Casework Treatment Procedures as a Function of Client-Diagnostic Variables

The study is an exploratory examination of the relationship between the psychosocial diagnostic evaluation and the treatment procedures used by the caseworker in the interview. The psychosocial diagnosis has been defined by twenty-four selected variables assumed to be relevant indicators of the diagnostic process. The treatment procedures have been defined by the Hollis' typology of casework treatment. The variation in the use of the treatment procedures is also examined in relation to three intervening variables: (1) treatment phase; (2) casework method (supportive vs. modifying); and, (3) caseworker. The study is based upon a secondary analysis of data originally collected for the Casework Methods Project, Center for Social Casework Research, Community Service Society of New York. The clients studied are a well defined group. The sample represents motivated, lower-middle class, Negro and White clients of slightly above average general intelligence living in intact families and seeking assistance from a private family agency for difficulties in marital and/or parent-child relationships. The sample tends to represent clients who continue in service through at least the ninth assigned service interview. These are clients who have agreed to partake in a research project and to have their interviews tape recorded. The study has examined eighty-seven tape recorded interviews drawn from thirty-five clients representing twenty-two families. Individual clients are represented by a range of from one to three interviews drawn from a maximum of three phases of treatment. The interviews are representative of assigned service client interview one through fourteen and assigned service case interview one through thirty-nine. The caseworkers treating the clients assessed the clients' status and functioning on the selected diagnostic variables. The treatment procedures used by that same caseworker with each client were determined through the content analysis of tape recorded interviews with the clients. Each worker statement (clause) was classified as one of eleven possible treatment procedures. The proportionate use of each procedure was computed for each interview. Differences in proportions were examined in relation to the independent variables. Variation in the use of the treatment procedures in relation to the independent variables of treatment phase, casework method, and case- worker were examined through a series of multivariate analyses of variance tests. The associations between the twenty-four diagnostic variables and the eleven procedures were assessed through a correlational analysis. In addition the twenty-four diagnostic variables were factor analyzed. Three hypothetical components were identified. Factor scores were computed for each client on each of the three components and correlated with the treatment procedures used with the clients. Non-parametric techniques were used for supplementary analysis. The general hypothesis that the procedures are associated with the diagnostic variables is partially confirmed for nine of the eleven procedures in the sense that a larger number of significant correlations occur than attributable to chance. However, the amount of variation explained by the diagnostic indicators is generally rather small. The degree of the associations are from weak to moderate. The theoretically expected associations tend to occur although to an extent less than anticipated. The largest amount of variation in the use of the treatment procedures was explained by differences among caseworkers. Differences among treatment phases explained a significant amount of the variation in one of the procedures. The writer anticipates that control for caseworker and phase would increase the diagnostic-treatment associations. In addition to the testing of the study hypotheses the study describes the treatment process in this sample of eighty-seven tape recorded interviews.