Study Questions

Study Questions 1. Modernism, postmodernism, structuralism, post-structuralism, critical realism 2. Enlightenment thinkers believe that reason could help people break free from the structures of the church and state and in doing so, achieve personal liberation, societal order, and social progress. 3. ???

4. a. b. c. d. e.

Reconciliation of social work values Places value of social justice at center stage Does not blame the individual for their difficulties Encourages us to adopt a multi dimensional analysis Ensures social workers recognize the effects of cultural and social structures on service users lives f. Values the contribution of local change processes can make in achieving on social change 5. a. Collaborative, highly structures, time limited, problem focused b. Crisis intervention is a form of problem solving used for the treatment of trauma c. Joint effort between social worker and service user d. Develops clients capacities 6. Parton: structures of knowledge, claims and practices through we understand, explain and decide things. They are frameworks of social organization that make some actions possible while precluding others. a. Sets of language practices that shape our thoughts, actions and words b. Ex. Biomedicine, economics and law 7. What is theory: • Devised to analyze, predict, or explain the nature or behaviour of a phenomena that could be used for the basis for action •

It is socially constructed

•

Often overlap (Payne)

•

Prone to fashion, influenced by forces

•

Informs what we value, do, fund and evaluate as “successful”

8. What is the difference between grand theory and practice theory: • Grand theories are the philosophical underpinnings that have influence and guide our practice theory •

Practice theories guide our actions as social workers

9. What would the development of Healy’s “framework of practice” involve for you? What does yours “look” like now? • Framework of practice: refers to the combination of formal knowledge and skills and informal knowledge and skills developed by the social worker in practice •

So basically, how does theory impact your everyday practical work, living, and view?

10. what are three markers of structuralism • Power, inequalities, marginalization, class & gender, advocacy, community •

Ex. A parade/rally for disadvantaged youth

11. what might an indigenous approach to knowledge entail? • promotes health and wellness through a ‘fully ecological’ and holistic approach based on the Medicine Wheel •

medicine wheel- considers, physical (black-adults), emotional (yellow-children), mental (white-elders), and spiritual (red-youth)

•

It is meant to provide direction and guidance for understanding the process of life and for striving to achieve well-being

•

a pro-active and empowering approach to social intervention with individuals as well as a self-help tool

•

Looks for balance and well being in life. If one of the wheel sections is not in tune it affects the performance of the others

•

Focus on community and accountability.

•

Elders are seen as the most valuable to the community because of their ability to pass down wisdom

•

Hierarchy- (can’t really remember and don’t have any notes on it but think…) it starts with earth, then nature, then elders….

12. what are the waves of systems theories? How are they different?

1) 1st wave: General systems theory • Developed in the 1930’s, and adopted to social work in the 1960’s •

Transactions between individual and their social environment

•

Challenges psychoanalysis by focusing on the current problems and not digging up the past

•

Stemmed from biology

•

Encourages sw to pay more attention to environmental change (not just nature)

•

Believe that social systems are stable

•

Today is used to help client challenge the individualistic focus of dominant discourses shaping health and welfare services

•

Core concepts: homeostasis (balance of human organism), entropy (disorder), equifinality (multiple ways of achieving desired state), and feedback (from client)

2) 2nd wave: Ecosystems theory • 1970’s •

Meant to improve and expand on GST

•

Make short and long term change

•

Central idea: person in the environment

 The Life model Stage 1: Initial phase -

Create a partnership

-

Ask how client sees situation and what they want to achieve

-

Clarify your role as the sw

Stage 2: Ongoing phase -

create eco-map (macro, meso, and micro)

-

Assess impact of each level

-

Engage client in participation

-

Strengthen clients problem solving skills by exploring, guiding and facilitating

Stage 3: Ending phase -make sure client know of you ending date in phase one -encourage client to give feedback of all emotions 3) third wave: Complex systems & chaos theory • Started in math, physics, and engineering •

Brought to social work by Peile

•

Recognition of the complex interactions between individual systems and social structures

•

Systems very sensitive, and much more complex then we thought

•

Transactions are non-linear and unpredictable

•

Behaviour of the whole system is greater than the sum of its parts (143)

•

Change is a usual feature of complex social systems

•

Deeper level of patterned order, not random

•

The butterfly effect

•

Do not see people as victims of their social context; nor see them as entirely free agents

