Problem Solving in Clinical Social Work

CURRENT THEORETICAL STATUS The roots of problem solving have been reviewed in the historical account of its development, and will now be examined from a different perspective. Although he included it in the last edition of Social Work Treatment, Turner indicated then that he did not see Perlman's conceptualization as a completed theory but rather as a "system of propositions from which hypotheses could be developed and a theory built" (Turner, 1986, p. 7). Compton and Galaway also refer to problem solving as a process or model rather than a theory, and they describe it as "a series of interactions between the client system and the practitioner, involving integration of feeling, thinking and doing, guided by a purpose and directed toward achieving an agreed-upon goal" (1994, p. 43). It is our view that, based on Turner's definition of a practice theory in Chapter 1 of this book, it is now clearly to be viewed as a social work theory. If we accept this, what can we look to as its conceptual foundations? PRINCIPAL CONCEPTS Problem solving is the rational process human beings use to negotiate a world of reality that is extremely complicated and, at times, both unknowable and unpredictable. Therefore, it is not always possible for people to follow the obvious guideline the model sets forth, that one must choose the path that leads most directly to a desired goal. In reviewing this complex picture, DeRoos notes that the rational decisions one makes for problem solving represent a subjective orientation to an incomplete picture of the objective world. This incomplete picture is our representation of objective reality, a simplified model of objective reality. Our actions are then in accordance with the model, not with objective reality (1990, p. 278). Common wisdom and experience seem to indicate to people that they can never know all that they need to know in order to make a "perfect" decision, so they tend to reach for those that are "good enough." Nevertheless, in order to achieve even a modest level of success, information must be assembled and processed, and for this, people use a mental model called a "heuristic." In logic, a heuristic device is a piece of knowledge or "rule of thumb learned by trial and error" (McPeck, 1981, p. 17). Heuristics serve the problem solver as a template for decision making when algorithms would cost too much in the amount of information, processing power, or time needed (DeRoos, 1990, p. 278). Algorithms are procedures that are guaranteed to solve all classes of problems (Gilhooly, 1988, p. 22) and are clearly of much more use in the world of mathematics and science than in the world of human affairs. Wimsatt notes that heuristics have certain characteristics that limit their usefulness as tools. They do not guarantee a correct solution although they cost substantially less in time, money, and effort than an algorithm (assuming that one is available for the specific human situation), and they produce systematic patterns of failure and

error (DeRoos, 1990, p. 278). Despite these limitations, human beings are not as constrained as they might be in their problem solving because, "through the convergent application of multiple heuristics, one increases the likelihood of attaining a desirable outcome" (DeRoos, p. 280); although heuristic correspondence with the real world may be imperfect, it is sufficiently congruent with reality to allow people to function adequately (p. 281). It appears that "heuristic problem solving focuses on the most solution-relevant variables (from the perspective of the problem solver) in a particular situation and ignores other variables. In that manner a very complex process can be coped with" (Osmo & Rosen, 1994, p. 123). In addition to using heuristic devices, human beings need to have knowledge of the world and their specific problematic issue, and the ability to apply this knowledge in a problem-solving process (DeRoos, 1990, p. 278). BASIC ASSUMPTIONS It remained for Compton and Galaway, in 1975, to elaborate upon and expand the basic model that Perlman had first conceptualized nearly twenty years before, and to make their thoughts available to social work students in textbook form. The authors note that their expansion and deepening of the Perlman model resulted in "extending the problem solving process to groups, organizations, and communities and in broadening our model to include more emphasis than one finds in Perlman's work on transactions with and change in other social systems" (1994, p. 49). As Compton and Galaway have theorized extensively about how problem solving works, much of the following material will be drawn from their deliberations (1994). The authors note that all of their assumptions are based on five theories drawn from those related to human development and the transactions people undertake with the social environment. These theories include systems theory, communications theory, role theory, ego psychology, and concepts of human diversity (1994, p. 57). Among the many assumptions they make, one is that problems in living do not represent weakness and failure on the part of a client, but rather are the outcome of a natural process of human growth and change (1994, p. 44). If problems are an inevitable part of life, the capacity to solve them is also accessible to people. The process may be blocked for clients because they lack knowledge, have inadequate resources, or experience emotional responses that impair their ability to problem solve. However, as part of the problem-solving method, the social worker consciously works at creating a collaborative relationship that can be used to motivate and support clients to do the hard work of thinking and feeling through their problematic situation. The relationship between client and worker in all modalities of practice is a source of encouragement and creative thinking in the problem-solving process. Of this Compton and Galaway say: Relationship is the medium of emotions and attitudes that acts to sustain the problem solving process as practitioner and client work together toward some purpose. Thus ... the problem solving process can be thought of as operating

