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Case management as a technology for preventing social orphanhood

The article discusses the features of the social protection system for children left without parental care in the Republic of Kazakhstan. The article reveals the problem of the development of innovative technologies in social work in SOS family-type children's villages, namely, the development of case management, and the objective need for their application in the process of supporting families and children in difficult life situations. The purpose of the article is to study the use of innovative technologies through the introduction of case management technology, as an important tool for supporting families and children left in difficult situations. To do this, the following tasks are solved: to give a complete picture of the algorithm of the case manager; to study the contribution of foreign researchers and compare it with the experience of SOS family-type villages. The main methods of research of the issue were historical and methodological study of scientific literature, synthesis and analysis of social work technology, meetings with the deputy director for the profile of social orphanhood and specialists of the SOS project of family-type villages, a training webinar within the framework of the studied problem with bachelors and undergraduates of the Faculty of Philosophy and Psychology of Karaganda University of the name of academician E.A. Buketov. The article shows that in the process of professional training of future social workers it is necessary to increase the level of knowledge and develop the skills necessary for the effective work of case managers of the project.

Introduction

The current trend of growing family problems and social orphanhood in Kazakhstan determines the need for a significant increase in the level of work with each individual family. There is a need for an individual approach to it, in working with a separate, specific case. At the moment, the procedures for providing assistance and services remain unclear and insufficiently developed and standardized. At the same time, algorithms have been developed that serve as a guide for social workers in the health sector, while at present there are no officially accepted algorithms for providing specific services and a clear prescribed continuum for providing assistance to disadvantaged families and children left without parental care. Since, today, social workers work with orphans with living parents, that is, social orphans.

As of 2019, there were 23,948 orphans and children left without parental care in Kazakhstan. Of these, 19,342 children (81 %) are under guardianship and in foster families, 4,606 (19 %) children are brought up in institutions for children left without parental care. 21 % of them lost their parents and became round orphans, more than 78 % of children remain orphans (social orphans) with living parents (deprived of parental rights — 2307, refused parental rights — 450, restricted in parental rights — 253, abandoned — 138, recognized by the court as missing — 129, recognized by the court as incompetent or limited in capacity — 27, recognized by the court as dead — 2) [1].

The main reasons that give rise to such a phenomenon as social orphanhood in our society are the following:

  • first, the crisis phenomena in the life of the state and society, associated with political and economic restructuring and reforms, affecting the family budget and the family microclimate;
  • secondly, the decline in the scale of life demands and social needs of young people, the decline in moral standards, irresponsibility for the consequences of temporary relationships, the birth of a child, and others;
  • third, the desire of parents to escape from reality in drug addiction, alcoholism, vagrancy;
  • fourth, early marriages that do not have economic security, ending in divorce and problems of singleparent families;
  • fifth, the birth of children out of wedlock, underage mothers, single mothers;
  • sixth, the forced long-term isolation of parents in detention facilities;
  • seventh, abandoned children with serious diseases;
  • children of parents deprived of parental rights, abandoned children or foundlings [2].

Activities for the prevention of social orphanhood of children are carried out by many organizations and departments, whose actions are divided, often duplicate each other, are focused on different criteria and reporting indicators, they do not have a single operational field and a single task. Work with families at risk at the state level is carried out through the activities of the following organizations:

  • educational institutions — through the activities of social educators, who often do not have the professional competencies of social work, especially in the technology of case management and the organization of individual work with the case and do not have the necessary resources;
  • health care institutions — based on the activities of social workers, who often have general professional training, but do not have an appropriate level of professional training in medical and social work and also have a weak resource base;
  • social protection institutions, since 2017 they have become more active. But also, in the system of public administration there are no departments at the local levels of government that could conduct full- fledged activities with families in difficult life situations (this term is defined in the Law of the Republic of Kazakhstan «On Special Social Services» of December 29, 2008, but does not reflect the full extent) within the framework of social work.

To confirm the discrepancy in the level of qualification of social work specialists, the following data can be provided. For example, according to a UNICEF study in Kazakhstan: [3]

  • social work is still a new academic and professional discipline;
  • the government is interested in strengthening the existing system, in issues related to both improving the regulatory framework and developing common standards;
  • the definitions of social work and social workers are not standardized across different sectors, nor are they fully consistent with international definitions and the concept of the profession;
  • case management is not part of the policy, provision and control of special social services and social work;
  • shortage of qualified and well-trained social workers;
  • the supervision mechanism is not provided for in the law and policy;
  • university education in the field of social work has a lack of practical focus and local practice, including weak links between educational institutions and potential employers;
  • it is necessary to ensure that all higher education programs in the specialty «Social Work» are based on competencies;
  • the position of social workers in society is relatively low, and the profession is considered unattractive and associated mainly with a narrow set of services (targeting only people with disabilities and the elderly);
  • there are no codes of professional ethics developed and adopted for social workers.