Jordan Questions 13-19 20. (Page 99-102) • Reflexive – developed as a way of overcoming the limitations of both evidence based and reflective traditions of knowledge o Recognizes that social workers are always making knowledge in practice o Knowledge and theory use is constantly being constructed in part through practitioners experiences and also through sources such as our practice content and formal theoretical base •

Reflective (Schon) – recognition of practitioners lived experience of practice as a basis for maing and using knowledge in practice.

o Knowing in action: the process of developing knowledge in practice rather than applying pre existing theories to it o Reflection in action: the process of refining knowledge in action so as to promote new ways of responding to the problems we in encounter in practice. The capacity to reflect in action is akin to “trial and error” o Places the practitioners, rather than the academic or researcher at center stage in knowledge development and use o Our knowledge is developed through and in action 21. (p117) • Pre intervention phase: understanding the contect of the intervention (prior to and during session 1) • Step 1: Defing target problems (session 1) • Step 2: Contracting (Session 2) • Step 3: Problem-solving implementation (Session 3-7) • Step 4: Termination (Last session) 22. (p103-104) Strengths perspective: it’s based on psychology 23. p 139-140 • • • • •

An ecomap is a graphic system for viewing the relevant connected case elements together within a boundary that clarifies for the practitioner, the case system as the focus of work It can enhance client opportunities to participate in the system The service provider and the service user work together to gather data about an analyze the impact of multiple systems on the service users situation Many theorist use an ecomap to assist in the assessment process Many social workers use the Brofenbrenners approach in which rings represent different levels (Micro, Macro, Mezzo)

25. Personal Preference 26. Audre Lorde is a Carribean-American write, poet and activist. She criticized firstwave feminists for only focusing on the white, middle-class experience of women. She is considered a founder of "black feminism" she focused on the intersectionality of race & gender and the differences in the female experience 27. pg 197 Post-structuralism: critiques the idea that we can deconstruct a structure without coming from a specific context. Post-modernism: truth is subjective. Postcolonialism: a reaction to the idea of superiority/progress 28. pg 206-212 adopt a curious & open, rather than "truth-seeking" position towards the

service user. Seek to assess and transform the narratives that construct our lives, seperate the person from the problem, extrenalize conversations 29. Black pg 12 group work instills hope, provides cohesion, is altruistic, models behaviour, promotes interpersonal learning and offers support. Group work is necessary because of oppressive societal culture which isolates, seperates and creates a feeling of powerlessness and alienation 30. prescriptive, implements a certain power structure, quantitative, compartmentalizes, positivist 31. Solution focused: don't focus on the problem, but on the solution, there is no connection between the problem and solution. Focus on behaviour, orientation is future, not interested in problem manifestation and pastTask-centred: work on small parts of the big picture, practical concerns rather than emotional problems 32. Narrative Therapy: influenced by post-modern approach, Foucault, through language power reveals itself 33. (personal preference based, so you may all choose something different) Task-centred because you need to solve what immediate practical concerns you can to keep the people alive and well-nourished 34. (personal preference based, so you may all choose something different) Strengths Perspective, because it emerged in that field and focuses on skills rather than deficits and labels 35. Classroom, hospital, police force 36. (personal preference based, so you may all choose something different) Narrative therapy, because it focuses on the narratives that shape us 37. Both. Grand theories deal with the larger understanding of social phenomena, the aboriginal worldview qualifies as such, Aboriginal approaches also include practice concepts Hanohano CHAPTER 1: Why context matters • Healy describes social workers as all having a practice purpose •

This is what we think we should do, and how we should do it

•

This can conflict with client’s needs, and also employer demands

•

She argues that institutional contexts must be understood as integral to how we practise

•

Social work has variability because:

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1) it lacks a common knowledge base, and agreed upon ways of building knowledge

•

2) social work does not have a primary field or organization of practice (teacher=school, nurse hospital etc)

•

3) the primary task of sw varies by practice context

•

Thus when constructing our sense of purpose, we need to be mindful of the primary task assigned to us within in our practise context

•

We need to enhance our capacity to understand, analyse and responde to our institutional contexts

•

We are active in creating contexts too

A Dynamic Approach (p. 5 diagram) • The institutional context of practice (laws, policies, what we are formally employed to do) •

The formal professional base (discourse, theories, philosophies, values, formal skills)

• •

Practice purpose (formal role description, client and worker characteristics)

•

Framework for practice (skills developed by sw in practice, practice wisdom, acquired knowledge, used ‘on the job’)