through a partnership resting on the ability of each partner to relate and communicate with the other (1994, p. 43). Clearly, the assumption is that client and worker will be able to communicate about problems, goals, resources, planning, and implementation. However, the authors are firm that the "burden of rational headwork lies with the practitioner, not the client," so although clients could benefit from learning the problem-solving process, there is no expectation that they must bring that knowledge with them to the helping interaction. In fact, the position is taken by some problemsolving theorists that clients experience some of their problems in living because they lack well-developed problem-solving skills. For example, Hepworth and Larsen devote a chapter of their text to outlining a method for teaching problem-solving skills to clients who lack this experience so that they can apply it in daily interactions (Hepworth & Larsen, 1990, pp. 415^424). Hepworth and Larsen outline the assumptions they make about teaching problem solving as follows: (1) people want to control their own lives and to feel competent to master the tasks they see as important; (2) motivation for change rests on some integration between a system's goal and its hopecomfort imbalance; (3) the social worker is always engaged in attempting to have some interactions or transactions with or among systems; (4) systems are open, and input across their boundaries is critical for their growth and change; (5) while a system must have a steady state for its functioning, it is constantly in flux; and (6) all human systems are purposive and goal seeking (1990, p. 57). USING PROBLEM SOLVING TO ACHIEVE CHANGE Compton and Galaway make the point that while the written description of problem solving is linear in nature, the application of the model in real life situations is circular. In any of the stages, the worker or client could loop back to an earlier stage or forward to a step that lies in the future, if the circumstances require it. The process is flexible in nature, allowing considerable latitude in its application. A modified summary of Compton and Galaway's short form outline of the problem-solving model follows. The longer form maintains the basic sequence, but elaborates on each step (Compton & Galaway, 1994, pp. 59-61).
PROBLEM-SOL VING MODEL

I.

Contact Phase A. Problem identificationas seen by client, others, and worker. Problem for work is defined.

B. Goal identificationshort- and long-term goals stated. What does client wish for or need? What resources are available? C. Contractpreliminary in nature as it consists of clarifying the agency's resources and committing to further study of the problem. D. Explorationof the client's motivation, opportunities, and capacities.

II. Contract Phase A. Assessment and evaluation

How are problems related to needs of client system? What factors contribute to the creating and maintaining of the problem? What resources and strengths does client have? What knowledge and principles could be applied from social work practice? How can the facts best be organized within a theoretical framework in order to resolve the problem? B. Formulation of a plan of action Set reachable goals Examine alternatives and their likely outcomes Determine appropriate method of service Identify focus of change efforts Clarify roles of work and client C. Prognosiswhat is worker's hope for success?

III. Action Phase A. Carrying out the plan Specify point of intervention and assign tasks Identify resources and services to be used Indicate who is to do what and when B. Termination Evaluate with client system accomplishments and their meaning Learn with client about reasons for lack of success Talk about ways to maintain gains Cope with ending of relationship Review supports in natural network C. Evaluation A continual process throughout contact Were purposes accomplished? Were appropriate methods chosen to induce change? What has client learned that can be used in ongoing problem solving? What can worker learn to help with similar cases? PROBLEMS WITH APPLYING THE MODEL One of the difficulties in applying problem solving to real-life situations is that it is too challenging to process all of the information called for in the various stages (Osmo & Rosen, 1994, p. 123) and as a consequence, people choose the solution that best satisfies, although it may be far from optimal. In a more specific analysis, Johnson and Johnson identify the blocks that exist to using problem solving effectively in groups. However, with some accommodation,
the issues they raise relate to problem solving in all human contexts (1975, pp. 269270). Their list follows: 1. Lack of clarity in stating the problem: this step requires time, as the process is bound to fail if people attempt to solve the wrong problem, or

one that is only partially defined. 2. Not getting the needed information: minimal information results in poor problem definition, fewer alternative strategies, with consequences inaccurately predicted. 3. Poor communication among those involved in the process: communication is central to the entire method from definition to task allocation, so clarity and comprehensiveness must remain goals of the interchange. 4. Premature choice or testing of alternative strategies: when the process discourages creative thinking and free expression, a direction which has not been thoroughly discussed might be chosen. 5. Climate in which decisions are made is critical or demands conformity: such a situation violates the self-determination value of social work and impoverishes the process. 6. Lack of skills in problem solving: people can be trained to use the method in the context of their current problem. 7. Motivation is lacking: people who problem solve must have some need to change their situation and hope that it can be changed. Pressure to change may come from many sources, but the experience of engaging in the process itself can generate hope.

