Transcript 投影片 1 - City University of Hong Kong

SS4115 integrated
Social Work
Practice
Outline
Definition
 Historical and rationale of integration
 Model of integration
- profession oriented integration
- method oriented integration
- agencies oriented integration
- locality oriented integration
- client oriented integration
 Difficulties and solution of integration
 Discussion
 Others

What is integration?
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It is to change the different parts into a new
whole.
During the integrating process, each of the
different parts will have to have some
adjustments in order to cope with the change.
The quality of the new whole is totally different
from the quality of the original parts.
(譯自: 阮曾媛琪, 1992; 社會服務整合化的意義及展望.香港社會工
作學報,第二十六卷第一期)
Why do we Integrate?
Respond to the changing needs of clients
and society.
 Repair the difficulty in Service Centre, e.g.
overloaded and overstretched.
 Solve the problem on service delivery.
 Prevent duplication on service.

Allow centre to allocate the recourse
flexibly.
 Reduce the high expenses in social
welfare agencies, e.g. the salary of senior
worker.
 Social Workers are suggested to be
generalist in all fields.

The development of integration
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Social welfare in the 1990s & beyond, the social welfare
Department purposed on integrated approach. (See
White paper Description 1991)
It aims at solving the difficulties brought by fragmented
services provided by various department or agencies.
By adopting the integrated approach, service users can
more easily get access to the service, and related
departments.
Agencies can provide service with existing resources
more vividly and economically.
The rationale of Integration
approach:
1. Coordination and Integration of the Service
Delivery:
 Provide clients with more convenient access to a
wide range of services (e.g. One-stop service)
and enable more flexible and cost-effective use
of available resources. Different service units
join together to work for the betterment of the
clients.
2. Holistic and Person-oriented approach
 The coverage of the service should include all
groups in society and no group is being left out.
(Comprehensive coverage)The services
provided by agencies should base on the needs
of clients and society. Clients can get
comprehensive care. It allows the worker uses
multi-content and multi-level approach to meet
the needs of clients.
Profession-oriented
integration
Definition: different
professions joint together
Advantages
1. Multi-context intervention and assessment
 Since social workers may not be competent
enough to cope with different problems of the
service users, profession-integration helps to
gather professional knowledge from different
fields to provide comprehensive service to
service users and assess clients’ needs in
broader and diverse context.

Example: school social workers can obtain
information from teachers about the student’s
behaviour problem in classroom in order to provide
in-depth assessments. Teachers may also assist
social workers to monitor the change of client in
classroom.
2. Convenient to service users
 Service users do not need to go to other
agencies to obtain service, but can
obtain different services in an integrated
centre, so it is more convenient and less
time-consuming to seek for services.

Example: parents can obtain family service in I.T.
centre, the PHAB Association.
3. Able to access resources quickly
 Profession-integration enhances the
communication and co-operation among
different professions, so social workers
may help to identify these professions
and related resources quickly.
4. Support different professions
 With communication and discussion between
professions, it helps to support different
professions in providing service or designing
intervention plan.

Example: School social workers support teachers in
handling students’ emotional problem so that teachers
can teach the class effectively.
Disadvantages
1. Time consuming
Takes more time to communicate and
cooperate with different departments and
centres, so more time is consumed in
administrative procedures.
2. Difference in vision, mission and work
practice among different professions
 With co-operation, the workers may have
to meet the demands and expectation of
other professions, which service users
may sacrifice in obtaining some of the
services. It is also difficult for different
professions to come up with a
consensus.

Example: The police of Yuen Long adopted the social
work notion of “zero tolerance to family violence” and cooperated with Yuen Long IFSC, they arrest abusers
without trying to remedy the situation and keep them
over night, so as to protect the victims and other family
members. Yet police may not understand the rationale
behind, they may mislead or deprive clients during
execution.
3. Higher the cost of service
 Having more professions to deal with a
case, it accelerates the cost of service.
The agency may need to employ
different professionals, so the service
users may not be able to afford the cost.
Method orientated
integration
Models of integration
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Use all three social work practice methods
to deal with the different levels of client’s
problem. E.g. Case, Group, Community
Work. The rationale of the integration is to
provide preventive, supportive and
remedial services to the clients.

