• Ex. A parade/rally for disadvantaged youth

11. what might an indigenous approach to knowledge entail?

• promotes health and wellness through a ‘fully ecological’ and holistic approach
based on the Medicine Wheel

• medicine wheel- considers, physical (black-adults), emotional (yellow-children),

mental (white-elders), and spiritual (red-youth)

• It is meant to provide direction and guidance for understanding the process of life
and for striving to achieve well-being

• a pro-active and empowering approach to social intervention with individuals as

well as a self-help tool

• Looks for balance and well being in life. If one of the wheel sections is not in tune
it affects the performance of the others

• Focus on community and accountability.

• Elders are seen as the most valuable to the community because of their ability to
pass down wisdom

• Hierarchy- (can’t really remember and don’t have any notes on it but think…) it
starts with earth, then nature, then elders….

12. what are the waves of systems theories? How are they different?
1) 1st wave: General systems theory
• Developed in the 1930’s, and adopted to social work in the 1960’s

• Transactions between individual and their social environment

• Challenges psychoanalysis by focusing on the current problems and not digging

up the past

• Stemmed from biology

• Encourages sw to pay more attention to environmental change (not just nature)

• Believe that social systems are stable

• Today is used to help client challenge the individualistic focus of dominant

discourses shaping health and welfare services

• Core concepts: homeostasis (balance of human organism), entropy (disorder),

equifinality (multiple ways of achieving desired state), and feedback (from client)

2) 2nd wave: Ecosystems theory

• 1970’s

• Meant to improve and expand on GST

• Make short and long term change

• Central idea: person in the environment

 The Life model

Stage 1: Initial phase

- Create a partnership

- Ask how client sees situation and what they want to achieve

- Clarify your role as the sw

Stage 2: Ongoing phase

- create eco-map (macro, meso, and micro)

- Assess impact of each level

 - Engage client in participation

- Strengthen clients problem solving skills by exploring, guiding and

facilitating

Stage 3: Ending phase

-make sure client know of you ending date in phase one
-encourage client to give feedback of all emotions

3) third wave: Complex systems & chaos theory

• Started in math, physics, and engineering

• Brought to social work by Peile

• Recognition of the complex interactions between individual systems and social

structures

• Systems very sensitive, and much more complex then we thought

• Transactions are non-linear and unpredictable

• Behaviour of the whole system is greater than the sum of its parts (143)

• Change is a usual feature of complex social systems

• Deeper level of patterned order, not random

• The butterfly effect

• Do not see people as victims of their social context; nor see them as entirely free
agents

Jordan Questions 13-19

20. (Page 99-102)

• Reflexive – developed as a way of overcoming the limitations of both evidence
based and reflective traditions of knowledge
o Recognizes that social workers are always making knowledge in practice
o Knowledge and theory use is constantly being constructed in part through
practitioners experiences and also through sources such as our practice
content and formal theoretical base

• Reflective (Schon) – recognition of practitioners lived experience of practice as a

basis for maing and using knowledge in practice.
 o Knowing in action: the process of developing knowledge in practice rather
than applying pre existing theories to it
o Reflection in action: the process of refining knowledge in action so as to
promote new ways of responding to the problems we in encounter in
practice. The capacity to reflect in action is akin to “trial and error”
o Places the practitioners, rather than the academic or researcher at center
stage in knowledge development and use
o Our knowledge is developed through and in action

21. (p117)
• Pre intervention phase: understanding the contect of the intervention (prior to
and during session 1)
• Step 1: Defing target problems (session 1)
• Step 2: Contracting (Session 2)
• Step 3: Problem-solving implementation (Session 3-7)
• Step 4: Termination (Last session)

22. (p103-104) Strengths perspective: it’s based on psychology

23. p 139-140

• An ecomap is a graphic system for viewing the relevant connected case elements
together within a boundary that clarifies for the practitioner, the case system as
the focus of work
• It can enhance client opportunities to participate in the system
• The service provider and the service user work together to gather data about an
analyze the impact of multiple systems on the service users situation
• Many theorist use an ecomap to assist in the assessment process
• Many social workers use the Brofenbrenners approach in which rings represent
different levels (Micro, Macro, Mezzo)

