Integrated Social Services: Reaching the Most Vulnerable. Training package for case managers

Module 5.Network analysis for supporting

the Case Manager’s work

CASE MANAGEMENT TRAINING PACKAGE

Working in the Case Management perspective

CM uses a pro-active approach(and not a reactive one)

That is: an action-oriented approach

An approach is action-oriented when it is community-based

But…what is COMMUNITY?

Case Management – module 5 – slide 2

The community

The COMMUNITY can be defined as a “group of human beings with a common

history”, where continuous relationships and exchanges

take place based on economical, material, social and cultural resources.

This group of people bases its relationship on trust,

and can cooperate to create groups and networks to reach

common goals.


The Community Culture is characterized by six dimensions:1. Technological2. Economic 3. Political 4. Institutional (social) 5. Aesthetic-value, and 6. Belief-conceptual.

• Each of these dimensions of culture is transmitted by symbols (not genes) and consists of systems of learned ideas and behaviour.

• All of these are elements within every social (or cultural) system. They are based on learned behaviour, which transcends the individuals who learned each part. If any dimension of culture is missing, by definition, all are missing.

The dimensions of a community culture (1)


The Technological Dimension of Community:The technological dimension of community is its capital, its tools and skills, and ways of dealing with the physical environment. It is the interface between humanity and nature.

The Economic Dimension of Community:The economic dimension of community is its various ways and means of production and allocation of scarce and useful goods and services (wealth), whether that is through gift giving, obligations, barter, market trade, or state allocations.



The Political Dimension of Community:The political dimension of community is its various ways and means of allocating power, influence and decision making. It is not the same as ideology, which belongs to the values dimension. It includes, but is not limited to, types of governments and management systems. It also includes how people in small bands or informal groups make decisions when they do not have a recognized leader.

The Institutional Dimension of Community:The social or institutional dimension of community is composed of the ways people act, interact between each other, react, and expect each other to act and interact. It includes such institutions as marriage or friendship, roles such as mother or police officer, status or class, and other patterns of human behaviour.



The Aesthetic-Values Dimension of Community:The aesthetic-values dimension of community is the structure of ideas, sometimes paradoxical, inconsistent, or contradictory, that people have about good and bad, about beautiful and ugly, and about right and wrong, which are the justifications that people cite to explain their actions.

The Beliefs-Conceptual Dimension of Community:The beliefs-conceptual dimension of community is another structure of ideas, also sometimes contradictory, that people have about the nature of the universe, the world around them, their role in it, cause and effect, and the nature of time, matter, and behaviour.



Another way to describe the community:the different layers of the relationships of

help

FORMAL SERVICESProfessional

service providers

INFORMAL SERVICESCitizens organised to a

certain extent (volunteers)

INDIVIDUAL SOCIAL NETWORKS Family members and friends linked

through emotional and personal relationships

Case m

anagers a

re h

ere!


FORMAL SERVICES

Professional service providers

INFORMAL SERVICESCitizens organised to a certain

extent (volunteers)

INDI VIDUAL SOCIAL NETWORKSFamily membersand friends linked through

emotional and personal relationships

Case m

anag

ers a

re her

e! The more complex and developed a community is, the more developed are the top levels of our “help-pyramid”. In a very simple and primitive community, the level at the base of the pyramid is usually enough to ensure social safety. When a society begins to specialize the production system and increase its social complexity, the other levels become more and more important.

In this process there is a danger or an opportunity: it depends on what kind social policies the society (institutions) adopts.

There are two alternatives:

1. When an upper level is developed, it tends to impoverish and then replace the lower ones (RE-ACTIVE APPROACH – traditional social work)

2. When an upper level is developed, it empowers and makes more effective the lower ones (PRO-ACTIVE APPROACH – Case Management)

Two different policies in the development of social protection

services


This provides services to individual cases when the situation has already become an emergency

and the possibilities to get help from the community are inadequate or no longer exist.

This starts before a social problem becomes an emergency that cannot be handled by the

community; qualified roles are given to the community members involved (teachers,

community and religious leaders) and other persons informally providing a social service

are involved.

Reactive (clinical) approach:

Proactive (community based) approach:


Methodology:

What is a social network?