•

All these influence each other

Discourse of Health and Welfare Institutions • Discourse: the sets of language practices that shape our thoughts, actions, and our identities •

Dominant discourse that shape health and welfare: biomedicine, economics, law(mainstream institutional context), human sciences, psychology, sociology (formal base of SW), alternative (consumer rights, religion, spirituality)

•

A discourse analysis approach encourages us to recognize the diversity of SWP, contest established ways of viewing and responding to clients needs

•

Discourse can shape SWP, but we can also be aware of the discourse we use

Theories for SWP • Provide guidance for practice as they identify who should be the focus of practice and how to go about it practically • Theories have a more limited scope of influence (compared to discourse) • Can provide us with insights into the dilemmas facing service users and diversify our options for responding • Provide a, rather than the, base for swp. • Healy takes on a post-modern perspective by saying that all the theories presented

in her book, have pros and cons and that there isn’t one good way to practice

Healy chapter # 5 Theories for practice draw on discourses from other discipline & fields (i.e. AOP from sociology & consumer rts) Theory for SW practice -

ideas from service discourses + specific purposes & experiences = Theory for Practice i.e. problem solving approaches developed from service users having difficulty w/adjusting to daily living Barriers to theory

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traditional forms of theory building have separated theory development from its application

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reflexive approach to theory – SW use theory & create theory in practice

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intention of theory – enable SW to practice thoughtfully, analytically & creatively

Why theory matters – accountability to service users, employers & funding agencies -

managerial reforms of social services focuses on ‘efficiency’ & ‘effectiveness’. Theory can:

-

improve service quality

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critically examine common sense ways of seeing & doing things

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enhance capacities to explore broader range of practice options

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i.e. Strengths Perspective helps us see clients’ strengths & capacities that might be invisible to us & others

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helps to assess & enhance quality of services we provide

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can help to reach a wider audience Evidence based or Critical Reflection

-

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Evidence based – advocates argue that should be grounded in rational knowledge, validated through scientific methods Sometimes organizations & public require validation

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i.e. Task-centred approach – one of the best known examples of this drive to create scientifically grounded SW practice

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Evidence based practice theory is effective in child protection, as is high risk & so requires validation & helps to formulate reasoning & evaluate their own work

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Creates top-down approach (T & White)

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SW – subject & user of knowledge, not maker

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(evidence-based knowledge) technical rationalist approach cannot provide basis for knowledge development & use in human services

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Decisions are often based on perceptions & feelings as well as material facts (therefore shit is messy)

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In assessing baby: (whether they are neglected). i,e, curdled milk in bottle, ageappropriate weight, affection for child Reflective approach

-

-

knowing in action, reflection in action, development of knowledge in practice as opposed to pre-existing theories intuitive & tacit knowledge is essential at effective practice Reflection in Action

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through trial & error – good at responding to non-routine events

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practitioner is centre stage, above academic

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our knowledge is developed through action

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intuitive & tacit knowledge could be inaccessible to service users, employers or funding agencies Evidence based knowledge – separates knowledge development from practice Reflexive Approach

–

recognizes SW’s are always making knowledge in practice, but prioritizes experiential & tacit knowledge over formal knowledge.

–

Knowledge & theory use us constructed in part through practitioner experiences, practice context & formal theoretical base 5 Theories of SW Practice 1. Problem-Solving Perspective 2. Systems Perspective 3. Strengths Perspective

4. AOP 5. Post Modernism, poststructural, & postcolonial These theories were selected because of… money & time restraints more widely applied to service providers, users relevant to formal knowledge base extends broadly of SW theory base, through understanding of post theories Conclusion SW is constructed through negotiation between 1. institution 2. professional knowledge & skills 3. frameworks of practice Chap 6 (Jordan) Chapter 7: Three Waves of Systems Theory • Systems theory emphasizes the role of these systems in contributing to individual and community well being Systems Theories in Context • It was not until the 1960’s that systems approaches re-emerged as a powerful theoretical foundation for the profession The Origins of Systems Theory in Social Work • First introduced the term systems theory to social work in 1930 • Systems theories provided an intellectual foundation for reintegrating the psychological and sociological discourses by recognizing that a range of systems that impact the service user in a myriad of ways 1. The First Wave: General Systems Theory • The initial proponents of systems theory emphasized its potential to provide scientific credibility to the profession and to develop an integrated theoretical foundation that would capture the central elements of social work practice in all its varied forms • Apply biological systems theories to the social world • Biological mechanical and social • Drawing attention to the transactions between the individual and their social environment