25. Personal Preference

26. Audre Lorde is a Carribean-American write, poet and activist. She criticized first-
wave feminists for only focusing on the white, middle-class experience of women. She is
considered a founder of "black feminism" she focused on the intersectionality of race &
gender and the differences in the female experience

27. pg 197 Post-structuralism: critiques the idea that we can deconstruct a structure
without coming from a specific context. Post-modernism: truth is subjective. Post-
colonialism: a reaction to the idea of superiority/progress

28. pg 206-212 adopt a curious & open, rather than "truth-seeking" position towards the
service user. Seek to assess and transform the narratives that construct our lives, seperate
the person from the problem, extrenalize conversations

29. Black pg 12 group work instills hope, provides cohesion, is altruistic, models
behaviour, promotes interpersonal learning and offers support. Group work is necessary
because of oppressive societal culture which isolates, seperates and creates a feeling of
powerlessness and alienation

30. prescriptive, implements a certain power structure, quantitative, compartmentalizes,

positivist

31. Solution focused: don't focus on the problem, but on the solution,
there is no connection between the problem and solution. Focus on behaviour, orientation
is future, not interested in problem manifestation and pastTask-centred: work on small
parts of the big picture, practical concerns rather than emotional problems

32. Narrative Therapy: influenced by post-modern approach, Foucault, through language

power reveals itself

33. (personal preference based, so you may all choose something different) Task-centred
because you need to solve what immediate practical concerns you can to keep the people
alive and well-nourished

34. (personal preference based, so you may all choose something different) Strengths
Perspective, because it emerged in that field and focuses on skills rather than deficits and
labels

35. Classroom, hospital, police force

36. (personal preference based, so you may all choose something different) Narrative
therapy, because it focuses on the narratives that shape us

37. Both. Grand theories deal with the larger understanding of social phenomena, the
aboriginal worldview qualifies as such, Aboriginal approaches also include practice
concepts Hanohano

CHAPTER 1: Why context matters

• Healy describes social workers as all having a practice purpose

• This is what we think we should do, and how we should do it

• This can conflict with client’s needs, and also employer demands

• She argues that institutional contexts must be understood as integral to how we

practise
 • Social work has variability because:

• 1) it lacks a common knowledge base, and agreed upon ways of building

knowledge

• 2) social work does not have a primary field or organization of practice

(teacher=school, nurse hospital etc)

• 3) the primary task of sw varies by practice context

• Thus when constructing our sense of purpose, we need to be mindful of the

primary task assigned to us within in our practise context

• We need to enhance our capacity to understand, analyse and responde to our

institutional contexts

• We are active in creating contexts too

A Dynamic Approach (p. 5 diagram)

• The institutional context of practice (laws, policies, what we are formally
employed to do)

• The formal professional base (discourse, theories, philosophies, values, formal

skills)

• Practice purpose (formal role description, client and worker characteristics)

• Framework for practice (skills developed by sw in practice, practice wisdom,

acquired knowledge, used ‘on the job’)

• All these influence each other

Discourse of Health and Welfare Institutions

• Discourse: the sets of language practices that shape our thoughts, actions, and our
identities

• Dominant discourse that shape health and welfare: biomedicine, economics,

law(mainstream institutional context), human sciences, psychology, sociology
(formal base of SW), alternative (consumer rights, religion, spirituality)

• A discourse analysis approach encourages us to recognize the diversity of SWP,

contest established ways of viewing and responding to clients needs
 • Discourse can shape SWP, but we can also be aware of the discourse we use

Theories for SWP

• Provide guidance for practice as they identify who should be the focus of practice
and how to go about it practically

• Theories have a more limited scope of influence (compared to discourse)

• Can provide us with insights into the dilemmas facing service users and diversify
our options for responding

• Provide a, rather than the, base for swp.

• Healy takes on a post-modern perspective by saying that all the theories presented
in her book, have pros and cons and that there isn’t one good way to practice

Healy chapter # 5

Theories for practice draw on discourses from other discipline & fields (i.e. AOP from
sociology & consumer rts)

Theory for SW practice

- ideas from service discourses + specific purposes & experiences = Theory for Practice

- i.e. problem solving approaches developed from service users having difficulty
w/adjusting to daily living

Barriers to theory

- traditional forms of theory building have separated theory development from its
application

- reflexive approach to theory – SW use theory & create theory in practice

- intention of theory – enable SW to practice thoughtfully, analytically & creatively

Why theory matters – accountability to service users, employers & funding agencies

- managerial reforms of social services focuses on ‘efficiency’ & ‘effectiveness’.

