"Value-Guided Practice for a Global Society," by Cynthia Bisman

1 Value-Guided Practice for a Global Society An Introduction

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What happens here in the United States affects my family in Mexico and the worth of the euro, and what happens in Africa affects my friends in the United States; we don’t realize how we are all connected. I chose social work to make the world a better place.

—A social worker

his book has been written to extend generalist practice in ways essential to 21st-century demands. It provides readers a comprehensive text that covers the values, knowledge, and skills necessary for all social work practitioners. New definitions and explanations for the established tenets of social work concepts and principles including assessments, relationships, communication, differential use of self, best practices, and interventions are illustrated and integrated with case material for practice guided by the profession’s values and ethics. Recognizing that practice with individuals is the shared foundational skill of every social worker, this comprehensive text is unique among the many on the market in covering what all students need to know for ethical practice with individuals in a world changed by globalization.

I was adopted as a Vietnamese orphan before I was 1 year old. Raised in New York City and licensed to practice social work there, I have never been to Asia. Now I am seeking to adopt a 2-year-old girl whose mother’s custody has been terminated.

Adoption social workers only want to focus on how my Asian heritage will affect my ability to parent. this child, whose birth family came to the United States from Guatemala. I found this frustrating.

There were many areas of concern for me, such as the child’s abuse and trauma; ethnic background was not one of them. Shouldn’t we focus practice on “where the client is”?

—A social worker

Global Consciousness This book explores the topic of global consciousness, introduced as a new construct for the social work profession. The global interconnectedness that increasingly defines the early 21st century has shifted populations and economic structures, requiring innovative ways to think about and implement the welfare state; this demands novel approaches from the social work profession. Toward this end, global consciousness provides an original framework for practice across systems and across ethnic backgrounds and national borders.

Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.

—Margaret Mead, feminist, humanist, cultural anthropologist How could you get back what has disappeared?

—Kiki Dimoula, national poet of Greece The world we have created is a process of our thinking.

It cannot be changed without changing our thinking —Albert Einstein

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Global consciousness prepares social workers for contemporary practice. Extending the important and necessary framework of international social work from its underpinning in nation-states, global consciousness provides a construction to understand a world in which circumscribed national boundaries no longer suggest reasonable assumptions about culture, ethnicity, language, and norms of behavior. Global consciousness allows for practice through a continuous global perspective, regardless of the initial geographic origin or current location of clients and practitioners.

Important contributions of international social work over its long history include recognition of and advocacy for action around international issues concerning domestic practices and policies, troubles shared by nations, dilemmas emerging from large-scale displacements and migrations, and international exchanges. These activities remain relevant and necessary. Global consciousness specifically targets a changed world with boundaries obscured by globalization and technological developments. It considers social work within a context of rapidly changing populations and communities that are now simultaneously local, global, and virtual. Social work practice with a global consciousness incorporates the lens of both geographic and cultural context, drawing from the profession’s values and skills as well as from multidisciplinary knowledge and skills to respect the uniqueness of each person and situation and also to recognize the universality of shared experiences.

In these chapters, global consciousness provides a new paradigm for social work by viewing the global in the local. The National Association of Social Workers (NASW) ethical Standard 6.01 states: “Social workers should promote the general welfare of society, from local to global levels, and the development of people, their communities, and their environments” (National Association of Social Workers [NASW], 2008 [1996], p. 21). Accreditation guidelines set by the Council on Social Work

Education (CSWE) now require international content in the curriculum of U.S. social work programs (Council on Social Work Education, 2008).The term global consciousness has a number of meanings and practices in a range of fields. At Princeton University, global consciousness is a multidisciplinary virtual project that explores linkages between people and the earth while attending to issues of presence and activity of consciousness. The Center for Consciousness Studies in Tucson, Arizona, attends to parapsychology phenomena. Jeremy Rifkin, an economist and international affairs expert, has written numerous books on climate and the environment, offering a reinterpretation of history from an empathic lens of expanded human consciousness. He believes that as technological developments open people up to a wider world, they may also help to create a more caring world: “New developments in global Internet connections suggest that it might be possible to imagine a paradigmatic shift in human thought and a tipping point into global consciousness” (Rifkin, 2009, p. 472). Suárez-Orozco and colleagues’ (2007) approach to this term is closest to the one developed and illustrated in this book with its emphasis on learning and understanding in the global era.