For example: IFSC is integrated as family
resources unit (preventive and
educational), family support unit
(supportive and empowerment) and family
counseling unit (intensive counseling).
Within these service units, it includes the
practice of case, group and community
work to intervene with client’s needs.
Advantages
1. Actively respond to clients’ needs
 The model could provide initiative to client’s needs. For
example: FSC used to specialize in doing the case. The
case was received passively. The center could not put
the first aid and assess potential risk of the family. The
support network is rather weak for those families in
need. After integration, more preventive and supportive
work would be done as to response to the needs of the
client. Worker would go outreaching to identify potential
clients.
2. Easy to assessable

Before the integration, client needed to face
geographic inconvenient. Different government
departments would respond to their work individually.
Case department and group department were different
units that located in different areas. Client needed to
refer to different departments when they undertook
case or group intervention. Method integration which
provides all three levels of practice would be
undertaken in one single unit. Client no longer needed
to refer to different departments to undertake different
services.
3. Person-centered
 Person centered approach is likely
applied as client could get
comprehensive case within three aspects
of intervention. Clients can obtain
different intervention methods according
to their needs.
4. Simpler administration
 One case file is used within the agency
for each client when getting different
services.
Disadvantages
1. The quality of work
 Dealing with all different methods may introduce
much more workload and pressure to workers.
Different methods may require skills to handle
the tasks; the worker may not familiar with all the
methods and thus have pressure when they are
requested to provide services that they are not
good at.
2. Use of the resources
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The resources may be reduced after method integration.
One service center is used to capture the work of case,
group and community work. However, the resources may
not be enough to provide all three aspects. Center has to
balance the resources and provide a fixed amount of group
work and community work project. The resources may not
be flexible enough in response to client’s needs.

For example: some of the family service centers such as single
parent center would be incorporated in the IFSC. The original
resources to run those family centers would not be given to IFSC.
There are insufficient resources to provide service to those clients
and the quality of service would be lower.
3. The quality of worker
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The worker used to specialize in doing one
field unit, however, after integration; worker
would require being skillful in both group work,
case work and community work. Workers may
not be able to master the demands of all the
methods .They would not handle the work
properly as lack of skill training.
4. Complicated administrative procedures

Different methods may associate with different
administration procedures, providing all these
methods by a single agency may make the
overall administration complicated. Even
though having the same case file, different
services may still be provided by different
workers
Agencies oriented
integration
Example:
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DECC (district elderly community center)
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Integration of Social Welfare Department,
DECC, NEC, Non-Governmental Organization
elderly centres, home services, care & attention
home, nursing home, the leisure and cultural
service department and Hospital Authority.
Advantages
1. Re-deploying existing resources:
Different agencies join in the service can
manipulate the resource more efficiency.
The flexibility of the service can be
increase due to the more resources in
used. Service become more faultless
which is benefit to our service users.
2. Injection of new resources:
Different kind of service provided wide
range of resource. It solved the problem
which is lack of resources, knowledge and
professional. It expand the function to
provide a wide range services to the
services users.
3. Increase agencies communication and
cooperation:
Agencies oriented integration highlight the issue
about cooperating between different agencies.
The information, knowledge were interchange
within agencies. Due to the cooperation
increase, service become diversely and gives
more choice to service users. Resources saving
with integration that reduce the repetition
expenditure on the same resources.
4. Save some NGO’s life and retain them in the community
Resources, manpower supported by different agencies
save some NGO’s life. They can had more chance to
provided service and maintain there competitiveness in
the community.
5. Joining professional workers together:
such as social worker, psychologist, elderly assessment
workers, doctors…etc. therefore, they could provide one
stop-service to service users.
Disadvantages
1. More complicated cooperation that may take a
long time to work with other departments.
2. Takes more time to communicate and cooperate
with all the departments and centres.
3. More difficult to allocate resources because
there may lack of manpower to proceed the
service render provided by the different
departments.
Locality-oriented
Integration
Definition
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Within one locality, different agencies or
workers join together. e.g. agencies join
together to respond to hot issues like
indecent assault. (Lo, 2006)
Examples of localityoriented integration:
Example 1:
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The anti-family-violence road-show of
Thye Hua Kwan Moral Society, Family
Service Centre (Bedok North) in
Singapore.
Background:
 Family Service Centre (Bedok North) located in old, poor district
where a lot of women suffer from family violence.
 Family violence doesn’t only happen to those low-educated women,
but also to the high-education one.
 Victims often did not like to disclose themselves.
 “Reporting family violence is the only way to stop violence.” Fidzah
(The Social worker) told us.
 The goal of the road show is to arouse the awareness of local
people about the issue and encourage them to report it to The FSC.
 Therefore, different centre cooperated to achieve these goals.
Details of the road-show:
 Road show titled “Break the Silence, Seek
Help to End Family Violence” held on
Sunday (July, 2006).
 The road combined a myriad of elements
of music, drama, games, pictures to
convert anti-violent message.
Example 2:
朗日計劃 of Yuen Long (West) Integrated
Family Service Centre
Programme Details:
 This is a programme jointly held by an
Integrated Family Service Centre of Social
Welfare Department, an Integrated Family
Service Centre of a NGO and a Youth
Centre of a NGO.

