CONTRACTING Chapter 9

Think big but do small. In assessment and contracting this is a good principle to follow. What does this statement mean?

CONTRACTING Assessment naturally flows into contracting. time

Assessment Contracting There is a natural flow in the process that moves into the contract phase. Remember…the assessment and contract phase never really cease until termination. Both are ongoing.

Assessment: Identifying Issues Listening for dominant issues/themes Summarization & try to verify the theme which allows the client to assume ownership Tentative stem + review of summaries + distillation of a dominant theme + check out the accuracy Ex. We seem to be talking about your current relationship from different angles: You report being depressed around your boyfriend You feel your friends’ boyfriend treat them better, and you think you can do better. Seems like all of these things are pointing in the direction of not wanting this relationship. Is that correct?

Reflecting An Issue Demonstration of your understanding of the client view of an identified topic of concern. The identified topic may not remain the focus of work but it is a place to start. Example: “As I understand it, the issue that you would like to address in our work _____________.”

Exercise: Reflect the Client’s Issue I am terribly concerned over my wife. She has this feeling she has to get out of the house and see the world and get a job. I am the breadwinner, and I imagine I have good income. I don’t know what to say to her. She is asking for my input and advice. I am afraid to give it. THERAPIST As you see it, there is(are)….major issues…you would like to address in our work. Together…

Identifying An Issue You might feel compelled to identify an issue which the client has not identified as a focus of concern. Example: From the discussion I have been wondering about____________. What do you think about_________? Is this an issue we should consider.

Identifying an issue... Remember…identifying an issue is the instance where you have detected an issue for work that the client has not directly indicated.

Clarifying Issues for Work Extract these issues from those the client has identified, those you have contributed, or some negotiated combination of the two. I think we agree about the main issues we need to work together on. Let’s review them as I write them down. First, there is the issue of __________. Second, there is ________________. The last thing we identified was ____. What do you think? Is this an accurate list of the issues that we'll address together?" NOTE: Always include the client's opinions on a course of action

Goals Can be anything the client wants to work on, either short or long term. They might include something the client wishes to attain in the future, but does not wish to or cannot work on right now.

Write down what you think are some of the most ‘typical client goals’ encountered in social work practice

Typical, Loosely Defined Client Goals Learn to relax Change or control negative emotions in response to a particular situation, event (loss of a job), or belief Prepare for changes they are likely to have to deal with in the future (children leaving home, parent moving) Eliminate or reduce undesirable behaviors (smoking, obesity) Cope with difficult situations (a difficult boss) Learn new and desirable behaviors (assertiveness) Become more motivated (doing homework between therapy sessions) in dealing with their problems Experiment with ways to manage stressful or anxiety-producing situations (giving a presentation in public) Cope with family members, issues and/or problems

Establishing Objective Goals Use the SMART format for objectives: Specific Measurable Achievable Realistic Timely

Goal: Spending more time with kids… S = Specific “I’d like to spend quality time with my kids more often” M = Measurable “I’d like to spend at least a half an hour a day” A = Attainable “I can work up to spending a half an hour a day over the next month” R = Realistic “I will spend 30 minutes on Monday, Thursday and Friday this week” T = Has a Time Frame “I will start by spending 30 minutes three days this week and then work up to five days in two weeks”

Effective Goals Stated as accomplishments Stated in clear and specific terms Stated in measurable or verifiable terms Realistic - have a reasonable chance of actually happening Adequate. If achieved they will improve the situation. Congruent with the client. Time-specific. There is a realistic time frame or agenda.

Well-Defined Goals Well-defined goals include goals that: Are in the client’s language, Are worded in the positive, Outline the process to achieve them, Are in the here and now, Are as specific as positive, and Are in the client’s control. The table on the next slide summarizes these criteria with sample goals that either meet or do not meet these criteria

Criteria Doesn’t Meet Criteria Meets Criteria 1. In client’s Language “Meet all the requirements of probation by June 10, 2004” "Get done with my probation officer.” 2. Worded Positively “Not use drugs or alcohol.” “Will continue doing activities that support a drug and alcohol free lifestyle.” 3. In the here and now “Will stay clean.” “Will” 4. Specificity “I will avoid or learn to cope with high risk situations” “I will drive my own car to any gathering where I feel that alcohol or drugs will be present, so I may leave if I feel I may use.” 5. In the client’s control “My probation officer will leave me alone.” “I will have done everything I can to get my p.o. to leave me alone.” 6. In process form “I’ll just quit.” “I will be spending more time playing guitar and finding a job.”

Making Goals Specific: Client Worksheet

Facilitating Goal Setting Empower the client to see where he/she wants to do to change. Tentafier + feeling word + perceived limitation + possible goal Ex. It sounds like…you are feeling depressed …because you can’t leave the relationship… because and you are afraid to be alone and you want to be able to . . .

Client belief in possibility of change is an important motivator Client belief in possibility of change is an important motivator. You can help clients look at both the benefits and costs of change. The table below provides an example.

Goal Setting Worksheets The following tools may assist you in setting goals with your clients http://www.roadtowellbeing.ca/worksheets/goal-setting.pdf http://www.educationoasis.com/curriculum/GO_pdf/goal_setting_worksheet.pdf http://apps.cignabehavioral.com/web/basicsite/consumer/educationAndResourceCenter/articleLibrary/working_person11.pdf http://www.cci.health.wa.gov.au/docs/ACFC25D.pdf

Developing an Action Plan The action plan is developed from the goals. You will also need to define your role, or roles, that you will play in the process.

Identifying Action Steps Often the goals are too large to accomplish in a single action. In that case you identify with the client small steps or task which progress toward the goal.

Planning for Evaluation Professional social workers are responsible for evaluating their practice. Regardless of the setting it is possible to formulate some evaluation method that will measure effectiveness of practice.

Planning for Evaluation Goal - Attainment Scaling Kiresuk & Sherman, 1968 This is a practical scale and one that you are encouraged to adopt, in some form, in your professional practice.

Goal-Attainment Scaling 1. Most unfavorable results. 2. Less than expected success. 3. Expected level of success. 4. More than expected 5. Most favorable outcome. Goal Attainment Scale Goal 1 Goal 2 Goal 3 Goal 4 Goal 5

Summarizing the Contract Contract Section of the Description, Assessment, and Contract (DAC) Model III Contract A. Issues. 1. Client-identified issues 2. Worker-identified issues 3. Issues for Work. These are issues that both parties agree to address. B. Goals. Related to the issues for work these are the final outcomes that you will be striving for.

The DAC Model continued... C. Plans 1. Action Plan. In this section summarize that actions that you and the client have planned. Note who, what, when, where, and how. 2. Client Task or Action Steps 3. Worker Task or Action Steps 4. In-Session Tasks or Action Steps 5. Maintenance Task or Action Steps. Outline tasks or activities that will occur on a regular ongoing basis. 6. Evaluative Plan. Outline the means and process by which progress will be evaluated.

Contracting Summary “During the contracting phase of social work practice, you, on the basis of the assessment and in conjunction with the client, attempt to define clearly the issues and goals for work and to develop plans likely to resolve the identified issues and achieve the final goals.”

Review This chapter covered the following main skills for contracting: Reflecting an issue Identifying an issue Clarifying issues for work Establishing goals Developing an action plan Identifying action steps Planning for evaluation Summarizing the contract