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Social Work: A case study in applying theories to practice

Presenting Circumstance

Mr. A is age 40, unemployed and living with his wife and six year old son; C in a two-
bedroom council flat in London. He is not only a gambler with drink problem, he is
known to the police and social services for domestic violence towards his wife; Mrs
A. He is notorious within the neighbourhood for his constant rows and aggression;
sometimes accompanied by violence towards his wife. The latter is a catalogue
shopping addict. As a consequence of their spendthrift lifestyles, the family is facing
action from the bailiffs for mounting debts. Additionally, their son’s aggression
towards local children within the estate means that the family is also facing the
possibility of eviction from their council home for reasons of persistent Anti Social
Behaviour (ASBO). As a further insight into the family’s circumstance, the couple’s
parents are living way from London.

So why, and which social work theories can be used to assess, explain and
justify the processes of intervention in this case? The positive indicators in this
case are that apart from having an insight into their situation they were welling to
receive help in resolving their problem. Most importantly, they wanted to rebuild their
relationship as opposed to a divorce

Introduction
While there is consensus that “the concept of theory is a social construct”, Payne,
(1997, p. 26), for the purpose of this discourse, theory denotes, “a set of
proposiotions which posit the nature of the relationships between predefined
constructs or variables” Glynis et al., (1995, p. 5). Similarly, while applying theories
to practice may not necessary lead to positive outcomes; it establishes a systematic
approach to social work processes. The problem with choosing a particular

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perspective is that, while no particular theory is implicitly comprehensive; objectively
applied, any theory can prove contextually appropriate.
However, Payne, (1997, p. 36) asserts that theories are most effective when
combined and that in isolation, “the theory’s value is vitiated” Indeed in
contemporary complex and dynamic society with corresponding heterogeneity in its
social problems, theory triangulation (combining theories) is essential to better
understand, explain and address the myriads of interrelated problems that is ‘social
work’. The very use of theory in social work per se is indispensible in establishing
some degree of rationality in what would otherwise be a chaotic occurrence.

Reasons for choosing particular theories

Argued on appropriateness rather than convenience; the ‘Psychodynamic theory


by Freud and the ‘Attachment theory by ‘Bowlby’ in particular; and the system
theory in general seem most applicable to this case study. This preference is based
on the premise that family and relationship problems may be rooted in ineffective
personality developmental childhoods. Within this context, Thomas and Pierson,
(1999, p.302) state that, “the psychodynamic approach views the adult
PERSONALITY as product of childhood development” Similarly, Payne, (1997, p.
79) states that “the important focus on social work on childhood and early
relationships and maternal deprivation comes from psychodynamics theory” Indeed,
Lishman, (2003, p. 14) suggests the use of the attachment theory in cases of
relationship and dysfunctional family situations because it seems to appropriately
explain behavioural and relationship problems as typical of this case. The
suggestion here is that, Mr A’s drinking, gambling, aggression with associated
violence; and Mrs A’s indiscriminate spending could be consequential of their
deficient or ineffective childhood developments. Additionally, according to Payne,
(1997, p. 291) both theories provide comprehensive models “that claim to offer a
system of thought to cover all the practice social workers might want to undertake”
Payne, (1997, p.291). Additionally, Wood and Hollis, (1990, p. 9) perceive
psychodynamic theory as inseparable from family therapy. It is the combination of
these arguments, capped with my critical judgement that has influenced the choice

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of these formal theories. With the family as a system; the sum of whose integral
contributions is a factor of the wellbeing of the whole unit, the system theory
adequately establishes the cause and effect relationship in the problems of the A’s
family. For example, resolving the conflict between the parents is bound to produce
similar effect of their child; C, and possibly resulting in a united and happy family.
Now what are these theories?

The Psychodynamic theory and its principles

Developed from the works of Sigmund Freud, psychodynamic theories assume that,
“behaviours come from movements and interaction in people’s minds” Payne, (1997,
p. 72). It “relates to the internal psychological conflicts between the irrational
pleasure drives of the id and the social conscience of the ‘Superego’, mediated by
the ‘Ego’ or psychological regulator.” Thompson, (2000, p. 63). Therefore, a well-
developed ego and superego would have ensured for a better relationship within the
A’s family. Psychodynamic would suggest that, Mr A’s drinking and aggression could
be a way of avoiding facing reality and his responsibility within their relationship by
falling back (regression) to his irrational ‘id’ behaviours. Wood, (1971). Equally, Mrs.
A’s compulsive catalogue buying and Mrs A’s gambling could be “drives to satisfy
some personal unidentified tension or libido within them.” Payne, (1997, p.73).
Additionally, Mr A’s aggression with associated violence in particular, and their
stormy relationship in particular, could signify under-development of their egos and
super egos to enable them socialise and behave rationally as married couples. The
implication is that, apart from their own neglected wellbeing; the A’s traumatic
relationship has deprived them of the effective communication and joint decision-
making about the welfare of their son. In conflict, parents are “too preoccupied with
their own feelings to understand their children’s needs” Mitchell, (1985).