Objective:
 The programme aimed at building
community and social network between
CSSA recipients and single-parent families
in two targeted public housing estates.
The programme made use of the client
data from the Social Security Field Unit to
screen out targeting clients.
Example 3:
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元朗區福利辦事處—元朗西「服務區域為本」協作網絡會議
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Programme Details:

This cooperate-network meeting is organized by the Social Welfare
Department. Members of the meeting included staff from Social
Welfare Department, Social Security Field Unit, Family and Child
Protective Service Unit, Integrated Family Service Centres of Social
Welfare Department, Integrated Family Service Centres of Nongovernmental Organizations, children and youth centres, secondary
schools, primary schools, kindergartens. The rationale of the
meeting is to create a communication platform to enhance the
cooperation between various agencies and departments within the
district. The meeting also served provided a platform for promotion
of services. The meeting is held every half year.

The meeting focused on monitoring and
improving the welfare services of the Yuen
Long District. Some foci of the meeting
were prevention of family violence,
enhance residents’ sense of belonging,
improve communication platform between
agencies and between agencies and
residents.
Advantages
To clients:
 As different types of welfare organizations will join and
hold function together to target the hot issue, citizens
could know more about hot issue and types of services
they needed at the same time.
 Locality-oriented integration responds to the hot issues
which usually reflect the needs of people.
 Easier to access as there are more than one agency
involved.
 It enhances local people’s sense of belonging to the
community.
To Social Worker:
 Multi-level intervention
 Bring in more views and alternatives in tackling the
issues
 Enhance workers’ sense of belonging to the locality
 Enhance the cooperation of workers in different
agencies.
 Self improvement by learning from other social worker
on handling the case, group, or community work.
To centre:
 It facilitates
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the mutual cooperation process
among agencies within the locality
Different agencies may have different
network and user groups, they can greatly
increase the work effectiveness and
efficiency by working together.
Agencies can assess clients’ needs in
broader and diverse context.
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It may simplify administration and communication
procedures after discussion and compromises over
communication platform like meetings
It allows multi-context intervention.
It prevents service duplication.
Better use of resources through centralized
management
For the more public advertisement of welfare
organizations to the citizens.
Provide different service creatively and flexibly .
To community:
 By involving many agencies within the locality, it is easier to
create an atmosphere in the locality concerning the issue,
which lead to better effect
 Better use of resources through centralized management
 Prevents crime
 Division of work depends on the characteristics of the agency,
result in higher efficiency in responding to local issue
 The community work shows compassion to the citizens and it
enhance the social cohesion in long term.
 it broadens the social network of the residents in the same
locality
Disadvantages
To clients:
 Clients may not know clearly about the
detail work division between the agencies,
and may get confused of which agencies
provide the service
To worker:
 The cooperation involved a lot of shared resource (time, material,
manpower, money...), it may result in conflict when there is unfair
events.
 Communication between workers from different agencies may not
be as feasible and effective from workers in the same agency; this
may lower the work efficiency
 As it involves many agencies and professionals, it is not easy to
communicate all the information accurately if not over a
communication platform like meetings
 It is time consuming to create the platform as it involves many
agencies and professionals within the locality
To centre:
 Different centre have different missions,
vision and work practices, these may
result in misunderstanding and conflicts
 Agencies have different work focus; it is
difficult to gather different agencies and
departments to focus on one specific issue
of the locality
To community
 Locality is very large and complex; target
at all hot issues may not be possible
Client-oriented
Integration
Definition