Theory can:

- improve service quality

- critically examine common sense ways of seeing & doing things

- enhance capacities to explore broader range of practice options

- i.e. Strengths Perspective helps us see clients’ strengths & capacities that might be
invisible to us & others

- helps to assess & enhance quality of services we provide

- can help to reach a wider audience

Evidence based or Critical Reflection

- Evidence based – advocates argue that should be grounded in rational knowledge,

validated through scientific methods

- Sometimes organizations & public require validation

- i.e. Task-centred approach – one of the best known examples of this drive to create
scientifically grounded SW practice

- Evidence based practice theory is effective in child protection, as is high risk & so
requires validation & helps to formulate reasoning & evaluate their own work

- Creates top-down approach (T & White)

- SW – subject & user of knowledge, not maker

- (evidence-based knowledge) technical rationalist approach cannot provide basis for

knowledge development & use in human services

- Decisions are often based on perceptions & feelings as well as material facts (therefore
shit is messy)
- In assessing baby: (whether they are neglected). i,e, curdled milk in bottle, age-
appropriate weight, affection for child

Reflective approach

- knowing in action, reflection in action, development of knowledge in practice as

opposed to pre-existing theories

- intuitive & tacit knowledge is essential at effective practice

Reflection in Action

- through trial & error – good at responding to non-routine events

- practitioner is centre stage, above academic

- our knowledge is developed through action

- intuitive & tacit knowledge could be inaccessible to service users, employers or

funding agencies

Evidence based knowledge

– separates knowledge development from practice

Reflexive Approach

– recognizes SW’s are always making knowledge in practice, but prioritizes experiential
& tacit knowledge over formal knowledge.

– Knowledge & theory use us constructed in part through practitioner experiences,

practice context & formal theoretical base

5 Theories of SW Practice

1. Problem-Solving Perspective

2. Systems Perspective

3. Strengths Perspective
4. AOP

5. Post Modernism, poststructural, & postcolonial

These theories were selected because of…

money & time restraints

more widely applied to service providers, users
relevant to formal knowledge base
extends broadly of SW theory base, through understanding of post theories
Conclusion

SW is constructed through negotiation between

1. institution

2. professional knowledge & skills

3. frameworks of practice

Chap 6 (Jordan)