Based on this, it is necessary to form future social workers' ideas and practical skills to work with a specific case. They should possess technologies for diagnosing each specific case, determining cause-and-effect relationships, and select adequate technologies for social work to overcome a difficult life situation. And, in our opinion, this is facilitated by the development of the use of the educational program «Social Work» — case management in the educational process for preparing students.

Experimental

In recent years, Kazakh researchers have done a lot of work on the study of the history and methodology of the use of innovative technologies in social work. The analysis of foreign and domestic literature on the issue of case management allows us to solve many urgent problems of psychological and pedagogical support for a family in a difficult life situation. The methodological basis is the study of case management technology by historical and chronological methods. Methods of historical-logical, comparative analysis, systematization, generalization, as well as methods of synthesis and description were also used.

The technology of working with the case — case management — has been developing since the beginning of the twentieth century. Virginia Robinson, a British academic and professor of social work, first used the term «social case work» in her analysis of new approaches to social work in the book «Changing Psychology in Social Work» (1939). Accordingly, «social case work» is a method of social work aimed at solving problems, improving functioning in society and developing the social abilities of an individual.

The case method in social work in the United States began to form at the end of the 19th century due to the activities of «Organized Charity Societies». This term has long been used in medicine to refer to the following concepts: disease, medical history, patient. In legal practice, a case is a court case, a precedent. In social work, the term case became common in the late 19th century to define a difficult social situation in which an individual or family finds themselves and in which they need the professional help of a social worker. Another term — social case work — originates from the concept of case work. Social case work in the early 20th century was the activity of a specialist aimed at adapting an individual and normalizing his social relationships with other people and society. Along with group work and social reform activities, case work was the main type of social work, the process of providing social assistance in the form of individual interaction between a specialist and a client or a small group (family). Social work of this type was called the case method, and the employee using it was called the social case worker [4].

As defined by the Case Management Society of America, «case management is a process that combines evaluation, planning, assistance and support in obtaining services that meet the health needs of the client, carried out through communication and finding available resources to achieve high-quality and cost-effective results» [5].

Sometimes case managers are hired by private companies that are concerned about the frequent illnesses of employees — the case manager in this case helps the employee plan treatment, conducts educational classes on health, helps to get medical services.

Case management as a process is very close to management models, so this technology (in specific cases, the method) can be considered to a certain extent as a universal one.

The following definitions are often used to describe case management and its goals in working with children and their families [6]:

  • case management is a way to increase the flexibility, continuity and responsiveness of service delivery; to ensure a holistic approach, where case planning and evaluation is based on the individual needs and strengths of the child and their family;
  • case management in social work affects both micro and macro levels. It requires the social worker to develop and maintain a trusting relationship with the child and their family, as well as to connect the child/family with available services, resources, and opportunities in the community.

In general, case management is the basis for successful work with the child and their family. Modern management theories define new methodological approaches to working with the case. The distinctive features of the management theory from the traditional management theory are: intensive psychologization of management, personal orientation of management activities based on respect, trust in customers and employees, taking into account their professional capabilities, creating a situation of success for them; transition from a vertical command-and-control system to a combination of horizontal and vertical control systems; improving interpersonal culture and personal responsibility for the development of educational standards, universal and national values; including marketing in management activities (studying the demand and needs of the population for the services of an educational institution); the orientation of the institution's activities to this demand, the targeting of activities; active influence on the population in order to form the need for the services of this institution.

Proponents of this position understand the interaction of subjects under management (A.T. Abramov, V.G. Afanasyev, P.I. Tretyakov, T.K. Chekmareva, T.I. Shamova, D.V. Yudin, etc.). Interaction in philosophy is understood as a complex, diverse process in which the change of sides occurs not just in an interconnected way, but in a mutually conditioned way (A.N. Averyanov, N.I. Zhbankova). Its essence consists in the continuity of direct and reverse effects, an organic combination of changes affecting each other subjects. In addition, interaction is an integral, internally differentiated, self-developing system (A.I. Uemov, B.M. Kedrov, etc.). This understanding of the interaction, which represents the essence of management, implies a mutual change of managers and managed people [7].