• •

Psychological pathology is considered to be socially and culturally produced Today systems perspectives can be used to challenge the individualistic focus of the dominant discourses shaping health and welfare services • General Systems Concepts o Used biological terminology to explain client needs o Some of the core concepts included transaction, homeostasis, entropy, equifinality and feedback 2. Second Wave: Ecosystems Perspective • During the 1970’s, the ecosystems approach to practice superseded general systems theory • The parts of the system can never be entirely separated from each other • Ecology as a useful metaphor for encouraging social workers to focus on transactions within and across systems and to seek sustainable, not only short term change • Person: environment transactions • Recognize that problems arise because of a poor fit between a persons environment and his or her needs, capacities, and aspirations • Does not propose specific intervention methods The Life Model of Social Work Practice • The life model is characterized by three stages: the initial phase, the ongoing phase, and the ending phase • 1. Initial Phase: Getting Started o The primary purpose of the initial phase is for the social worker and service user to establish an active partnership based on mutuality and reciprocity o Use of empathy o Work together to identify and, where necessary, prioritize life stressors • 2. Ongoing Phase: Working Toward Goals o Out primary purpose in this phase is to promote adaption in the person: environment relationship so as to maximize Tracy’s well-being and that of her child o Goal clarification, facilitation, coordination, and individual and systemic advocacy o Many theorists use an ecomap to assist the assessment process o The ecomap is a graphic system for viewing the relevant connected case elements together o The Practice Process  Enhance and strengthen service users adaptive capacities and problem solving abilities  Promote change at the micro, messo ad macro levels • 3. Phase Three: The Ending Phase o A well planned termination of intervention o Regularly referring to this throughout the intervention process o Encourage the service user to discuss their responses, such as anger,

sadness, or relief, about the conclusion of the intervention 3. Third Wave: Complex Systems Theories • By the late 1990s, a number of social work theorists were applying complex systems ideas to social work practices • Complex systems ideas enrich, rather than replace, existing about systems theories • Behaviour of the whole system is greater than the sum of its parts • Use inductive approaches to contribute to evolution to larger complex systems • Characterized by non-linearity • General systems theorist suggest that social systems are stable, complexity theorists argue that change is a usual feature of complex social systems • Repeatedly self reinforcing feedback • Characterized by complex behaviour • The term phase change refers to the moment at which the system switches from one pattern of complexity to another • Importance of socialist mathematical knowledge Strengths and Limitations of Systems Theories in Social Work Strengths • They provide a framework for understanding and responding to people in their environment • Provide a unifying conceptual foundation for social work as a profession Weaknesses • Lack of clarity about core systems concepts • Absence of both theoretical and empirical justification of systems viewpoints in practice • Inconsistencies between social work values and systems theories • May need to break down into smaller pieces • Recognizes all information available to us but doe not help s to prioritize it.

Knowledge & reasoning in SW: educating for humane judgement (Taylor & White) Paper – suggests ways in which students can be helped to remain in uncertainty & interrogate their knowledge & case reasoning Min points: -

educating for certainty is often misplaced

-

look at certainty & way its produced in practice

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educational implications of emphasis on certainty before making alternate suggestions about educating for uncertainty (in reference to SW w/children & families)

-

SW often receives conflicting info & interpretations (i.e. Mother, child and previous case worker)

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i.e. Victoria Climbie key staff failed to process accurately & decisively upon medical info. On other hand, Laming report stated that SW was criticized for failing to critically analyze info, given to her by aunt

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Report: SW was too passive & critical for carving too much certainty from contradictory info

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Through confirmation bias, whereby people will seek out info that supports original hypothesis, people often miss important info as in case w/Victoria

Producing Certainty (malleability of psych. Theory) -

necessary to interrogate carefully how we use theory to what purpose & to what effect we need to consider how popular ‘common sense’ knowledge is invoked to make determinations about cases Judgements & Characterization

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SW often strive for certainty

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In many situations, the certain thing is not necessarily the right thing

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SW’s need to stay in uncertainty linger, hold onto doubt

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Many programs promote top-down thinking

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Pressure to ‘handle cases quickly & efficiently’ may predispose SW’s to use formal knowledge in way that shores up anchor hypothesis when we may instead want to encourage destabilization Educating for Uncertainty

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wise judgement under conditions of uncertainty process knowledge & an ability critically to analyze practice may be equality or more important that dissemination of formal knowledge