Chapter 7: Three Waves of Systems Theory

• Systems theory emphasizes the role of these systems in contributing to individual
and community well being
Systems Theories in Context
• It was not until the 1960’s that systems approaches re-emerged as a powerful
theoretical foundation for the profession
The Origins of Systems Theory in Social Work
• First introduced the term systems theory to social work in 1930
• Systems theories provided an intellectual foundation for reintegrating the
psychological and sociological discourses by recognizing that a range of systems
that impact the service user in a myriad of ways
1. The First Wave: General Systems Theory
• The initial proponents of systems theory emphasized its potential to provide
scientific credibility to the profession and to develop an integrated theoretical
foundation that would capture the central elements of social work practice in all
its varied forms
• Apply biological systems theories to the social world
• Biological mechanical and social
• Drawing attention to the transactions between the individual and their social
environment
 • Psychological pathology is considered to be socially and culturally produced
• Today systems perspectives can be used to challenge the individualistic focus of
the dominant discourses shaping health and welfare services
• General Systems Concepts
o Used biological terminology to explain client needs
o Some of the core concepts included transaction, homeostasis, entropy,
equifinality and feedback
2. Second Wave: Ecosystems Perspective
• During the 1970’s, the ecosystems approach to practice superseded general
systems theory
• The parts of the system can never be entirely separated from each other
• Ecology as a useful metaphor for encouraging social workers to focus on
transactions within and across systems and to seek sustainable, not only short
term change
• Person: environment transactions
• Recognize that problems arise because of a poor fit between a persons
environment and his or her needs, capacities, and aspirations
• Does not propose specific intervention methods
The Life Model of Social Work Practice
• The life model is characterized by three stages: the initial phase, the ongoing
phase, and the ending phase
• 1. Initial Phase: Getting Started
o The primary purpose of the initial phase is for the social worker and
service user to establish an active partnership based on mutuality and
reciprocity
o Use of empathy
o Work together to identify and, where necessary, prioritize life stressors
• 2. Ongoing Phase: Working Toward Goals
o Out primary purpose in this phase is to promote adaption in the person:
environment relationship so as to maximize Tracy’s well-being and that of
her child
o Goal clarification, facilitation, coordination, and individual and systemic
advocacy
o Many theorists use an ecomap to assist the assessment process
o The ecomap is a graphic system for viewing the relevant connected case
elements together
o The Practice Process
 Enhance and strengthen service users adaptive capacities and
problem solving abilities
 Promote change at the micro, messo ad macro levels
• 3. Phase Three: The Ending Phase
o A well planned termination of intervention
o Regularly referring to this throughout the intervention process
o Encourage the service user to discuss their responses, such as anger,
 sadness, or relief, about the conclusion of the intervention
3. Third Wave: Complex Systems Theories
• By the late 1990s, a number of social work theorists were applying complex
systems ideas to social work practices
• Complex systems ideas enrich, rather than replace, existing about systems
theories
• Behaviour of the whole system is greater than the sum of its parts
• Use inductive approaches to contribute to evolution to larger complex systems
• Characterized by non-linearity
• General systems theorist suggest that social systems are stable, complexity
theorists argue that change is a usual feature of complex social systems
• Repeatedly self reinforcing feedback
• Characterized by complex behaviour
• The term phase change refers to the moment at which the system switches from
one pattern of complexity to another
• Importance of socialist mathematical knowledge
Strengths and Limitations of Systems Theories in Social Work
Strengths
• They provide a framework for understanding and responding to people in their
environment
• Provide a unifying conceptual foundation for social work as a profession
Weaknesses
• Lack of clarity about core systems concepts
• Absence of both theoretical and empirical justification of systems viewpoints in
practice
• Inconsistencies between social work values and systems theories
• May need to break down into smaller pieces
• Recognizes all information available to us but doe not help s to prioritize it.
 Knowledge & reasoning in SW: educating for humane judgement (Taylor & White)

Paper – suggests ways in which students can be helped to remain in uncertainty &
interrogate their knowledge & case reasoning

Min points:

- educating for certainty is often misplaced

- look at certainty & way its produced in practice

- educational implications of emphasis on certainty before making alternate suggestions

about educating for uncertainty (in reference to SW w/children & families)

- SW often receives conflicting info & interpretations (i.e. Mother, child and previous
case worker)

- i.e. Victoria Climbie key staff failed to process accurately & decisively upon medical
info. On other hand, Laming report stated that SW was criticized for failing to critically
analyze info, given to her by aunt
- Report: SW was too passive & critical for carving too much certainty from
contradictory info

- Through confirmation bias, whereby people will seek out info that supports original
hypothesis, people often miss important info as in case w/Victoria

Producing Certainty (malleability of psych. Theory)

- necessary to interrogate carefully how we use theory to what purpose & to what effect

- we need to consider how popular ‘common sense’ knowledge is invoked to make

determinations about cases

Judgements & Characterization

- SW often strive for certainty

- In many situations, the certain thing is not necessarily the right thing

- SW’s need to stay in uncertainty linger, hold onto doubt

- Many programs promote top-down thinking

- Pressure to ‘handle cases quickly & efficiently’ may predispose SW’s to use formal
knowledge in way that shores up anchor hypothesis when we may instead want to
encourage destabilization

Educating for Uncertainty

- wise judgement under conditions of uncertainty process knowledge & an ability

critically to analyze practice may be equality or more important that dissemination of
formal knowledge
 Uncertainty & self-questioning

- Socratic self-questioning & critical engagement w/role of emotion in making

judgements of value

- Art & literature essential in fostering ‘narrative imagination’ which is essential in

critical engagement

- Through problem based enquiry & action learning models, experiential techniques
(roleplay)

Conclusion

- broader approach that encompasses practical reasoning, emotion, & most of all
intelligence that is disciplined & creative

Arnd-Caddigan & Pozzuto

• Case study in which they examined a SW assessment of a stimulated client
situation, and then interviewed the social worker about her report and impressions
of the case

• It was done to prove that theory is always used. Participant said she didn’t use
theory, although evident proved contrary