It provides the service in order to meet the
individual or family needs, it is different
from placing the clients into the existing
services, thus, the planning of integration
services develop in community and clients’
needs. Clients obtain the services which
they need in the same agency, even the
same worker.
Two styles of client-oriented integration:
1. Same clients but different needs.
2. Different clients but same needs.

Examples:
1. The Jockey Club Centre for Positive Ageing
 It is specially designed for the care of elderly with
dementia, and for training carers working in the field as
well as informal carers, (e.g. family members, domestic
helpers). Quality services are assured with the
professional involvement, a team of specialists
comprising a medical doctor, nurses, occupational
therapist, physiotherapist, social workers and personal
care workers operate the Centre. It provides one-stop
services to the elderly with dementia.
2. Integrated Family Service Centre
 IFSC as a whole, it includes Family
Counseling Unit, Family Support Unit and
Family Resources Unit. People come from
different needs, for instance: financial
needs, housing needs, needs for job and
emotional needs, etc.
Advantages
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The services were not divided into different departments,
we can understand the individual, family and community
needs in all-round, therefore we can provide appropriate
service for their needs.
Multi-level assessment of different clients: different
perspectives from different professions to assess the
same case. Effective - comprehensive care to satisfy the
client’s need.
Clients can obtain different services in the same agency,
it can save their time and it is convenient to them. they
can also obtain different services from different workers
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Person-centered: clients get comprehensive care, it
respects individual and start from client’s needs.
Make a good use of allocation of manpower, places,
facilities and other resources with good flexibility. Clients
may have a larger space in centre for activities.
Apply diversification and multi-level of social work
intervention with good flexibility.
Simpler administration: one case file within the agency
for each client while getting diverse services

In IFSC, every client just has one case file, no matter what
services they got. (financial and counseling service )
Disadvantages
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Cooperation with different workers
The quality of service depends on the
cooperation of different workers and their
communication style.
Different methods may associate with different
administration procedures, providing all these
methods by a single agency may make the
overall administration complicated.

Different methods require different skills,
knowledge and experiences from workers,
workers may not be able to master the demands
of different professional knowledge and
intervention methods.
 In
the JCCPA, they run a case management
intervention method to deal with every client,
however, their case managers are come form nurses,
occupational therapist, physiotherapist and social
workers, so they may not acquire professional
knowledge from other fields.
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Different professionals work together, but different
people have different style to deal with the same case.
We can not control their treatment method and style.
Dealing with all different methods may introduce much
more workload and pressure to workers, as they may not
have the knowledge in different professionals and
perspectives.
Even though having the same case file, different
services may still be provided by different workers
Positive comments on the practices
and Client-oriented Integration
We can understand more about the client
and did not divide into different parts and
needs, it is easy for us to have a well
recognition of the client.
 It is good for us to work with different
professionals and workers, we can learn
from their experiences.

Negative comments on the practices
and Client-oriented Integration
We need to spend more time to have
some discussion, for example, different
professionals share their professional
views and opinions on the same case in
the case conference.
 It is easy to argue with different workers
through discussing and sharing different
points of views.