This book develops and uses the following definition of global consciousness for social work: Global consciousness is a recognition of the world as a unity consisting of complex interactions among people across the globe. In viewing the world as one ecological system, global consciousness requires critical thinking and communication that is open and sensitive to multiple meanings for the same phenomena.

For practice with a global consciousness, social workers must be able to 1. Attend to a global society with its complex mixture of people and environments. Social work’s person-in-environment perspective must be broadened across ethnic, racial,

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cultural, and geographic variables, incorporating the profession’s mission of human well-being, which includes both individual and social well-being.

Respect the uniqueness and dignity of all people and advocate for their empowerment.

Through human relationships, social workers advocate for and with clients to foster self-determination and empowerment and to create change in a range of individual and social conditions.

Remain aware of self as simultaneously distinct from and in community with others.

This requires reflexivity—looking outside of oneself from the perspective of another person while at the same time recognizing one’s worldview and membership in particular groups.

Convey curiosity and caring through differential use of self. This demands articulation of one’s biases and personal reactions to client situations, accompanied by flexibility and openness in reaching out to a diverse world.

Embrace critical thinking and critical practice. These are skills of reflection and action in using reasoning, geographic and cultural context, peer-reviewed scholarship, and the profession’s values and skills while also recognizing the client system as the best ethnospecific cultural expert.

Promote communication within and across borders with sensitivity and tolerance for multiple meanings attributed to the same phenomena. Recognition of and respect for differences in languages and cultures and the infinite ways of interpreting events are necessary for one’s own communications as well as for facilitating interactions among and within cultural groups and nation-states.

Global consciousness is an important new construct for social work practice. It provides an extension to international social work made necessary by globalization. Expanding

the profession’s reach beyond culture, individuals, and their immediate communities, it encompasses the wider world as community. This recognizes the social world as one ecological system with multiple subsystems that are in continuous interaction, resulting in changes of culture, places, and people that may make them unrecognizable, as the Greek poet Dimoula so compellingly states in the epigraph given on the chapter-opening page.

In its respect for the uniqueness and dignity of each person, global consciousness addresses issues of diversity and difference with sensitivity to a range of border crossings, such as class, race, ethnicity, and nationality. Whether in Philadelphia, London, or Nairobi, the movement of people requires a change in social workers’ ideas and perceptions, not a change in the physical locale of the social worker. The world comes to each location. Contexts of geography as well as of culture are therefore necessary components of practice in a global world; this new construct of global consciousness for social work practice promotes ethical practice on a global scale both within and across national borders.

Values, Ethics, and a Social Morality Perspective Inherent in global consciousness is a moral perspective. Social work’s values and ethics are the profession’s distinguishing features; they provide the language for promoting the profession’s mission of social justice and human well-being locally and globally. This book translates these abstract concepts into practice to change the behavior of individuals and society—the nexus of the profession’s domain. Human rights, cultural relativism, and philosophical frameworks drawn from Appiah (2005), Kant (1785), Mill (1863 [1957]), Sen (2009), and feminist ethics of care (Koggel, 2007; Kabeer, 2012; Tronto, 2012) are examined for ethical practice in a global society. Work by various social work scholars to clarify the profession’s mission and translate the values into practice behaviors includes Dolgoff,

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Loewenberg, and Harrington (2005), Reamer (2002), and Reisch (2002).

The focus in chapter 3 is on the profession’s mission to advance social morality—to embrace the dual areas of individual and social well-being that together constitute human well-being; this directly reflects the personin-environment paradigm. These perspectives inform and guide social work’s knowledge and skills, leading to the promotion of social justice.

A term difficult to define, social justice means fairness and access to opportunities for social mobility and improved potential for individuals and society—a better life for all people. It requires tolerance for diversity and a broad and inclusive focus on the morality of social structures and policies as they influence both the social life and the private lives of individuals.