Questions
7. What is theory:
• Devised to analyze, predict, or explain the nature or behaviour of a phenomena
that could be used for the basis for action

• It is socially constructed

• Often overlap (Payne)

• Prone to fashion, influenced by forces

• Informs what we value, do, fund and evaluate as “successful”

8. What is the difference between grand theory and practice theory:

• Grand theories are the philosophical underpinnings that have influence and guide
 our practice theory

• Practice theories guide our actions as social workers

9. What would the development of Healy’s “framework of practice” involve for you?
What does yours “look” like now?
• Framework of practice: refers to the combination of formal knowledge and skills
and informal knowledge and skills developed by the social worker in practice

• So basically, how does theory impact your everyday practical work, living, and
view?

10. what are three markers of structuralism

• Power, inequalities, marginalization, class & gender, advocacy, community

• Ex. A parade/rally for disadvantaged youth

11. what might an indigenous approach to knowledge entail?

• promotes health and wellness through a ‘fully ecological’ and holistic approach
based on the Medicine Wheel

• medicine wheel- considers, physical (black-adults), emotional (yellow-children),

mental (white-elders), and spiritual (red-youth)

• It is meant to provide direction and guidance for understanding the process of life
and for striving to achieve well-being

• a pro-active and empowering approach to social intervention with individuals as

well as a self-help tool

• Looks for balance and well being in life. If one of the wheel sections is not in tune
it affects the performance of the others

• Focus on community and accountability.

• Elders are seen as the most valuable to the community because of their ability to
pass down wisdom

• Hierarchy- (can’t really remember and don’t have any notes on it but think…) it
starts with earth, then nature, then elders….

12. what are the waves of systems theories? How are they different?
1) 1st wave: General systems theory
• Developed in the 1930’s, and adopted to social work in the 1960’s

• Transactions between individual and their social environment

 • Challenges psychoanalysis by focusing on the current problems and not digging
up the past

• Stemmed from biology

• Encourages sw to pay more attention to environmental change (not just nature)

• Believe that social systems are stable

• Today is used to help client challenge the individualistic focus of dominant

discourses shaping health and welfare services

• Core concepts: homeostasis (balance of human organism), entropy (disorder),

equifinality (multiple ways of achieving desired state), and feedback (from client)

2) 2nd wave: Ecosystems theory

• 1970’s

• Meant to improve and expand on GST

• Make short and long term change

• Central idea: person in the environment

 The Life model

Stage 1: Initial phase

- Create a partnership

- Ask how client sees situation and what they want to achieve

- Clarify your role as the sw

Stage 2: Ongoing phase

- create eco-map (macro, meso, and micro)

- Assess impact of each level

- Engage client in participation

- Strengthen clients problem solving skills by exploring, guiding and

facilitating

Stage 3: Ending phase

 -make sure client know of you ending date in phase one
-encourage client to give feedback of all emotions

3) third wave: Complex systems & chaos theory

• Started in math, physics, and engineering

• Brought to social work by Peile

• Recognition of the complex interactions between individual systems and social

structures

• Systems very sensitive, and much more complex then we thought

• Transactions are non-linear and unpredictable

• Behaviour of the whole system is greater than the sum of its parts (143)

• Change is a usual feature of complex social systems

• Deeper level of patterned order, not random

• The butterfly effect

• Do not see people as victims of their social context; nor see them as entirely free
agents
Parish, Burry and Pabst: Providing Comprehensive Case Management Services to
Urban Women with HIV/AIDS and Their Families

