Description
Please answer the following questions:1. Your book introduces the theories of Abraham Maslow and his hierarchy of needs. The theory suggests that very poor people struggling to survive do not pay attention to the higher needs of belongingness, love, and esteem, because all of their energy has to go to survival: food, clothing, shelter. What do you think, and why? Provide at least 2 examples to explain your answer. (textbook) 2. The almshouse of the 19th century and the Social Security Act were each created to address the problem of poverty. Each reflects the attitude of society toward poverty at that time. Explain how these two approaches differ.3. Please choose the multiple choice answer then explain your reasoning why.(1.) The Elizabethan poor laws created the first government sponsored human service system which created categories of poor people. Which group does NOT to to the almshouse? (a) orphaned or abandoned children (b) the disabled (c) the poor who could not work (d) the elderly.(2) In the 18th century, when poorhouses and almshouses were expanding, what theory led to the belief that citizens should not help the disadvantaged, because they must help themselves and or perish? (a) less eligibility (b) social Darwinism (c) worthy and unworthy poor (d) laizzez faire (3) Social reform in the U.S. in the late 1800’s and early 1900’s was a direct reaction to what historical event(s)? (a) industrialization (b) immigration (c) urbanization (d) all of these4. Answer the following. (1) What best describes the human services perspective? (a) society must care for the worthy poor (b) the poor are weak and therefore need our support (c) the problems of the poor are environmentally or socially based (d) more government is better in order to care for the poor(2) The most important piece of legislation passed by Roosevelt in 1935 to alleviate the income problems of the aged, blind, and disabled was (a) medicare (b) social security (c) medicaid (d) food stamps(3) Which of the following would NOT be classified as a human service organization? (a) the family (b) a nursing home (c) mental hospital (d) a child care agency5. Based on what you have learned about the need for mental health services, discuss what you believe are relevant obstacles in finding treatment for a person suffering with co-occurring mental illness and substance abuse in no less than three paragraphs, please discuss potential solutions to these articles. Please make sure everything is in numerical order and cited!Groups
in Need
Who are the poor?
• Relative lack of money,
resources, & possessions
• Those who have suffered a
temporary setback –
reducing their ability to be
self-supporting.
• Can you think of some examples…
Who are the poor?
• The middle class fell into the
lower class
• Widening gap between rich &
poor and the ranks of poor
people swelled
• Wage Gaps
• Women & Minorities
• Lower wages – serious
consequences on economic
security for these families
• Impact trickles down to the
children
Welfare
• How a society insures against the risks
inherent in human life – unemployment,
poverty, sickness, and old age.
• Collection of programs designed to
assure economic security to all citizens
by guaranteeing the fundamental
necessities of life: food, shelter, medical
care, protection in childhood and old age.
Social Welfare Programs & Policies
• Public Assistance
• Food Stamps & Vouchers
• Housing Subsidies
• Child Care
• Medical Care
• Social Security
• Unemployment & Workers’
Compensation
• Veterans Benefits
Programs for the Poor
• Aid to Dependent Children, a
federalization of state mothers’
pensions, which became Aid to Families
with Dependent Children (AFDC)
• Temporary Assistance for Needy
Families (TANF) would later replace
AFDC
What most Americans referred to as
‘welfare’
Children in Need
• Changing family dynamic
• Fewer parental resources – less time, money, and
stress induced by the single-parent family
• Parents must take on role of mother & father while
balancing work – creating stress in the family.
• Children from single-parent families are at greater
risk for mental illness, violence, drug use, and suicide.
Unemployment
• Changes in the Economy
• The economy has a powerful influence on what kind of social
welfare a society provides
• Transnational corporations are dominating national as well as
international economies
• The Recession
• More money was invested in the financial market than in
production
• Unemployment
• Unemployment insurance is generally extended beyond the
usual twenty-six weeks
• In times of persistent joblessness
Children in Need
Poverty
Illness
Disassociation
Emotional Distress
Abuse & Neglect
Physical abuse
Sexual abuse
Emotional assaults
Abandonment
Maltreatment
Domestic Violence
• Who are the victims?
• Types?
• Physical violence
• Emotional abuse
• Why don’t they leave?
1-800-799-SAFE (7233)
Senior Citizens
• We have a growing populations of
seniors
• Baby Boomers started turning 65 in 2011 and will
double in numbers by 2050
• Those 85 years and older also experiencing rapid
growth
• What is the influence on human services
programs?
Social Security
• First known as the Old-Age, Survivors, & Disability Insurance.