Uncertainty & self-questioning -

Socratic self-questioning & critical engagement w/role of emotion in making judgements of value

-

Art & literature essential in fostering ‘narrative imagination’ which is essential in critical engagement

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Through problem based enquiry & action learning models, experiential techniques (roleplay)

Conclusion -

broader approach that encompasses practical reasoning, emotion, & most of all intelligence that is disciplined & creative

Arnd-Caddigan & Pozzuto • Case study in which they examined a SW assessment of a stimulated client situation, and then interviewed the social worker about her report and impressions of the case •

It was done to prove that theory is always used. Participant said she didn’t use theory, although evident proved contrary

Questions 7. What is theory: • Devised to analyze, predict, or explain the nature or behaviour of a phenomena that could be used for the basis for action •

It is socially constructed

•

Often overlap (Payne)

•

Prone to fashion, influenced by forces

•

Informs what we value, do, fund and evaluate as “successful”

8. What is the difference between grand theory and practice theory: • Grand theories are the philosophical underpinnings that have influence and guide

our practice theory •

Practice theories guide our actions as social workers

9. What would the development of Healy’s “framework of practice” involve for you? What does yours “look” like now? • Framework of practice: refers to the combination of formal knowledge and skills and informal knowledge and skills developed by the social worker in practice •

So basically, how does theory impact your everyday practical work, living, and view?

10. what are three markers of structuralism • Power, inequalities, marginalization, class & gender, advocacy, community •

Ex. A parade/rally for disadvantaged youth

11. what might an indigenous approach to knowledge entail? • promotes health and wellness through a ‘fully ecological’ and holistic approach based on the Medicine Wheel •

medicine wheel- considers, physical (black-adults), emotional (yellow-children), mental (white-elders), and spiritual (red-youth)

•

It is meant to provide direction and guidance for understanding the process of life and for striving to achieve well-being

•

a pro-active and empowering approach to social intervention with individuals as well as a self-help tool

•

Looks for balance and well being in life. If one of the wheel sections is not in tune it affects the performance of the others

•

Focus on community and accountability.

•

Elders are seen as the most valuable to the community because of their ability to pass down wisdom

•

Hierarchy- (can’t really remember and don’t have any notes on it but think…) it starts with earth, then nature, then elders….

12. what are the waves of systems theories? How are they different? 1) 1st wave: General systems theory • Developed in the 1930’s, and adopted to social work in the 1960’s •

Transactions between individual and their social environment

•

Challenges psychoanalysis by focusing on the current problems and not digging up the past

•

Stemmed from biology

•

Encourages sw to pay more attention to environmental change (not just nature)

•

Believe that social systems are stable

•

Today is used to help client challenge the individualistic focus of dominant discourses shaping health and welfare services

•

Core concepts: homeostasis (balance of human organism), entropy (disorder), equifinality (multiple ways of achieving desired state), and feedback (from client)

2) 2nd wave: Ecosystems theory • 1970’s •

Meant to improve and expand on GST

•

Make short and long term change

•

Central idea: person in the environment

 The Life model Stage 1: Initial phase -

Create a partnership

-

Ask how client sees situation and what they want to achieve

-

Clarify your role as the sw

Stage 2: Ongoing phase -

create eco-map (macro, meso, and micro)

-

Assess impact of each level

-

Engage client in participation

-

Strengthen clients problem solving skills by exploring, guiding and facilitating

Stage 3: Ending phase

-make sure client know of you ending date in phase one -encourage client to give feedback of all emotions 3) third wave: Complex systems & chaos theory • Started in math, physics, and engineering •

Brought to social work by Peile

•

Recognition of the complex interactions between individual systems and social structures

•

Systems very sensitive, and much more complex then we thought

•

Transactions are non-linear and unpredictable

•

Behaviour of the whole system is greater than the sum of its parts (143)

•

Change is a usual feature of complex social systems

•

Deeper level of patterned order, not random

•

The butterfly effect

•

Do not see people as victims of their social context; nor see them as entirely free agents

Parish, Burry and Pabst: Providing Comprehensive Case Management Services to Urban Women with HIV/AIDS and Their Families •