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Attachment theory.
Bowlby defines attachment theory as;
“a way of conceptualising the propensity of human beings to make strong
affectional bonds to particular others and of explaining the many forms of
emotional distress and personality disturbance, including anxiety, anger,
depression, and emotional detachment, to which unwilling separation and
loss give rise”

Bowlby, J. (1984, p. 27)

Like Freud, Bowlby believed that the root of the development of personality lay in
early childhood development, and that any trauma or failure in this early relationship
would permanently shape the development of the child’s personality. The premise
here is that ineffective or the lack of attachment in childhood or the excess of it could
have been responsible for the problems in this case study. Similar to the
psychodynamic theories, the attachment theory suggest that the roots of the
couples’ difficulties may be due to ineffective or deprived affectionate bonding to
their mothers or care-givers in their childhoods. There is consensus that experience
of it affects the development of other relationships; with the deprivation and
disadvantage having major damaging effects on children’s development and later
life.” Payne, (1997, p. 75); Howe, (1987). Thus, C’s aggressive behaviour could be
suggestive of the same deficiency. Another explanation for C’s aggression could be
that, rather than the lack of attachment, he might “have been over protected by his
mother, so that he never learned the socially acceptable methods of relating to
others” Payne, (1997, p. 80). The lack of intimacy in the A’s relationship (may be due
to their inability to share and relate as couples) could also be creating frustrations
that are expressed in terms of aggression, drinking and gambling. In relation to
bonding, Adams, L. et al., (2002, p. 170) states that, “a woman neglected as a child
may have low self-esteem, feels anxious and agitated in close relationships”.
Presuming that Mr A experienced a similar childhood, Adams, L. et al (2002, p. 170)
further state that, “mutual anger as each partner believes that the other is capable of
causing them hurt makes the relationship full of conflict and turbulence, anxiety and
depression.” Presuming this to be the case, could Mrs A’s compulsive buying be a

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coping mechanism for yet undiagnosed depression or a vengeful and misinformed id
response to her husband’s behaviour? Similarly, where Bowlby directs the
“psychoanalytic interest in early mother-child relationships to maternal deprivation”
Howe, (1987), could Mrs A’s compulsive shopping be explained by the tendency to
indiscriminately acquire those material privileges she never experienced in her
childhood? Where a supportive social environment would have mitigated the impact
of this ineffective attachment, the family resides beyond easy reach of their parents.
Even in the case where neighbours would have provided support for the family, their
anti social behaviour has rendered them outcast within the neighbourhood.

While both theories could account for Mr A’s aggressive behaviour, in terms of
unresolved childhood conflicts, Crawford and Walker (2003, p. 61) suggest that it
could be due to gender role and identity whereby he is imitating his father’s
“dominating behaviour, finding it hard to express emotions and demonstrating caring
actions and skills.” C’s aggression could be explained from similar perspective.
Conversely, Mrs A is passive; unable to express her individuality and independence.
Holistically both theories are unanimous that dysfunctional relationship can be
attributed to deficiencies in childhood development. Understanding social problems
from such perspectives provide rational arguments to justify a social work rather
than medical model approach in addressing social problems. For example, detaining
Mr A for substance abuse without recourse to inquire into the underpinning reason
for his deviance, or providing him with a supportive rather than punitive exit option
can only produce short-lived solutions. Applying the psychodynamic and attachment
theories, the sustainable approach should be to empower the clients to acquire
those social skills that they missed in their childhood; and which have been at the
roots of their difficulties. According to Payne, (1997, p. 64), these supportive and
therapeutic approach can help clients “change their deviant pattern of behaviour”
Using the arguments from the psychodynamic and attachment theories as bases for
intervention, relevant care plans should therefore be set against the background that
the members of this family need to re-learn or acquire those skills that would
henceforth enable them to live and behave as social beings if they are not to be like
they parents. As earlier mentioned, the problem with using theory to explain social
problems is that no one theory can be comprehensively adequate. In agreement,

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Payne, (1997, p. 93) points out that psychodynamics “is a theory for talking therapy,
preferring verbally able clients with psychological problem”.

Intervention
According to Winnicott’s work, parents like Mr and Mrs A should be sensitise “on
how to adapt from focussing on their inner world by developing capacity for dealing
with the outside world” Payne, (1997, p. 75). Using person-in-situation approach,
both parents should be encouraged to think and understand their debts, gambling,
drinking, compulsive buying as provoking agents in instances of aggression and
general disharmony. Within the context of ego and superego reformation, initial
actions should suggest, encourage and assist the couple to start communicating in a
rational and socially acceptable ways. This will include the respect and acceptance
of their respective individualities, concerns and opinions. Starting with simple joint
activities like taking their son to the park, the whole family may start to engage in
meaningful socialisation. The rational is that by so doing, they would develop and
perfects those acceptable social ethics that they never acquired in their childhood.
Indeed, they may start to engage with their local community; they are part of social
systems and play a social rule. Pertaining to their financial difficulties, the role of the
social worker should be to provide them with the necessary information to jointly
examine their situation and if need be, use the service of debt counsellors. Same
applies to the marriage as a whole, if things do not work out through mutual
negotiations; maybe with the social worker acting as an impartial mediator or
facilitator, then marriage counselling services may have to be engaged. Equally, if
attempts to sort out their financial problem do not cut out Mr A’s drinking and their
spending, then he may have to consult an alcohol as well as a gambling addiction
advisory service. The rational in all these initiatives is that by first maximising on
their own potentials, clients are empowered to be their own doctor. Using external
services should be a last resort and a formal way of providing what clients are
unable to achieve through their own efforts. Understood and explained from the
psychodynamic and attachment perspectives, but addressed from a system
perspective, if these actions could enable Mr A to become the major bread-winner,
this feeling of responsibility and self-worth could filter to other areas of their family
and relationship.