Things to do to survive

Things to do to feel good

about ourselves

Things to do to feel accepted

by others

Tasks

Relationships

environment

Social and Cultural Environment

Inst

itutio

nal

enviro

nment

Physical Environment

Cognitive abilities, behavioural skills

Emotions,identity, self-esteem

Health


The coping network includes all the persons of a social network who are involved in fulfilling a

specific need (for example, assisting a child victim of abuse in the family).

When the network is not strong enough to fulfil the need, there is a “social problem”.

What is a coping network?


The coping network

The coping network is composed of all the persons who interact with the person/family in need, and can positively contribute to provide protection

and careIt is composed of public officers (local

administrators, police, magistrates) professionals (doctors, teachers, counselors,

sports trainers, NGOs operators) and common people sharing their daily life with the

individual (family members, relatives, neighbours, friends, members of religious

groups)All these people have to be involved in decision

making, until they are able to take care of the social case without the guidance of the Case

ManagerCase Management – module 5 – slide 13

Main characteristics of the networking methodology

There is a problem (social, health, protection); the social network surrounding the person with the problem cannot cope with the need in an adequate way

The goal for the case manager, or GUIDE of the network, is to help the network to improve and become self-sufficient in dealing with a problem

Thus this is not only a problem for the single beneficiary, but first and foremost a problem of his/her social network

With the networking methodology the case manager (expert) intervenes to strengthen the network, helping and guiding it with the involvement of other ‘informal’ resources, and not only of professional services


The guide mediates between the network and other resources, without (never!) giving ‘directions’; his/her role is based on trust

The guide:- facilitates the communication within the network; - mediates different points of view; - takes into consideration the possibilities and the expectations of everyone involved

The guide acts as a ‘resource centre’ for information sharing: he/she has to know the community, and to share his/her knowledge to help the network to strengthen itself

How does the network guide do this?


A map for describing the social network of a person: Todd’s diagram

relatives

School or job mates

Neighbours and friends

Practitioner of the public services

NGOs’ membersvolunteers

Five different social areas client

TODD’s diagram is a method for describing the whole social network of a person/family. The plots of the network are put into the diagram divided into 5 categories and located at a distance from the subject proportional to closeness with him/her. A social network has points of strength and weakness, both qualitative and quantitative. There can be a reciprocal knowledge between two plots, or not. In the first case this relationship can be mutual (neither positive or negative), or not.


The social network of Judith when the taking in charge has begun

relatives

School or job mates

Neighboursand friends


NGO’s membersvolunteers

Judith

12

34

5

6

7

8

9

10

Plots list:1. mother2. father3. sister4. aunt5. Other aunt6. Dr Marcus7. Case manager8. First teacher9. Second teacher10. neighbour


relatives

School or job mates




relatives

School or job mates




JudithJudith

12

34

5

6

7

8

9

10

Plots list:1. mother2. father3. sister4. aunt5. Other aunt6. Dr Marcus7. Case manager8. First teacher9. Second teacher10. neighbour

First network evaluation

Within the red circle have been placed the network plots involved in the problem of Judith’s homework (the coping network). Some of these plots have a very negative perception of the problem (i.e. the teachers), someone is too involved (the mother), and someone too little (the aunt).Some plots of the network do not know each other and others probably have reciprocal negative relations (parents vs. teachers).Furthermore, the network is very weak, both because there are not many members for such a difficult task, and because there is no member belonging to three social areas out of the five who participate to the coping network. At the beginning, the task of Judith’s homework is only a question between parents and some discouraged practitioners.


The social network of Judith when the taking in charge is established

relatives

School or job mates




Judith

1

23

4

12

6

7

89

10

Plots list:1. mother2. father3. sister4. aunt5. Other aunt6. Dr Marcus7. Case manager8. First teacher9. Second teacher10. Neighbour11. Monica12. Cleric13. Special teacher14. Headmaster15. Pedagogue16. psychologist

11

5

13

14

1516

Friends ofRecreation centre


Established network evaluation

Within the red circle have been placed the plots involved in the problem of Judith’s homework and socialisation (the coping network). All of the people involved have a more positive perception of the problem compared with the beginning of the project.The number of the involved members is much higher, they are more cooperative amongst each other, belong to four social areas out of five (but we can consider that the improvement of the school relational climate has promoted new friendships in the school setting as well), and everyone is closer to Judith than in the past.The enlargement of the coping network (before involving other informal members, and then other formal ones) has not only allowed the first task (Judith's homework) to be better addressed, but also to take further into consideration the following: socialisation, sport, improvement of school climate, psychological well-being of Judith and her parents.