• Although HIV/Aids does not make any racial, gender or cultural distinctions for
women, particular urban-dwelling women of colour, it represents a challenge that
is unparalleled by any other disease
• Comprehensive, multi-systems case management, including home visits,
transportation, and housing support, provides a means by which problem solving
and advocacy are provided and an effective way of coordinating the use of and
communication among multiple agencies
• Poor women are at a disproportionate risk of HIV/AIDS, regardless of their
lifestyles
• In the face of challenges to survival such as poverty, domestic violence, high-
crime neighborhoods, homelessness, and other difficulties in meeting basic needs,
the management of HIV/AIDS related needs easily becomes compromised. Such
compromises can jeopardize the survival of women
Women's Risk Factors and Case Management Issues
• Case managements has gone through many transitions
• First developed as a means of coordinating the complex needs of recently
deinstitutionalized chronically mentally ill persons, case management has also
evolved into an effective means of coordinating services that are needed by an
array of at risk populations, such as persons with disabilities, elderly people,
cancer patients etc.
• Case management reflects various core social work principles of problem solving
within a clients environmental context and achieving change in the person, the
environment, or both
• Case management provides a crucial means of providing continuity and
coordination of services among various agencies and providers and minimizing
the risk of separate agencies proposing duplicating or contradictory interventions
• Case management is also a means of ensuring accountability for providing
services to clients in need
• Especially when families who are living in chronic poverty are accustomed to and
distrustful of the intrusive elements that are common to many public agencies,
comprehensive case management provided by a single source can both enhance
the effective use of resources and minimize the potentially detrimental
intrusiveness of multiple providers efforts
o Ex. The historical and medical patterns may further contribute to the
reluctance of African American and other women of colour to accept
traditional Western medical treatment protocols
 **Case managers are in an ideal position to advocate and negotiate
systems on behalf of those who need such prescriptions to manage
their medical conditions
• Through effective case management, persons living with HIV/AIDS can be
 provided more comprehensive services to coordinate the complexities od their
medical regimes, find housing, receive adequate nutrition etc.
• Comprehensive case management is also suited to providing he linkages
necessary to sustain abstinence and reduce the risks of relapse in cases involving
substance abuse
The Back to Basics Project
• Initiated in 1999, the back to basics project was a 3 year intervention that was
designed to serve as a national demonstration project
• It provided comprehensive, multi-system case management services to 145
families in an urban mid Atlantic city who had been homeless and ho had a
member whose HIV/Aids status was either newly diagnosed or newly disclosed
• The majority of the families had multiple members with HIV/AIDS
• The project had several major goals
o To provide 80 families with crisis intervention services
 Affordable housing, food, clothing etc.
o Enhance the stability of the participant
o Wanted the participants to become part of a supportive, interactive
community of families with members living with HIV/AIDS
• Back to basics had a focus group for clients where clients and their family
members could discuss both their difficulties and their success

Descriptive Findings
Clients
• 145 families completed the intake process
• The projects original goal of providing service for 80 families over a 3 year period
was exceeded by over 80%
• Most of the clients and their families were in crisis and had an immediate need for
food, clothing and shelter
Rent, Utilities, Housing and Food
• Over 2/3 of the families had histories of delinquent payments of rent that
compromised their eligibility for establishing utility services and or being
accepted for leases
• Other challenges to providing assistance with rent and utilities included the
shrinking rental housing market and clients with criminal backgrounds
• Housing needs: clients housing needs remained a crucial aspect of case
management throughout the project
• Food: during the course of the project 58% needed food once, 25% needed food
twice and 10% needed food on as many as five occasions
Income
• Poverty is a consistently significant issue for women with HIV/AIDS
• Sources of income included;
o Supplemental Security Income
o EI
o Disability funds
o Transitional Emergence Medical Assistance
Out of Home Placements of Children
• Women with HIV/AIDS and a history of homelessness are at a high risk of haing
their children place in out of home care because of their unstable housing and the
potential for medical crises
• It was therefore important that these women identify and establish child care
resources, so that places could be in place if out of home care was necessary
Ongoing HIV/AIDS Education and Support Services
• Back to Basics project was to establish a system of ongoing support services that
would be readily accessible to families.
• At the end of the project several support services were in place, and others were
being developed and pilot tested
Barriers to Achieving Stability
• Four primary barriers in clients achieving stability in the project
o Poverty
o Limitations resulting from poor credit histories
o Difficulty following through on tasks
o Substance abuse
• Other barriers
o Lack of transportation
o Limited housing resources for clients
o Limited follow through on tasks
DISCUSSION AND IMPLICATIONS
• Relatively small caseloads (approx 15) allowed staff to work closely in an
empowering manner with the women to contribute to their movement toward
independence
• The most important implication of this project was the complexity of the lives and
needs of women with HIV/AIDS
• The lives and needs of women with HIV/AIDS are multi-faced and demanding
• The back to basics project provided comprehensive, community based case
management services for women who were otherwise at risk of receiving
inadequate services to meet their needs