SOC 386 Week 4 Discussion: Hamad Sarraf Case Study

Human Behavior and the social environment

DQ 1

Read the Case Example of Hamad Sarraf in Chapter 7 of “Applying Theory to Generalist Social Work Practice.” Discuss two cognitive behavioral theraphy (CBT) strategies and two CSWE competencies/behaviors that are critical for Sarraf as he leads the parenting group.

Case Example: Hamad Sarraf is a parent educator who was hired by a Head Start program after completing his Bachelor of Social Work (BSW) degree. Head Start is a prevention program that supports at-risk youth by providing preschool education, parent training, and case management to help meet the basic needs of the children and families. One of the primary purposes of the program is to prepare a child for kindergarten. Many preschoolers who attend this program demonstrate behavioral problems, including low attention span, conflict with peers, and difficulty following the program rules. These challenges could hinder a child’s success when entering elementary school. Hamad’s job is to meet with parents both individually and in a group setting to respond to these behavioral challenges by providing support and education for the parents.

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There are many ways in which Hamad applies the principles of cognitive and behavioral theories in this work as a parent educator. As one example, he provides psychoeducation when he meets one on one with parents and when he facilitates the parenting group on Thursday evenings. Psychoeducation for parents involves teaching families about how to create an environment that supports healthy functioning of a child (Corcoran, 2003). Parent skill training according to cognitivebehavioral theories involves (a) helping parents shape positive behavior in their children by setting up reinforcement schedules and (b) replacing unhelpful thinking patterns with parenting schemas that support effective parenting. SOC 386 Week 4 Discussion: Hamad Sarraf Case Study

On Thursday, Hamad started his first parenting group. Six single parents and three partnered couples attended the group to learn about how this Head Start program can support their parenting. Hamad chose to start the group by using Socratic questioning, asking the parents to discuss what they see as their primary purpose as a parent. This question offered an exploration of automatic thoughts and core beliefs that inform parenting strategy. The parents discussed a series of thoughts ranging from a primary focus of safety to one of responsibility to teach their children how to develop into productive citizens within their communities.

Although most of this conversation was quite positive, one mother appeared frustrated by the group experience. Brenda Davis, an African American grandmother, was raising her three grandchildren, and the youngest was enrolled in the Head Start program. When Hamad asked Brenda for her thoughts about parenting, she asked in return, “Can I ask you something? How old are you, and do you even have any kids of your own?” Hamad, a 23-year-old recent BSW graduate of Iranian descent did not have children and was raised in a small rural town, quite different from the large metropolitan area in which this Head Start program resided.

Hidden in Brenda’s comments was a fear that this young man, whose experiences in terms of his race, culture, and lack of parenting history were so different from Brenda’s own, may make him unhelpful as a leader of a parent education group. This fear may be warranted based on Brenda’s previous experiences. Hamad responded to Brenda’s question openly and respectfully, stating, “I am happy to answer your questions. But first, can you tell me a little bit about what about this information is important for you?” This question is a way of understanding Brenda’s position. It also offers an exploration about her thinking patterns, her past experiences, and how these inform this current interaction.

Brenda explained to the group that she had been in previous groups with young, inexperienced social workers who she felt did not understand the challenges of being a grandmother raising three African American young men in a community that was primarily Latino and white. She stated that she has felt judged and unsupported by previous service providers and therefore did not trust that this group experience would be helpful for her. Hamad first modeled open communication listening closely to Brenda’s concern. Rather than trying to defend his ability to lead the group, he validated Brenda’s concern through minimal encouragers and nonverbal responses that demonstrated he was interested in hearing her concerns.

As he encouraged Brenda to speak further, it became clear that Brenda’s thinking about this group was based on previous negative or ineffective experiences. It is not unusual for clients to enter a new helping relationship with concerns grounded in previous negative experiences, leading to automatic thoughts about a current helping relationship. Hamad took this opportunity to understand the thinking processes on which Brenda’s initial question was grounded. He used the microskill of summarization to reflect Brenda’s concern and acknowledged how frustrating it must be to have such extensive yet unvalued parenting experience as a mother and grandmother.

As a way of restructuring her thoughts, Hamad behaved in a way that was different from Brenda’s past experience. He acknowledged Brenda’s expertise and then responded to her initial question, stating that he was young, did not have children, and would not pretend to have more to say about parenting than someone with her history. He then explained that he was a facilitator of the group, that he was there to provide support to parents and facilitate dialogue with the group about parenting, and that he would personally commit to her that her experience was an essential part of this group discussion and that her expertise would be valued. After this exchange, Brenda appeared more comfortable. She stated that she appreciated his honesty and pointed out that his approach was different from previous experiences.

In this exchange, there are several examples of cognitive and behavioral theories. First, Hamad was modeling the type of interaction he was hoping to achieve in the group. Second, this modeling and his direct statement that he would honor Brenda’s experience was a way of restructuring her thought processes about what it means to be in this helping relationship. Hamad was not claiming that all helping relationships moving forward would be positive or would look like the one being established in this group, but he was causing Brenda to view this helping relationship in a different way, thereby increasing her willingness to participate.