• For many years both social insurance and unemployment
insurance discriminated against African Americans and
women.
• Largely as a result of Social Security’s benefits, the elderly,
who, as late as 1960, had a poverty rate three times that of
any other age group, by the late 1970s were less likely to be
poor than any other Americans.
People with Disabilities
Intellectual Disability (ID)
• Intellectual and adaptive limitations
• Characterized by deficits in general mental abilities:
Reasoning, problem solving, planning, judgement,
academic learning
• Occurs before the age of 18
Developmental Disability (DD)
• Severe & chronic – likely to continue for the rest of
their lives
IE: Down syndrome, autism, cerebral palsy
• Onset before the age of 18
• Limitations in daily living skills
• Need for individually planned & coordinated services
Trends in Mental Health
Care
Institutionalization vs. Community
Mental Health
1. Inpatient Care
2. Outpatient Care
3. Partial Hospitalization
4. Emergency Care
5. Consultation, Education, &
Information
Mental Health Care
• What services are needed in the community?
• Housing
• Outreach
• Hospitalization Readmission
• Skills of Living
People with Mental
Illness
• Involves feeling states, perceptions, & behaviors that only
sometimes depart from “normal” range.
• Mental Illness is a “catchall” term including everything from
serious mental illness (SMI) to temporary emotional upsets.
• Prevalence – 30% of adults and 17% children and
adolescences in the U.S. display serious emotional
disturbances and are in need of treatment (U.S. DHHS, 2010)
• Recent trends:
• People with SMI such as schizophrenia, and those with substance
abuse disorders are increasingly seeking psychotherapy.
• Expansion of medical health insurance for therapy has allowed people
of all economic levels, to include minorities, access to treatment.
Substance Abuse
• Addictive substances can be legal or illegal.
• Tobacco has been named “one of the biggest
public health threats the world has ever faced”
World Health Organization (WHO), 2011
• Alcohol follows 2nd to tobacco as a major legal
chemical addiction
• Heroine and other opioids are the #1 drug issue
across the country.
• Highly addictive, cheap, easy to score.
• Many start using legal over-then-counter
medications to relieve chronic physical and/or
psychological pain.
Co-Occurring Disorders
• Often referred as “dual-diagnoses” or
‘dual disorders”
• Both diagnoses are considered “Axis 1”
in the DSM V and are entered together
as coexisting
• Category most often used for those with
substance use disorders in and mental
illness
• Common in the veteran community
• Let’s discuss obstacles to treatment…
Obstacles to Treatment
• Clinically appropriate services –
• Funding streams –
• Education & training –
• Patient issues –
Integrated Treatment
Plan
• Establishment of both the mental health and substance
abuse services within the same agency
• Providing psychotherapy & substance abuse counseling
IE: Thrive Recovery Center
• Establishing an agreed-upon treatment plan that addresses
specific goals for behavior change.
• Identifies the best counseling modality with the patient
(individual and/or group).
• Provides community resources such as AA, NA, etc.
• Maintains a resource list of referral agencies & personnel
to case manage other life area needs such as housing,
employment, benefits, medical care, etc.
Criminals
• Juvenile Offenders
• Often have criminal parents
• Lower IQ / levels of education
• Live in emotionally cold, discordant families
• Reside in poor, disorderly communities
• Begin misconduct at an early age
• Use drugs and/or alcohol
• Adult Offenders
The Homeless
• How do you see the homeless?
• What are the stereotypes –Are they
lazy? Addicted to substances?
Mentally ill?
Circumstances that may lead to
homelessness include:
• Unemployment / underemployment
• Lack of affordable housing
• Loss of public assistance
• Eviction
• Natural disasters
Summary
• Target populations are usually underserved and
misrepresented.
• Note that each population there is overlap of
issues among the groups.
• Disproportionately – poverty and aging population
are associated with mental & physical disorders.
• Substance abuse and co-occurring disorders result
in a weight on the community.
Prevention/intervention models of community care
will assist in relieving many of the social issues.
HS 215
Human Services
Network of programs and agencies designed
to meet human needs.
Who sponsors these programs and
agencies? The answer to this question provides the framework for
reviewing the history of human services.
Religious Institution
Government
Wealthy Class
Business Class
In India, Ayurveda, a traditional holistic health
care system, older than any other system of
medicine, has been practiced in India since at least
3000 BC.
Sanitary engineering was practiced. By 2500 BC,
the people had water borne toilets in each house
which were linked with drains covered with burnt
clay bricks. To facilitate operations and
maintenance, it had man-hole covers, chambers
etc.