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Children-focused intervention
As a vulnerable client; legally incapable of providing informed consent, social work
intervention on behalf of a child like C’s has to be legally compliant and appropriate
as well as being based on systematic approaches. Thus, while exceptional
circumstance may suggest the evocation of “control order to protect the child”
Watson et al, (2004, p. 107) the legal preference as suggested by the children Act
1989 is to “support children and family to stay together.” Parker and Bradley (2003,
p.21). However, since according to Schaffer, (1990) “the situation most conducive
for children’s welfare is minimum overt conflict”, the direct exposure of C to Mr A’s
aggression and violence on his mother; and the constant rows does not only
constitute domestic violence, but child abuse, Hague and Malos, (1998, p. 19).
While arguments based on the psychodynamic and attachment theories may
suggest a more supportive and therapeutic intervention to enable C’s parents to
carter for his welfare, the potential to suffer significant harm from this situational
hazard may legally suggest a more drastic or punitive approach. As mandated by
the legal framework under “the children Act 1989, Policy and procedural guidance
under Area Child Protection Committee (ACPC) and the Home Office (2000);
“Framework for the Assessment of Children in Need and their families“ Watson, F. et
al (2004, P. 89), a “child-focused risk assessment” will establish where C’s best
interest would be best served while things are sorted out.

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Appraisal

As evident in this case study, the application of either the psychodynamic or


attachment theories is contextual and dependent on the preference of the applicator.
Consequently, the lack of a standardised bench-mark makes the evaluation of their
effectiveness and appropriateness problematic and relative rather than absolute.
However, the use of theories in the understanding, explaining, planning and
intervening in social work is indispensible if practice is to be systematic.
Nevertheless, any incoherence in applying these theories to practice could be a
mirror of the complexities of life’s realities themselves? Similarly, no social work
contexts are ever identical, neither are client groups homogeneous; a situation that
would render the standardisation of perspective approaches futile.

Recalling that stated that I opted for the Psychodynamic and attachment theories
because of their appropriateness, critiques point to inherent shortcomings in both
perspectives. Indeed, critics argue that “psychoanalysis has a scientific and
originally biological approach to explanation that cannot be easily tested in
conventional scientific ways.” Harris, (1984, p. 24). Others assert that,
psychodynamic does not respect human self-determination; pointing out that, in
social work practice where the quest is to eliminate discrimination, “psychodynamics
is a means of understanding how men achieved and maintain supremacy in
patriarchal society.” Stream, (1979). Moreover, psychodynamic seen as limited to
clients with verbal ability who can contribute in discussions and self-determination at
the exclusion of service-users with psychological problem. As for the attachment
theories, critics point out that a child like C can make attachment relationship to
other people, not just the mother. Additionally, that “reliance on one exclusive
relationship can itself be damaging, as it does not allow for supportive healthy
relationship with others” Crawford and Walker, (2003, p. 44). Holistically, by trying to
apply both theories to predict people’s behaviour, “the danger is that this argument
can stereotype characteristics and people, thus potentially supporting prejudice and
oppressive behaviour” Crawford, (2003, p. 10). Moreover, reducing complex human
behaviours as in this case study using abstract concepts that are socially
constructed is bound to produce reciprocal outcome and contestations.

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Conclusion
The centrality of theories in social work practice is that they provide and establish
rationality and systematic ways of addressing otherwise haphazard occurrences.
Additionally, as in this case study, they draw attention to the rationale control that
human beings have over their environment and their own behaviour” Payne (1997,
p.297). While social work outcome may not be perfect nor even always satisfactory,
the critical and systematic approach provided by the theories ensure that good-
enough decisions are consistently made on the best information and judgment
available. Where psychoanalysis and attachment theories have linked social
problem as consequential of developmental deficiencies in childhood, the prognosis
is that without a systematic social work intervention to safeguard a replication, the
micro and exosystems of the family will collude to sustain the ongoing crisis, while
producing a conducive environmental for a reciprocal consequence. Within the
complex environment of interrelated and complex social problems, a better insight
into particular problems is better gained through the multiple application of theories
(triangulation); in isolation, “the theory’s value is vitiated” Payne, (1997, p. 36). In
family interventions, any effective intervention to an integral part will eventually
reciprocate similar impact of the wellbeing of the system as a whole.

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