relatives

School or job mates




relatives

School or job mates




JudithJudith

1

2

3

4

12

6

7

89

10

Plots list:1. mother2. father3. sister4. aunt5. Other aunt6. Dr Marcus7. Case manager8. First teacher9. Second teacher10. Neighbour11. Monica12. Cleric13. Special teacher14. Headmaster15. Pedagogue16. psychologist

11

5

13

14

1516

Friends ofRecreation centre


Case Manage

r

LEGAL SERVICES

HEALTH SERVICES

WRONG NETWORKING!

POLICE

Family

RELATIVES

NEIGHBOURS

EDUCATION SERVICES

COMMUNITY RESOURCES

Family

LEGAL SERVICES

HEALTH SERVICES

POLICE

RELATIVES

NEIGHBOURS

TEACHERS

COMMUNITY RESOURCES

COMMUNITY LEADERS

SOCIAL SERVICES

RELATIVES

Case Manager

RIGHT NETWORKING!


Home care Service

Hospital

Family Doctor

Nelson’s psychiatrist

School

Social Activities Centre

English teacher

………………………..

Bureaucratic offices

Families networkAssociation

Nelson Rose

Peter

Luis

Lisa Maria

Sylvie

Children’

s

friends

Nelson’s

Pub friends

?

Abroad ?

First report about social

need

?

?

?

John

A multilevel description of social network: the “bubble” model (1)


Anne

The “bubble” model offers some important advantages compared to Todd’s Diagram.First, it is easily drawn by pencil on a sheet, during a meeting or an interview.Secondly, it allows the creation of a map of the community around the case before building the coping network.The model can be enriched step by step, and it becomes not only a geographic map of the network, but also a historical representation of the project. The example illustrates the case of Nelson, a family father, who has problems of mental health and alcohol dependence. The model tells us, for example, that Nelson’s wife (Rose) was adopted by Anne, while Nelson’s parents are likely abroad.This model also shows the second level networks, i.e. the partial network of a member of the coping network (for example, the friends of Nelson’s son, Luis). The representation of this network can significantly help the CM’s work.


A multilevel description of social network: the “bubble” model (2)

A small dictionary of the social network

Primary network: this is constituted by the members of the family (who cannot be chosen) and by friends (who can instead be chosen). The primary network is characterized by affective relationships which provide safety and the sense of belonging and identity.

Secondary formal network: this is constituted by the public/private institutions which have been created for providing eligible services. The relationships with them and their practitioners are only professional.

Secondary informal network: this is constituted by NGOs, associations, social groups, volunteers; all these subjects have been created for reaching specific goals of public utility, but it is usual that some members of this network become members of the primary network.


Main variables describing social relations in a social network

Plexity: describes the type of a relationship (friendship, relationship, neighbourliness, work, professional). A relation is called Uniplex if it belongs to only one kind, and Multiplex if belongs to more than one (e.g. a colleague who is also a friend or a relative).

Symmetry: a relationship is symmetric if it is described in the same way by both the subjects of the relationship itself (for example, a good or bad relationship); otherwise it is asymmetric.

Intensity, Intimacy, Lasting : although these variables describe different aspects of a relationship, they are usually directly proportional: the more the intensity, the more intimacy and longevity there is, and so on.

The second level networks: these are constituted by people who the subject does not know (or knows slightly), but who can be a potential source of help and/or information (for example, own friends’ friends or colleagues or relatives).


Main variables describing the structure of a social network

Homogeneity and Heterogeneity: a social network can be constituted by people, relatives excluded, having (or not) in common some features: the same age, sex, policy or religious beliefs, behavioural habits, and so on.

Density: this variable measures how many dyadic relationships the members of the network have, on average, by comparison with the other members: the higher the density is, the higher is the chance to build shared projects.

Cluster: a network can be constituted by some sub-networks (called clusters) which can be very strong, but which have no relationship with each other, sometimes for distance reasons, sometimes because the clusters belongs to very different cultural worlds. Typically, this is the situation of immigrant people, or people who have had an important experience elsewhere (for example, in a recovery community for drugs abusers).


Documents

Integrated Social Services: Reaching the Most Vulnerable. Training package for case managers