2000 BC Yorubic medicine
practiced in West Africa,
consisted mainly of
herbology. This medicine
was a synthesis of
Egyptian and ancient
African tribal practices for
healing.
It still permeates the
Caribbean today, brought
there by slaves, and then
mixed with Catholic
beliefs.
Egypt passed one of the earliest temperance acts in 1000
BC –”Don’t drink yourself helpless in the beer garden. You
speak and you don’t know what you are saying. If you fall
down and break your limbs, no one will help you. And your
drinking companions will get up and say, ‘Away with this
drunkard.”
The Chinese, the Hebrews, the Greeks, all developed codes
related to public health, but human services were still
mostly the responsibility of the individual.
The Romans did however keep statistics, which aids
in planning. They put more emphasis on engineering
structures for public safety and health. Consider the
public baths, aqueducts, paved streets, street
cleaning, protected water supply, sewer systems.
They planned for cities, rather than for families, and
thus their communities grew far larger than the
Greek colonies.
200-475: From early on, the message was
one of help for the poor.
However, in this same time period, the
plagues arrived and the growth of
Christianity led to a belief in turning to faith
and prayer for the answers, not to
physicians or government leaders.
Whereas, the Romans at least tried to
understand disease, the early Christian thinkers
relegated disease to the work of the demons.
The period from 476 AD to 1000 AD is the
period of time when science took a back seat to
spirituality. The clergy were the only educated
class. Even the human body when naked was
considered sinful. Thus care of the body was
neglected. People seldom bathed. The more you
could forget about your body, the holier you
were. Perfumes covered body odor; spices
covered food spoilage.
This conflict between Faith and
Science continues to this day.
When Constantine I
legalized the Christian
Church, the newly
legitimized church set
up poorhouses, homes
for the aged, hospitals,
and orphanages. These
were often funded, at
least in part, from grants
from the Empire.
Initially, the Church
sponsored and
developed institutions
for the poor, mentally ill,
orphaned, aged,
disabled, within the
walls of monasteries.
Eventually these moved
off site.
From the earliest days of
the Church, the expressed
belief was that the
wealthy or those with
adequate resources had a
responsibility to help the
less fortunate. Those less
fortunate began to expect
this assistance, and a
clear distinction in class
developed.
By 590 AD the church
had a system for
circulating the
consumables to the
poor: associated with
each parish was a
diaconium or office of
the deacon.
The clergy of the church
maintained this role for
many centuries.
During the Middle Ages,
the Christian church had
vast influence on
European society and
charity was considered to
be a responsibility and a
sign of one’s piety. This
charity was in the form of
direct relief (for example,
giving money, food, or
other material goods to
alleviate a particular
need), as opposed to
trying to change the root
causes of poverty.
Beginning in Italy, this
revival of an emphasis
on learning, and a
movement away from
spiritualism to reality.
The spirit of inquiry
started to shift the
balance from the
Church and
spirituality to Science
and Government.
As government took over more of the
fundraising previously managed by the Church
in the form of church tithes, the State wanted
control over this money, mostly for waging war,
so Govt. made it illegal to give money or
services to those who could work.
Thus begins the notion of the worthy poor,
those who deserve our help (disabled, seniors,
children) and those who do not deserve our
help. Churches were only to help the worthy
poor.
Henry VIII as part of his
plan to take over he
Church in England, set
up the first government
sponsored structure for
income maintenance
and public welfare.
(1536)
Why?
By 1601 the
Elizabethan Poor Laws
were passed, codifying
this structure of
shelter and food for
the poor.
These were a kind of
social control as well
responding to a time of
significant upheaval.
Three Categories
Poor who were capable
of work
Poor who were
incapable of work
because of age,
disability or
motherhood
responsibilities
Orphaned or
abandoned children
Workhouse: for those
capable of work:
massive overcrowding,
filth, inadequate food
Poorhouse or
Almshouse: for those
incapable of work,
mostly the same
conditions
During these early
years, villages in
England could also
allow families to stay
in their homes, and get
home relief. They
never got cash but
donations of food and
clothing.
The 1834 Amendment
forced local
government to give up
home relief, and the
poor to go into
workhouses.
These Victorian era
workhouses were as
bad as depicted in
Charles Dickens.