In Kazakhstan, the case management technology is a fairly new method in the field of social work. The United Nations Children's Fund UNICEF makes a huge contribution to the development of social work, the promotion of technologies for working with families and children in Kazakhstan. For example, the handbook for health, education and social protection workers «Case management in social work at the local level» was developed in 2012. The general purpose of this handbook is to help professionals working with socially vulnerable children and families to master the methods of case management that contribute to the preparation and implementation of plans for individual social work. The goal of this approach (case management) is to create an environment that promotes more effective assistance to families in raising children and preventing the placement of children in residential institutions, such as baby homes or orphanages [8].

In October 2018, the National Resource Center for Social Work was established with the support of the United Nations Children's Fund (UNICEF). The center's experts developed methodological approaches to creating a Social Map, the project «Algorithm of actions of a social work consultant in the field of targeted social assistance using Case Management technology». With the support of the Center, amendments were made to the charter of the NGO «Association of Social Workers of Kazakhstan», which was established in 2004, at the initial stage of the formation and development of social work in the country as an academic discipline, science and practice. In April 2019, the Regional public Organization «National Alliance of Professional Social Workers» was established. It consists of certified social workers who have received good training in the bachelor's, master's, and PhD programs in social work. The Alliance aims to develop social work as a profession, expand and strengthen international cooperation, and provide expert and educational assistance to social workers at all levels working at the local level.

The experts developed basic modules on social work, which include «Case management in social work», «Concept, competencies and ethical principles of social work», «Communication skills of a social worker». The developed content was discussed at the meeting of the Republican Educational and Methodological Council of the Ministry of Education and Science of the Republic of Kazakhstan on Social Work on the basis of the L. Gumilyov ENU in June 2019. Together with the Department of Labor Rationing, a card of the profession «Supervision in social work» of the 7th level of qualification was developed and introduced into the professional standard «Psychological and social work». The functions of «Case management» were introduced as additions to the labor functions of the profession card «Social Work Specialist» of the 6th level of qualification. These changes were approved by the Order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated May 30, 2019 № 292.

The small but positive experience of the National Resource Center for Social Work has shown the need for further modernization of the system of social work with the family. The vulnerability of the system of social work with children left without parental care is that the potential of case management technology is not sufficiently used, it is not a part of social policy, provision and control of special social services and social work, but at the international level this technology is considered the best practice in the provision of social services. Some institutions have developed case management models, including through pilot projects supported by UNICEF in the health sector. However, these models need further study to see their potential application in various branches of social work.

Results and Discussion

Case management is a professional approach to the provision of services, a way of organizing and coordinating social protection. Case management is not a social service in itself. There is still no generally accepted definition of case management, nor a universal model of case management in the practice of social work. The definition below explains its nature within the framework of the family strengthening project «Family and Childhood Support Center» based on SOS Children's Villages of Kazakhstan, which is guided by the handbook of the United Nations Children's Fund UNICEF in Kazakhstan «Case Management in Social work at the local level» (2012) and the Continental Guide «Guide to Case Management Procedures in Family Strengthening Projects» (2012).

The project «Family and Childhood Support Center» on the basis of SOS children's villages of Temirtau has been working since 2017. In the first years of the project, the target group was substitute families, that is, guardians of children. Since 2019, they began to accept families in difficult life situations. This is a group of beneficiaries who are often dependent, incurably ill (at the moment, the project accompanies 9 beneficiaries with AIDS), substitute families (in these families secondary orphanhood is threatened), reintegration families (in 2020, one family was reunited, and 5 families are undergoing reintegration work). In 2020, the project was supported by 86 families, 135 children, and 117 adults. To date, 31 families have graduated from the project on self-sufficiency.

Within the framework of the scientific research cooperation of the Department of «Social Work and Social Pedagogy» of the Karagandy University named after E.A. Buketov and SOS Children's Villages of Temirtau for the last ten years, an active search for effective methods and technologies in working with children left without parental care has been conducted. Three topics of the master's thesis were defended based on the study of this aspect (the formation of family values and professional interests of orphans). The teaching staff of the department works fruitfully in this direction, highlighting and popularizing the experience of the SOS Children's Villages projects among bachelors, undergraduates and practicing social workers (round tables, webinars, cultural and leisure programs, career guidance work). We used the methods of observation and surveys during the meetings held in the village with the deputy director for the prevention of social orphanhood and specialists of the SOS project of the family-type village, a training webinar within the framework of the studied problem with bachelors and undergraduates of the Faculty of Philosophy and Psychology. In the course of it the professional necessity of training bachelors of social work in the use of case management technology in working with children in difficult lifsituations was identifie(Figure 1).

Figure 1. Screenshot of the webinar held on 10.02.2020.

