Binder has taught pediatrics and interviewing to successive generations of medical students. His easy-to-read, compelling, and comprehensive guide outlines effective strategies for interviewing parents and children efficiently. Topics covered include engaging patients and families, efficiently and smoothly obtaining a history of present illness and making a good differential diagnosis, uncovering hidden agendas, collaborative discussion in diagnosis and treatment, practicing family oriented care, taking a full social history, and all other aspects of carrying out the pediatric interview.
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Mottakers e-postadresse:. Din e-postadresse:. Social work participants listed shyness, the child's age, concentration span and spontaneity as influencing the helping relationship. In a study done by Bedi non-verbal gestures contributed to the client's feeling of comfort Bedi, Participant 6 made the point that as a child she looked towards positive body language before opening up to an adult.
Non-verbal messages should convey warmth towards the client Egan, ; Seden, because clients value warmth in the social worker Holland, Social work participants sensed that child clients might prefer a social worker whom they perceive as present, available, accessible and who carries their best interests at heart.
Egan and Hycner and Jacobs explain presence as a "turning of my whole person" to another, noticing the person's uniqueness and just being with the person. Presence conveys to clients that the social worker is with them and it enables the social worker to listen carefully Egan, Being available to the child client can simply entail making time for the child and not being hasty. Participant 5 mentioned the detrimental effect haste has on relationship building by stating that "sometimes I am in such a hurry that nobody would want to talk to me, I need to be calmer, beaming warmth, friendliness and interest.
The underlying principle in the Children's Act 38 of is the child's best interest. Social work participant 1 touched on this phenomenon by saying that if she was a child client, she would prefer a social worker who was on her side. The above-mentioned values of non-judgement, openness, presence, hope, respect and warmth will create the atmosphere for a calm, safe, relaxed and comfortable setting, as described by social work participants, where individual intervention with a child can take place.
Personality of the social worker. Ackerman and Hilsenroth concluded in their study that certain personal attributes of the helper have a positive impact on the helping relationship. On the other hand, Holland writes that, specifically in social work cases, neither the social worker's personality attributes nor the type of case influenced the quality of the helping relationship because the dynamics in a social work relationship are complex. In line with Ackerman and Hilsenroth's findings , social work participant 3 stated that her own discomfort and reserved personality makes it difficult for her to connect with a child client, explaining that "when a child is quiet I don't know what to say.
It is part of my personality. Ward recognises that the social worker's attributes are interwoven with personal life experiences, motives and weaknesses. He views these as strengths, because they enable the social worker to better understand the difficulties of clients. This links to Seabury et al.
Social workers thus enhance the intervention by bringing their own personality to their work Geldard et al. A child can identify a person who is not authentic, as participant 7 elucidated: "children read you and can see when you are false.
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Skills of the social worker. Appropriate self-disclosure is used by participant 1 and 6 to demonstrate the social worker's humanness. Participant 1 illustrated this by saying that "I search for something communal between me and the child, in order for the child to see me as a human being, not only as a social worker. Another skill that increases the "humanness" of the social worker is empathy Glicken, Participants 1 and 2 mentioned the importance of soft, empathic responses in establishing a helping relationship.
Empathic listening is important to building a strong helping relationship Bedi, , because it communicates "I am with you" Hepworth et al.source url
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Participant 1 uses humour to put the child at ease and to establish the initial connection, while participant 5 uses positive reinforcement. There is a fine line between complimenting the child and reinforcing strengths. This means that positive reinforcement should not be founded on approving or disapproving of the client's behaviour, because the client might change behaviour to please the social worker and cover other behaviour to avoid the disapproval of the social worker Geldard et al.
Social work participants concurred that questioning a child is not beneficial towards engaging the child in dialogue. As participant 4 stated that "you cannot just ask children direct questions the whole time, because they clamp up. They don't want to talk. In this regard participant 4 said: "Fou start off with 'tell me' and then they say nothing and then you start to ask closed questions. Participant 2 stated: "Fou know, something that I have experienced myself.
Considerations for initial contact sessions with a child client. It is advisable for social workers to establish their own pattern for introductory sessions with children. A well-established but adjustable pattern for introductory sessions allows the worker to focus on the child rather than the next activity. According to participant 5, this "makes the process easier" and more fluent. Yet one should guard against becoming rigid in a specific pattern, as participant 6 stated "what works with the one, does not work for the next child.
In the next section a few patterns are discussed that emerged from the data regarding initial individual sessions with child clients. Pre-meeting stage.
Kroll refers to the stage before actual contact with the client as the "tuning" in period. During this stage Geldard et al. Geldard et al.
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Child participant F contributed to the premeeting stage by requesting that social workers should notify him of an intended visit. This is an important procedure, as Spray and Jowett reported that apprehension increased when a social worker makes impromptu visits. First impressions. Establishing rapport typically begins with greeting the client warmly and asking the client how he prefers to be addressed Hepworth et al.
The child participants appreciated that social workers greeted them with a handshake, made eye contact and introduced themselves. Courtesy helps to establish rapport with the client. These aspects convey to the client the value of dignity and worth Hepworth et al.
Two child participants mentioned that the social worker forgot their names and one participant appreciated the effort made by the social worker to write down her name correctly. However, in line with Kroll , social work participant 6 and child participants D and F mention that note taking during the initial session might break contact with the client. Joining with the child.
Pediatric Interviewing - A Practical, Relationship-Based Approach | James Binder | Springer
The participant social workers suggested that the child clients be given a quiet calm time during the first session, when they can orientate themselves towards the setting and the social worker and so adjust to the new situation. Furthermore, the social worker should not initially engage in talking, but rather enjoy calm moments together while, for instance, working with clay or drawing.
Kroll is of the opinion that it is best to "be" rather than to "do" during this stage of the meeting. This is in line with the suggestion by Geldard et al. This allows the child a time where he can observe the social worker in the safety of his parents' presence. Children witness how their parents engage with the social worker and consequently gain permission to engage with the social worker.
Some children enjoy a routine to help them enter a playroom Carroll, The social worker can then show children the counselling environment and let them know where the parents will be waiting Geldard et al. Miller suggested that the intervention should start with the social worker alongside the child. The social workers and children agreed that it is best if the social worker moves from behind her table to greet and talk to the child client.
A Practical, Relationship-Based Approach
The child participants also prefer a social worker next to them rather than sitting behind a table. Most clients come to the social worker with a degree of apprehension, viewing the need for help as a failure on their part and feeling embarrassed about opening up about their personal lives Hepworth et al. Hepworth et al. Social work participant 4 stated in this regard: "we are so focused on the problem that we forget we can talk about the weather as well.
Yet child participant F preferred not to talk about school-related topics. Sensitivity is important, because some clients want to talk about their problems immediately and their anxiety level may grow if the social worker delays with a warm-up period Hepworth et al. Reason for referral. Some social work participants do not address the reason for referral immediately, especially if it is a sensitive case, for example, sexual abuse, while other social work participants prefer to address the reason for referral immediately.
Social work participants could not decide which is best and decided that it depends on the context of the case. Social work participant 4 suggested starting with the child client's perception of the reason for the referral, clarifying if necessary. Child participant D noted that if he was the social worker "he would have explained what he was doing there [when visiting a child client]".
Carroll interviewed play therapists who described their initial process, which included a discussion on the purpose of the intervention. The helping relationship with the practitioner should be confidential, because it promotes trust Geldard et al. Social work participants 1 and 6 explain confidentiality as well as how feedback to the parents will commence.