“Workhouses were funded by the government and the
government gave the workhouse masters absolutely tiny
budgets to run institutions the size of prisons! In order
to feed and clothe and house their hundreds of inmates,
workhouse masters had to scrimp, save, stretch and
squeeze every single penny for all it was worth. If this
meant serving substandard food or providing barelydecent sleeping-quarters or if this meant not giving the
inmates roast turkey at Christmas…that was what they
did. The fact that the workhouse masters and matrons
were not paid much for their depressing work only made
them even more corruptable, and it wasn’t unknown for
masters and matrons to dip their fingers into the
cashbox and help themselves to the workhouse’s funds.”
Nobody came to the
workhouse for food.
Prison food was
generally considered
better. Some residents
committed petty
crimes in order to get
to the prison housing
and food.
Worst of all were lying-in mothers recovering after
the birth of children. In some workhouses these
women were given a diet of fluids until the seventh
day after the birth of their children. They were then
returned to normal diet, without any supplements
or special treatment.
In addition single mothers were often discriminated
against. In some places any additional items to the
diet allowed for new mothers, such as tea and sugar
or toast and water, were not given to those who had
had illegitimate children.
Condemned Idleness
John Calvin influence
Rule of less eligibility
Effect of laizzez faire
economy
View of human
services as misguided
societal gift
Social Darwinism
In the U.S., conditions
within the institutions
for the poor, orphaned,
mentally ill, disabled,
aged were abominable.
“Extreme” immigration
from 1890-1910 from
southern and eastern
Europe amplified the
need for an urban
response.
IN New York and in other urban centers facing the challenges of immigration and
poverty, a group of women rose up to meet the challenges, when government was so
lacking in response. Jane Addams, the mother of social work, was one of these and
She founded the settlement house, Hull House, in Chicago, along with some of her
Friends. In New York, it was the Henry Street Settlement House, founded by Lillian
Wald. Similarly, many Irish and Italian Catholic nuns opened schools, hospitals and
Orphanages in urban centers and elsewhere.
With the Stock Market
crash of 1929, the U.S.
was sunk into the
economic depression
marked by soup and
bread lines, suicides,
bank failures, the dust
bowl, and dance
marathons (for
money.)
The Charity approach to
relief wasn’t working.
Anarchy threatened.
What happened politically?
The Human
Services
Professional
Humans Helping Humans
Improving the quality of life for populations
we serve.
How can people access help?
How do individual workers choose their roles?
Generalist Workers
Largest number of workers and have
most direct contact with those in need
Perform some of the same duties as
traditional professional – extend of
decision making, level of responsibility,
and range/depth of activities not as
great
© 2012 Pearson Education, Inc. All rights reserved.
What are some of the
generalist professions you
can think of that offer
human services?
© 2012 Pearson Education, Inc. All rights reserved.
Careers in Human Services
Physical Therapy
Occupational Therapy
Dance, Music, & Art Therapy
Clinical Psychology
Helps teach individuals with disabilities “life skills”
Creative Arts Therapy
Rehabilitation of people with disabling conditions
Focuses on treatment of mental & emotional disorders
Counseling
Helps people consider choices & options in life;
preventing or overcoming specific crises
Careers in Human Services
Alcohol & Substance Abuse Counseling
Mental Health Counseling
Newer & distinct addition to HS professions
Social Work
Focus on helping individuals realize to live as full & successful
lie as possible
Emphasize 3 basic methods in the helping process: Individual
Casework, Groups, & Community Organization
Psychiatry
Conduct diagnostic interviews, assessment, & develop
treatment plan specific to the needs of the client
Medical specialty – investigate, diagnose, & treat a range of
mental, emotional, or behavioral disorders
Life Coaching
Another relatively new H.S. occupation that help people define
goals in careers, relationships, health, & personal growth
Training & Education
Physical Therapy
Occupational Therapy
Creative Arts Therapy
Clinical Psychology
Counseling
Training & Education
Alcohol & Substance Abuse Counseling
Mental Health Counseling
Social Work
Psychiatry
Life Coaching
Oversight
National Organization of Human Services
(NOHS)
Facilitates collaboration among human
services providers; promotes ethical
conduct; fosters excellence in teaching,
research and curriculum planning; promotes
professional development social justice
National Association of Social Workers
(NASW)
American Psychological Association (APA)
Office of Alcohol & Substance Abuse
Services (OASAS)
Values Exercise
What values underlie your desire to help
others?
What social issues do you feel strongly
about?
What would you like to accomplish in
human services?
How do you go about solving personal
problems?