The algorithm for providing services in the project is based on the innovative technology of social work-case management and consists of several stages:

  • identification of families and children in difficult life situations through educational institutions (social educators and psychologists of kindergartens and schools), health care institutions, social protection organizations, police agencies, juvenile justice (juvenile affairs inspectorate), hotlines, neighbors, passers-by, other members of society and organizations, independent appeals (personal, relatives and other persons), through social networks, e-government of the Republic of Kazakhstan egov.kz, etc.;
  • advising children and adolescents, their parents (legal representatives) on socio-legal, psychological and pedagogical issues (trainings under the program «Strong parents, strong children», mutual assistance groups, foster parents «school, mothers» club);
  • development of individual family and child plans for overcoming difficult life situations, their support (provision of comprehensive support services for substitute and biological families, psychological and pedagogical support, provision of special social services to substitute families (adoption, guardianship, patronage, guest family), professional individual legal consulting services by lawyers, conducting educational, methodological and informational work);
  • implementation of correctional and rehabilitation work with parents, assistance in identifying and implementing their own opportunities to overcome difficult life situations (prevention of family problems within the framework of improving the level of parental competence in raising children, provision of state social assistance, psychological services, art therapy classes, professional training of parents in partnership with state organizations, employment through the Employment Center of the city, advisory assistance on the preparation of documents for targeted grants to aspiring young entrepreneurs, women, for the unemployed from low-income and large families on a gratuitous and irrevocable basis) [9];
  • implementation of foster care for a child in a family (short-term placement (up to 180 days) of children aged 3 to 18 years in a professional SOS foster family (married couple) «Zhansaya»);
  • current assessment of the family, achieving changes in the family (determining results through innovative case management technology);
  • ensuring the reception, maintenance and upbringing of children in cases that raise concerns for the life and health of children, as well as when establishing the status of an orphan child and a child left without parental care;
  • permanent placement of the child in the family if it is impossible to return theto the blood family.

Case management in the provision of direct services to children and their families is a process consisting of the following sequentially related stages:

  1. Admission to the project;
  2. Evaluation;
  3. Family development planning;
  4. Implementation of the Family Development Plan (PRP) and achievement of the goals;
  5. Review of progress;
  6. Closing the case.

The diagram below shows the relationship between the main stages of the case management process and the time frame that is usually required for their implementation (Figure 2).

1 week

2-3 week

1 week

Figure 2. Stage of the case management process

The advanced experience of working with dysfunctional families and children left without parental care in SOS Children's Villages of the family type of Temirtau city, considered by us, shows the authority and sovereignty of the developed and implemented innovative technologies in all implemented social projects, unique features of the algorithm of working with the case, which shows the need for globalization and popularization of successful experience in the work of all institutions working with children in difficult life situations.

Conclusions

The status of social work is improving all over the world. Modernization of the social sphere puts forward qualitatively new requirements for the staffing of the social protection system of the population of Kazakhstan. Effective social services can be provided by a professional body of social workers who have been trained in accordance with modern international standards and are systematically prepared for successful practice.

Thus, based on the analysis, we can draw the following conclusions:

  • clear steps and algorithms for the provision of assistance/services that guide social workers in their work should be developed, including strengthening their reporting system. This includes introducing a case management/social support system that will ensure that children (and their families) are supported according to their individual needs, systematically and in a timely manner, through direct support or referral, and clarifying the roles and responsibilities of each participant;
  • there is a need to develop clear procedures for the provision of assistance and services, including referrals, and clearly allocate responsibilities, by adopting a case management/social support approach;
  • it is necessary to legislate the introduction of case management/social support as the main approach in social work and the provision of social services in all sectors, to review the current procedures for the provision of services. This will require the development of standardized case management procedures that will be applied to all children receiving special social services or registered in the system, including the development of a single standardized package of procedures and documents.

The comprehended traditional and innovative technologies of working with families in difficult life situations (the technology of social and educational elevator, the technology of working with a network of social contacts, the technology of intensive family therapy, etc.) [10].

The identified barriers that prevent the promotion of innovative technologies in the activities of students working with children left without parental care (lack of specializations in the modular curriculum, low representation of the curriculum disciplines, lack of development of programs of production practice programs to improve the practical component of professional activity, etc.).

The article analyzes the features of regional social policy, the degree of development of the regulatory framework for working with this category of families (projects of the SOS Children's Village family «Zhansaya» (temporary placement of children), the «Asar» center for mothers and children in difficult situations, the project «Support for family and childhood» (center for special social services) [11].

Thus, it can be stated that the obtained new theoretical, methodological and practical data necessary for specialists working with families in difficult life situations showed the need to include in the curriculum for the preparation of future bachelors of social work disciplines that consider the methodological and methodological foundations of working with the case to improve the professionalism and quality of services provided by social workers.

 

References

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