A range of ethical codes allows examination of social work’s historical basis in morality within the context of its status as a profession. I focus on the direct linkages between its mission and the values of service, human dignity, relationships, integrity, and competence, as well as on the inherent contradictions between the ethical principles that both emerge from the values and extend them. My discussion of ethical reasoning incorporates empowerment and advocacy, and my examination of challenges and future directions discusses multidisciplinary social welfare perspectives for practice toward global social justice and human well-being.

Chapter 3 also considers the conundrum faced by the profession and especially those in practice. The profession’s social justice mission reflects a universalist or deontological view— based as it is on principles of what is right or wrong and what Reamer (2012) calls “dutybased ethics,” associated with Kantian ethics and the moral philosophy adapted by Rawls (1971) for social work. Yet social work’s strong ethical commitment to cultural sensitivity and respect for difference can lean toward a consequentialist or teleological view based on what is most beneficial for the greatest number of people, a view associated with Mill (1863 [1957]).

Virtue-based ethics focuses on character and relationship—what kind of person I want to be and what I owe to others—associated with Aristotle, Confucius, Buddhism, and some religions and has received much contemporary attention for its complementing both the universalist and consequentialist views while adding the “common good” to what is “good for the individual.”

Moreover, its concern with fairness can resonate with a broad range of norms in various parts of the world. Narrative- and case-based ethics also fits comfortably in this body of thinking with its emphasis on rich descriptions by clients of their stories followed by similarly rich explanations by social workers in the case studies. This book explores these challenges through case studies and analyses of practice behaviors and decision making. Banks (2006), Clifford and Burke (2009, Hugman (2005), and Butcher, Banks, Henderson, Robertson (2007) contribute perspectives critical for ethical practice.

Additional Unique Features In addition to covering global consciousness and a values/ethics perspective, this book uses a historical context to frame the profession’s evolving knowledge base, mission, values, and practice components. History grounds those entering the profession so that they can draw from the past to shape new directions responsibly and evaluate emerging concepts. Contemporary relevance and effectiveness of the profession requires familiarity with the ideas and intentions of those who have come before.

Chapter 2 explains and illustrates the two core paradigms of social work. “Person in environment” encompasses the multiple levels of practice—people, policies, communities, and organizations—delivered through interactions with individuals, groups, and families. “Biopsychosocial” practice includes physiologic factors (chemistry, neurology, genetics, physiology), the psychological (cognitive, affective, and emotional functioning), and a special focus on the social (community resources, social supports, income, education,

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and housing). A historical perspective introduces social work as a profession within the broad context of professional occupations and connects the founding of social work with its contemporary paradigms. This connection to history can facilitate incorporating the new construct of global consciousness with its broadening of social work’s domain to include the biosphere, organisms, and cells along with the earlier concepts of society and culture (Engel, 2003), A framework that covers history in the context of emerging ideas allows for focus on practice that addresses specific variables such as individual predispositions, familial effects on personality, social norms, and access to resources, as well as their interactive effects on each other.

Chapter 4 covers case theories for assessment that incorporate evidence from multiple sources, including clients and the professional literature gathered by social workers to make sense of each client’s situation from a biopsychosocial perspective. These assessment methods organize the practice, shaping relationships, communication, differential use of self, and intervention. This chapter also addresses the complex ethical challenges for assessments within a globalized society, including technological developments and multidisciplinary perspectives.

Building human dignity and respect in relationships with renewed emphasis on their core significance to the profession in fostering inclusion, belonging, and caring among people within and across national borders is the focus in chapter 5. Informed by the values of human dignity and respect and their continuing historical significance, explanations and illustrations of relationship building emphasize belief bonding along with ethical and cross-cultural challenges, purposefulness, boundaries, issues of helping and power, supervision, beginnings, and endings.

Chapter 6 addresses shared constructions of meaning in communication with constituencies that extend the local toward a more global

focus for practitioners and clients as seekers of mutual meaning in complex phenomena. My focus is on the exchange of thoughts, feelings, and information, presenting communication as a concept bound by culture and context. Ethical global practice requires intercultural communication that considers changes in the mode, quality, and quantity of interactions brought about by technological developments. I also consider the importance of social workers’ communicating with a wider public and their use of tools to record and analyze their interactions with others, including clients, supervisors, and team members.