Although HIV/Aids does not make any racial, gender or cultural distinctions for women, particular urban-dwelling women of colour, it represents a challenge that is unparalleled by any other disease • Comprehensive, multi-systems case management, including home visits, transportation, and housing support, provides a means by which problem solving and advocacy are provided and an effective way of coordinating the use of and communication among multiple agencies • Poor women are at a disproportionate risk of HIV/AIDS, regardless of their lifestyles • In the face of challenges to survival such as poverty, domestic violence, highcrime neighborhoods, homelessness, and other difficulties in meeting basic needs, the management of HIV/AIDS related needs easily becomes compromised. Such compromises can jeopardize the survival of women Women's Risk Factors and Case Management Issues • Case managements has gone through many transitions • First developed as a means of coordinating the complex needs of recently deinstitutionalized chronically mentally ill persons, case management has also evolved into an effective means of coordinating services that are needed by an array of at risk populations, such as persons with disabilities, elderly people, cancer patients etc. • Case management reflects various core social work principles of problem solving within a clients environmental context and achieving change in the person, the environment, or both • Case management provides a crucial means of providing continuity and coordination of services among various agencies and providers and minimizing the risk of separate agencies proposing duplicating or contradictory interventions • Case management is also a means of ensuring accountability for providing services to clients in need • Especially when families who are living in chronic poverty are accustomed to and distrustful of the intrusive elements that are common to many public agencies, comprehensive case management provided by a single source can both enhance the effective use of resources and minimize the potentially detrimental intrusiveness of multiple providers efforts o Ex. The historical and medical patterns may further contribute to the reluctance of African American and other women of colour to accept traditional Western medical treatment protocols  **Case managers are in an ideal position to advocate and negotiate systems on behalf of those who need such prescriptions to manage their medical conditions • Through effective case management, persons living with HIV/AIDS can be

provided more comprehensive services to coordinate the complexities od their medical regimes, find housing, receive adequate nutrition etc. • Comprehensive case management is also suited to providing he linkages necessary to sustain abstinence and reduce the risks of relapse in cases involving substance abuse The Back to Basics Project • Initiated in 1999, the back to basics project was a 3 year intervention that was designed to serve as a national demonstration project • It provided comprehensive, multi-system case management services to 145 families in an urban mid Atlantic city who had been homeless and ho had a member whose HIV/Aids status was either newly diagnosed or newly disclosed • The majority of the families had multiple members with HIV/AIDS • The project had several major goals o To provide 80 families with crisis intervention services  Affordable housing, food, clothing etc. o Enhance the stability of the participant o Wanted the participants to become part of a supportive, interactive community of families with members living with HIV/AIDS • Back to basics had a focus group for clients where clients and their family members could discuss both their difficulties and their success Descriptive Findings Clients • 145 families completed the intake process • The projects original goal of providing service for 80 families over a 3 year period was exceeded by over 80% • Most of the clients and their families were in crisis and had an immediate need for food, clothing and shelter Rent, Utilities, Housing and Food • Over 2/3 of the families had histories of delinquent payments of rent that compromised their eligibility for establishing utility services and or being accepted for leases • Other challenges to providing assistance with rent and utilities included the shrinking rental housing market and clients with criminal backgrounds • Housing needs: clients housing needs remained a crucial aspect of case management throughout the project • Food: during the course of the project 58% needed food once, 25% needed food twice and 10% needed food on as many as five occasions Income • Poverty is a consistently significant issue for women with HIV/AIDS • Sources of income included; o Supplemental Security Income o EI o Disability funds o Transitional Emergence Medical Assistance

Out of Home Placements of Children • Women with HIV/AIDS and a history of homelessness are at a high risk of haing their children place in out of home care because of their unstable housing and the potential for medical crises • It was therefore important that these women identify and establish child care resources, so that places could be in place if out of home care was necessary Ongoing HIV/AIDS Education and Support Services • Back to Basics project was to establish a system of ongoing support services that would be readily accessible to families. • At the end of the project several support services were in place, and others were being developed and pilot tested Barriers to Achieving Stability • Four primary barriers in clients achieving stability in the project o Poverty o Limitations resulting from poor credit histories o Difficulty following through on tasks o Substance abuse • Other barriers o Lack of transportation o Limited housing resources for clients o Limited follow through on tasks DISCUSSION AND IMPLICATIONS • Relatively small caseloads (approx 15) allowed staff to work closely in an empowering manner with the women to contribute to their movement toward independence • The most important implication of this project was the complexity of the lives and needs of women with HIV/AIDS • The lives and needs of women with HIV/AIDS are multi-faced and demanding • The back to basics project provided comprehensive, community based case management services for women who were otherwise at risk of receiving inadequate services to meet their needs