TREATMENT: PRINCIPAL THERAPEUTIC CONCEPTS

In the early conceptualization of this approach, Perlman conceived of problem solving as her contribution to what social casework should be. In that conceptualization, it was clearly seen as a process rather than a goal and much effort was put into thinking about how to make the process happen. For her, the process involved an active engagement of the client in recognition and ownership of the problem. She was strongly influenced by the work of John Dewey and his conviction that learning was problem solving (Perlman, 1957, p. 247). This notion fits very well with Perlman's own conviction that social work practice had to move away from an overemphasis on pathology to an increased recognition of the health or the strengths the client possessed to deal with the problem. This was also a good fit with Perlman's original position, in which she did not see the problem as intrapsychic or within the client, but primarily as a problem or problems in daily living that impeded the level of satisfaction the client experienced in daily activities. Thus, the problem-solving process is a tool for resolving problems that arise in the course of everyday life (Bunston, 1985) and impede the level of satisfaction persons experience in their daily activities.

Hepworth and Larsen outline the assumptions they make about teaching problem solving as follows: (1) people want to control their own lives and to feel competent to master the tasks they see as important; (2) motivation for change rests on some integration between a system's goal and its hope-comfort imbalance; (3) the social worker is always engaged in attempting to have some interactions or transactions with or among systems; (4) systems are open, and input across their boundaries is critical for their growth and change; (5) while a system must have a steady state for its functioning, it is constantly in flux; and (6) all human systems are purposive and goal seeking (1990, p. 57).

I.

Contact Phase A. Problem identificationas seen by client, others, and worker. Problem for work is defined.

B. Goal identificationshort- and long-term goals stated. What does client wish for or need? What resources are available? C. Contractpreliminary in nature as it consists of clarifying the agency's resources and committing to further study of the problem. C. Explorationof the client's motivation, opportunities, and capacities.

II. Contract Phase A. Assessment and evaluation How are problems related to needs of client system? What factors contribute to the creating and maintaining of the problem? What resources and strengths does client have? What knowledge and principles could be applied from social work practice? How can the facts best be organized within a theoretical framework in order to resolve the problem? B. Formulation of a plan of

action

Set reachable goals

Examine alternatives and their likely outcomes Determine appropriate method of service Identify focus of change efforts Clarify roles of work and client C. Prognosiswhat is worker's hope for success?

III. Action Phase A. Carrying out the plan Specify point of intervention and assign tasks Identify resources and services to be used Indicate who is to do what and when B. Termination Evaluate with client system accomplishments and their meaning Learn with client about reasons for lack of success Talk about ways to maintain gains Cope with ending of relationship Review supports in natural network C. Evaluation A continual process throughout contact Were purposes accomplished? Were appropriate methods chosen to induce change? What has client learned that can be used in ongoing problem solving? What can worker learn to help with similar cases?

LIMITATIONS

1. Lack of clarity in stating the problem : this step requires time, as the process is bound to fail if people attempt to solve the wrong problem, or one that is only partially defined. 2. Not getting the needed information: minimal information results in poor problem definition, fewer alternative strategies, with consequences inaccurately predicted. 3. Poor communication among those involved in the process: communication is central to the entire method from definition

to task allocation, so clarity and comprehensiveness must remain goals of the interchange. 4. Premature choice or testing of alternative strategies: when the process discourages creative thinking and free expression, a direction which has not been thoroughly discussed might be chosen. 5. Climate in which decisions are made is critical or demands conformity: such a situation violates the self-determination value of social work and impoverishes the process. 6. Lack of skills in problem solving: people can be trained to use the method in the context of their current problem. 7. Motivation is lacking: people who problem solve must have some need to change their situation and hope that it can be changed. Pressure to change may come from many sources, but the experience of engaging in the process itself can generate hope.