Critical consciousness, reflection (considering what happened and what should follow), and reflexivity (increasing awareness of personal assumptions) for differential use of self are examined in chapter 7. These concepts allow practitioners to develop self-awareness along with deep knowledge of the profession and its ethical guidelines so that they can base practice on social work’s values and the client’s needs; continual observation and thought allows workers to identify and remain aware of their personal values in order to keep them separate from their professional behaviors.

Chapter 8 explains and illustrates strategic interventions as directed by evidence, best practices, and case theory and supported by emerging normative theories and concepts such as ecological approaches and ethics of care. These interventions include the statement of the problem, short- and long-term goals and goal-setting, and evaluation, all of which relate “what” is done to “why” it is done. I also discuss challenges of cross-cultural practices across and within national borders as social workers act to protect from harm and provide for necessary concrete services within a framework of promoting social justice and enhancing human well-being. Best practice is therefore highly complex and requires a wide range of data sources to support intervention decisions that result in good outcomes for clients. From this perspective, data are not limited to information

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gathered from clients and other related people and professionals; they must also come from research, concepts, theories, and approaches discussed in the professional literature. Peerreviewed journals, books, and a range of statistical material (census figures, United Nations reports, etc.) on populations and problems pertinent to situations faced by clients add critical information, and most are easily accessible in our networked world.

Most chapters conclude with exercises, examples, and discussion questions.

Practice Theory Readers of this book will acquire a conceptually grounded framework through which to organize each practice component into a dynamic whole. Bertha Reynolds, one of social work’s most important teachers, long ago recognized the need for practice theory: “The security of having at least a core of theory common to all of social work, and of seeing it in a dynamic way, so that change can be welcomed instead of feared as new data come, is one of the greatest needs of social work in our time” (Reynolds, 1942 [1965], p. 8). In this book, we see how assessment directs relationship and communication yet is dependent on client trust and on the shared meanings. It also becomes evident that without assessment, intervention takes place in a vacuum, and without differential use of self, interventions may cause harm.

Siporin (1975) discusses the value of practice theory in providing “a structure of ideas that we use in helping people” (p. 118). This practice theory was informed by the social work practice literature, the CSWE accreditation guidelines, the NASW standards (NASW, 2008 [1996]), and multiple codes of ethics (British Association of Social Workers, 2002; Canadian Association of Social Workers [CASW], 2005; IFSW & IASSW, 2004), as well as by analyses of case material provided by social workers through intensive interviews and audio and video material. Treatment theories such as narrative or cognitive-behavioral therapy or

theories of diagnosis such as attachment or social isolation address specific client problems or populations or help guide assessments. Distinct from these theories, social work practice theory, along with the profession’s values and ethics, sets a foundation for ethical decision making about which of these other theories to use for assessments and interventions. Theory building is continuous; new problems require new knowledge about human development and about the social world. These social work domains are constantly in flux. The relationship of biology to psychology was viewed as somewhat fixed in the 1950s; family therapy as a field and modality of practice did not become widely accepted until the 1970s; AIDS was not a problem until the 1980s; and in 2010, debates began about eliminating Asperger’s syndrome as a separate category from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and to fold it in as an “autism spectrum disorder (ASD)” Tensions continued into 2014 about this change: some families welcome the shift to a continuum, and others worry about decreased support—financial and biopsychosocial (Baron-Cohen, 2009; Carey, 2012; Grinker, 2010). New practice environments and technologies and previously unknown problems will create needs for new theories just as the components of practice theory must evolve to address changes in people and environments.

Practitioners need both kinds of theory to understand and explain the situations in their work and help address thorny questions such as whether categorizing Asperger’s syndrome as an ASD in the DSM V was positive. Practice theory rationalizes the art of social work in ways that specific assessment or intervention models cannot. While the primary focus in this book is on change with individuals, practice theory that rationalizes the art of social work provides a way of thinking about direct and clinical social work practice to build linkages between what is done and why it is done across these multiple levels and from a biopsychosocial perspective that recognizes problems in social functioning

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as a function of biological factors, psychological issues, and the social context (Bisman, 1994).