Professional Code of Ethics
Moral correctness
Defines minimal standards of professional
conduct
Ensures human services professionals meet
various standards, requirements, & levels of
competency
Define the scope of responsibility between
the helper and client within a particular field
Overlap exists among the various codes of
ethics; IE: Confidentiality, Privacy, Informed
Consent, Duty to Warn, Self-Determination
NASW Code of Ethics
HS 215
Human Services
Personal Theories
We do this naturally to make
sense of all the stimuli and
experience in our daily lives.
Scientific Theories
These are developed to help us
understand human behavior
and look for ways to effectively
intervene and bring successful
function out of dysfunction.
1. Human behavior is
complex making it
difficult for one theory
to satisfy all cases.
2. Theories often
develop from certain
kinds of behaviors.
3. Different theories
focus on different
levels of observation.
1. Biological: Dysfunction is related to
biological factors such as genetics, abnormal
physical development of the brain, etc.
2. Psychological: Dysfunction is part of an
adaptive struggle to gain gratification of
needs and goals by interacting with the
environment.
3. Social: Dysfunction is related to
powerful influence of social environment.
Which level of observation goes with the
ideology that the individual has to take
responsibility for their dysfunction?
Which level of observation goes with the
ideology that the individual is “victimized
by his or her environment.”?
Religious Approach
Magical Approach
Dysfunction is the
work of evil spirits.
Approach #1:
Medical
Views dysfunction,
especially
psychological
disorders as having a
medical cause, such as
a physical abnormality
or a disease process, or
a personality disorder.
Surgical approaches to
treatment, including
psychosurgery
(lobotomies)
Medical interventions
such as shock therapy
or psychotherapy.
Chemical
interventions
Confinement
Approach #2: Human
Services Model
Goal to improve the
environment of those
who are poor and
showing dysfunctional
behaviors.
If a particular therapy
works, use it. Very
pragmatic.
Uses Hansell’s Theory (1970) to structure
interventions. (see book, pg. 163-164)
Goal is to link client with sources of
satisfaction for missing “needs.”
Problem Solving orientation/ pragmatic
Utilizes many “referral” options
The worker is an advocate, mobilizer,
teacher, and administrator.
Three theories (Models) of Therapeutic
Intervention, straddling both Medical
Model and Human Services Model.
1.
2.
3.
Psychoanalytic Model
Humanistic Model
Behavioristic Model
Rooted in Freud’s theories of Neuroses,
including phobias, obsessions, and
compulsions. The individual is torn
between the neuroses and society’s
demands for control of the impulses,
leading to the dysfunction. Defense
mechanisms reduce this tension, often
manifested as repression, or release
through physical activity or artistic activity.
Associated therapeutic concepts for
psychoanalytic theory
Talking therapy: “on the couch”, emphasis
on past
Free Association, Dream analysis
Transference
Newer concepts theories include:
Mix of past and present orientation
Recent theorists who modified the Freudian
approach include: Karen Horney, Erich Fromm,
Erik Erikson.
Reaction to “animalistic drives” of Freudian
approach, instead emphasizing the unique
qualities of humans, their capacity for
choice and their potential for personal
growth. Emphasis on free will.
Uses holistic perspective, emphasizes
individual’s unique experience.
Therapist is less directive, and emphasizes
strengths approach.
Carl Rogers
Abraham Maslow
Self
Actualization
Hierarchy of
Needs
Self Concept //
Congruence
“What a man can be,
he must be.”
Rooted in animal studies of behavior, it developed
as a reaction to vague reports of individual
sensations and perceptions.
Used theories of classical conditioning (Pavlov)
to look at human behaviors, especially those
related to fear. Behavior is involuntary.
Operant conditioning theories rely on voluntary
choices: rewards and punishments.
B.F. Skinner
Espoused Operant
Conditioning theories to
study behavior. “Freedom is
an illusion.”
John B. Watson
Coined term,
“Behaviorism”
Applied behavioral
principles to
psychological disorders
Aaron Beck: Cognitive
Behavioral Therapy
Not concerned with the cause of the problem. Our
perceptions affect our emotions. Understand false
perceptions.
This therapy helps individual identify these
thoughts and evaluate how realistic they are. Goal
is to change the distortion.
Address problem. Retrain how we think.
CBT can very effective for treating phobias, eating
disorders and anxiety. Brief therapy.
Affordable. Cost effective.
Derived from Scientific field, it can be used in
seeing individuals as subsystems of larger living
systems: family, community, nation.
Issue of interdependency, rather than strict
independence.
This theory informs family therapy.
Can you see its application to the Human Services
perspective on dysfunction? How about to an
agency or department in an organization?
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