Finally, shaping was present. When Hamad reinforced Brenda through supportive interviewing skills, he encouraged the behavior of open dialogue. When Brenda then responded positively to Hamad and thanked him for answering her questions honestly, she in turn was reinforcing his approach. As the group continued, interventions including modeling, shaping, and cognitive restructuring were a part of the content of parent training and were implemented throughout ongoing interactions within the group. SOC 386 Week 4 Discussion: Hamad Sarraf Case Study.

Student Application of Skills As described in Chapter 1, social workers use microskills to facilitate social work interviews. Several basic and advanced interviewing skills have been discussed in this chapter. For example, we discussed the use of Socratic questioning and open-ended questions to uncover unhelpful automatic thoughts and schemas. In contrast, active listening techniques such as reflecting feelings and content may be helpful when seeking to understand the links among cognition, emotions, and behavior. Consider the following questions to increase your understanding of how social work skills are used to implement cognitive and behavioral theories. 1. 2. When social workers use cognitive and behavioral theories, assessment involves collecting information about the duration, severity, and intensity of the problem. What questions might you ask when conducting an assessment with a young mother whose 5-year-old is refusing to attend kindergarten because of anxiety?

Information sharing is an advanced interviewing skill that fosters growth by offering new understanding about a particular topic. Psychoeducation, as discussed earlier in this chapter, is an example from cognitive theory of information sharing. What information might you share with this mother regarding how positive and negative reinforcers may be encouraging her child’s problem behavior? Part of intervention according to cognitive theory involves identifying and restructuring illogical beliefs. You may help the child to imagine what it feels like to walk into kindergarten. The microskill of asking questions might be used to help the child talk about what he is thinking as he imagines entering school. This process is done to uncover automatic negative thoughts. Describe how you would structure this imagery activity to fit the developmental stage of a 5-year-old. Behaviorism suggests behaviors that are reinforced will be increased.

You may intervene in this situation by meeting with the mother to create a reinforcement schedule to encourage her son when he makes the choice to attend school. How would you and the mother work to create this schedule? How would you determine which reinforcements should be included? Compare and contrast what a social worker using cognitive and behavioral theories might be thinking about this case compared with a social worker who is using a strengths perspective. What might be similar and different according to these varied theoretical approaches? How are microskills implemented differently when contrasting cognitive and behavioral theories with a strengths perspective?

Strengths and Limitations of Cognitive and Behavioral Theories As mentioned in Chapter 1, social work has become increasingly interested in identifying and choosing interventions that are identified as effective through research evidence. One of the strongest benefits of choosing CBT is that it has been established through extensive research evidence as effective for anger management (Beck & Fernandez, 1998), depression (Beck & Dozois, 2011), and other psychiatric disorders (Butler, Chapman, Forman, & Beck, 2006). CBT has demonstrated positive effects for children and adolescents (James, James, Cowdrey, Soler, & Choke, 2013), young and middle-age adults (Stewart & Chambless, 2009), and older adults (Shah, Scogin, Presnell, Morthland, & Kaufman, 2013).

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Therefore, CBT is one of the most widely used interventions across social work settings. Cognitive and behavioral theories also offer both an explanation and a corresponding intervention for application with various client groups and social problems. Some people might suggest that cognitive and behavioral theories are well developed. The concepts and underlying principles are relatively clear, increasing the ease of application for many social workers, particularly when training has been provided regarding specific cognitive and behavioral interventions (Shah et al., 2013). However, cognitive and behavioral theories have some important limitations that should be understood. One concern is that they tend to focus on individual functioning and pay little attention to macrosystem influences (Walsh, 2010). As described in Chapter 2, social work values a person-in-environment perspective that considers how the interaction with environment and society provides an important explanation of behavior. Cognitive and behavior theories remain focused on the individual and the closest systems.

For practitioners working on a mezzo practice or macro practice level, cognitive and behavioral theories may be less helpful. Another limitation of cognitive and behavioral theories stems from a concern that by seeking to change thoughts and behavior, these methods can give social workers too much authority. Social work as a profession values self-determination and advocates a client’s right to autonomy. Some people are concerned that an irresponsible use of cognitive and behavioral theories can replicate the experience of colonization through which marginalized groups are required to adapt to the social norms and values of the dominant society. Although some of the theoretical perspectives discussed earlier in this book, such as the strengths perspective, seek to build egalitarian relationships with clients, early implementation of cognitive and behavioral theories was founded in the idea that the expertise for how best to make changes lies within the professional.

This is not to say that all social workers engaging in cognitive and behavioral theories practice according to this assumption. As mentioned in Chapter 1, many workers integrate a set of theories to overcome the limitations of one theory. Integration is one way to address this problem. It is essential that practitioners implement any theory according to social work’s mission and values. To employ the theoretical assumptions of cognitive and behavioral theories, particularly when working with underprivileged groups such as children and people of color, it is essential that social work practitioners understand the potential risk of using cognitive-behavioral interventions in a way that imposes values inconsistent with the worldview of a child, adult, family, or community. SOC 386 Week 4 Discussion: Hamad Sarraf Case Study.

DQ 2

Principles of Cognitive and Behavioral Theory (CBT) are discussed with several examples of how CBT is applied. You are a case manager for a homeless veteran named Sam. What three strategies from CBT would you use and what specifically would you do? What questions would you ask? What would you attempt to implement that helps Sam based on the CBT model.