Users of This Book This foundational practice text fully meets accreditation expectations for practice in the United States and covers issues pertinent to practice in other nations. Adhering to current CSWE (2008) Educational Policy and Accreditation Standards (EPAS) and to those emerging for 2015, these chapters embrace a human rights viewpoint and teach for competence in evidence-based practice with a personin-environment and strengths perspective; biopsychosocial assessments; attention to a global world; critical thinking accompanied by reflection and reflexivity; policy practice and advocacy; integration of multiple sources of knowledge; effective oral and written communication in working with diverse individuals, families, groups, organizations, communities, and colleagues; engagement, assessment, intervention, and evaluation with individuals, families, groups, organizations, and communities. To meet these accreditation guidelines, all chapters draw from the ethical codes of the professional organization that sets standards for practice in the United States (i.e., NASW) and from those of the international organizations— the International Federation of Social Workers (IFSW) and the International Association of Schools of Social Work (IASSW)—for ethical decision making in practice. Coverage emphasizes respect for human diversity, the value base of the profession, and its ethical standards in recognizing and managing personal values to ensure that professional values guide practice.

Cases, Narratives, Practitioners Comments by social workers accompany all the case studies and narratives and are central to understanding the concepts presented throughout the text. Information about the social workers includes facts about their upbringing and their cultural backgrounds and provides a fuller picture of what it means to be a social worker

in practice with clients; this helps us identify with them as real people who are working in challenging situations. Furthermore, knowledge about their own values and qualities helps us to understand their decision making and appreciate the impressive diversity within our profession. Personal and background information reveals them as a diverse population on the variables of race, disabilities, class, sexual and gender orientation, and ethnicity, among others. Social workers present their cases, which cover a range of practice areas and populations, including child welfare, illness, gerontology, substance abuse, reproduction, school social work, family problems, violence, sexuality, death and dying, discrimination, and poverty.

Acquired from various countries, cities, and regions, these cases (many followed through different chapters) illustrate practice to alleviate oppression and promote civil society that is relevant domestically as well as globally. Note that to adhere to confidentiality guidelines, the case studies and narratives for each chapter section include a range of locales rather than the specific city or nation for each case. Moreover, for confidentiality of clients and social workers, names have been changed in all cases, and no one has been presented in his or her actual employing agency or geographic locale. Identifying data have been shifted so that individuals cannot be connected to the facts about them.

Some cases are composites, and some have been discussed in other books (Bisman, 1994; Bisman & Hardcastle, 1999). Yet the thrust of analysis in all cases is on global and critical consciousness and a values/ethics perspective.

Finding neutral terms was a struggle, and so was deciding to specify the many differences among social workers and clients despite arguing against relying on dated notions of ethnicity and race, among other variables. The context of cultural backgrounds and socioeconomic location became necessary in exploring when these variables are relevant to practice and when they are harmful. It is hoped that learning about cases directly from the social workers

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themselves helps readers to practice both the art and science of social work. “Clients” is used inclusively to refer to individuals, families, groups, organizations, and communities (NASW, 2008 [1996], p. 2).

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To become a social worker is to enter a profession that challenges with ambiguity and fulfills with change toward the common good.

Through work on the social welfare, social workers deal with public matters and personal troubles. A cookbook approach cannot adequately cover the intellectual and emotional journey necessary for effective social work practice. Instead of recipes, social workers need to draw from a wide range of knowledge in order to develop understanding and use skills that fit the unique needs of each

client. This requires recognition that professional practice is both science and art. In her admonishment that “the real world is not an exam,” Zuger advocates for less emphasis on test scores of medical students which don’t prepare them for “complicated, contradictory cases for which there were no clear ‘best’ strategies, but many reasonably acceptable ones” (2014, p. D4). This book examines how social workers draw from theories and the empirical world, despite difficulties in applying scientific rules or verifying data, to inform the aesthetics of practice—their creative integration of material to fit the unique lives and idiosyncrasies of human beings and their communities within social work’s values and ethics framework— toward the moral ends of human well-being and social justice that imbue the profession with its purpose and define the role of social work in society.