Difficulties in
implementing
integrated practice
Difficulties 1:
Misunderstand the concept of integration
 Different professions are only joining
together to provide different services
without recognizing the concept of
integration. They may have some
misunderstanding and did not know the
rationale or meaning of the integration.
Method to face or solve the difficulties:
 Provide training to worker in
understanding the concept of integration.
 To train staff such as case manager who
responsible for coordination between
different professions.
Difficulties 2:
Difference in vision and practice between
professions and agencies.
 Not all the professions obtain the training
know about integration and there is a
difference between every profession. Such
as social worker, teacher, occupational
therapist and physiotherapist etc.
Method to face or solve the difficulties
 Train
up professional managerial personnel to monitor
the integrated practice.
 Pursue further education is needed for different
professionals or workers in order to fulfill the new
trend of case management.
 Communication

Different professions or departments should
have a good communication channel to share
their knowledge, views, and intervention method
with others.
Difficulties 3:
Demand both specific and generic skills of
workers.
 The balance of specialist and generalist,
some workers are required to be skillful in
group work, but some are good at case
work. Except for special skill, different
workers have different treatments or
intervention methods.
Method to face or solve the difficulties
 Require social workers to attend
continuous trainings.
Difficulties 4:
Worker’s may not have enough knowledge,
acceptance and initiative to adopt
integration in their practice
Method to face or solve the difficulties
 Provide
practice guidelines and training to
social worker.
Difficulties 5:
Time Management
 In takes time to communication with other workers and
agencies
Method to face and solve the difficulties

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Communication
Case conference is a good chance for different
professionals or workers to deal with the problems of the
clients. They should make a good use of the case
conference to exchange their opinions and intervention
methods for professional development.
Difficulties 6:
Funding from the government is limited
 How to distribute the funding to different
departments and organization in a more
appropriate way? How to face the demand
of quantity of services provided. For
example, not enough school social
workers.
Discussion

Integration offers one-stop services and service users
could obtain the required services within one setting. To
increase the range of services and relatively, more
resources is needed for the administration fee and to
hire more workers for the provision of services. But it is
known that government did not raise any subsidy to the
integrated setting after integration. Therefore, the
workload of workers become heavier and the
performance of workers is going to be questioned.
Integration is rather ideal to offer comprehensive
services to the service users but in reality, the resource
is not directly proportional to the increasing of services
and so it is value to think if service users could really
gain any benefits from integration.
Discussion (Cont’)

The mission of integration is to combine wide range of services for
the services users. Through the interview with some social workers
in the I.T. setting of The PHAB Association, they expressed that
workers were responsible for the youth service in the C&Y centre in
the past. But after integration, workers needed to cope with the
family and outreaching services and actually they were not
competent enough to handle those problems. The purpose of
integration is to offer clients with better services but in the reality,
worker’s ability or coping skills might not adapt to this sudden
changes. Therefore, the mission of integration is going to be
questioned as clients might not obtain ‘Good services’ after
integration.
Others
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The integration of different culture’s worker in Singapore
As the Social workers in Singapore come from different
culture background (India, Malaysia, Chinese…), some
of them were educated in their own country (Malaysia).
However, they worked together to function well as a unit,
because their clients may also come from different
culture (to meet the needs of clients). They respect each
other and they learn other’s language to achieve cultural
Integration.
Reference:
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何潔雲, <<資源重整---香港青少年綜合服務本地經驗反思>>,
“社會福利與社會工作本土化---理念與實踐”學術研討會,1997, 台北
阮曾媛琪, 1992; 社會服務整合化的意義及展望.香港社會工作學報,第
二十六卷第一期
Web site:
Lai Chi Fung. The budget cut of family service center. Retrieved
http://www.hkbu.edu.hk/journewsnet/news/news420.htm from
31/10/2006.
home4u.hongkong.com/education/training/skh/milestone.html
http://home4u.hongkong.com/education/training/skh/model.html
http://home.netvigator.com/~yipsir/newpage5D-278.htm
http://swforum.socialnet.org.hk/article/001112.htm
http://www.emb.gov.hk/index.aspx?nodeID=1974&langno=2
Member list
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Annie Chan 50486570
Cindy Chan 50584341
Jess Cheung 50552091
Esther Ho 50510653
Susanna 50585097
Philip Won 50588180
Hazel Tong 50535440
Chole 50726925