Both internal and external variables of the environment should be integrated in order to understand human behavior. A biopsychosocial approach is the best approach to understand the ecology of person and environment transactions. It explains that personal characteristics interact with environmental circumstances such as poverty and violence to contribute to people’s different paths of social development (Ashford, LeCroy & Williams, 2017). Paternalism means interfering with an individual’s freedom for his or her own good. It implies acting in a way that interferes with people’s freedom of choice as it hinders client’s right to pursue their self-selected goals (Reamer, 1983).Biopsychosocial framework therefore helps social workers to understand human behavior by looking at various points of view and integrating them at different levels including family level, individual level, organizational, community, and societal levels in order to foster or limit paternalism.
There are three categories of paternalism including interfering with an individual’s actions or intentions, deliberately withholding information from an individual and deliberately misinforming an individual (Reamer, 1983). Interfering with the intentions of an individual could occur when a client is hospitalized against his or her wishes or forcing a self-destructive client to stop self-destructing. Withholding information about something highly significant to the client or misinforming a client about something important may cause the client to harm themselves when they finally acquire the right information. Therefore, a social worker should make every effort to foster maximum self-determination for the clients which is their right to act in accord with their own goals, desires, and wishes in order to fight paternalism (Reamer, 1983).
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In order to understand these three categories of paternalism in social work, three basic dimensions for understanding human behavior and social environment are used. They include biophysical, psychological and social dimensions. The three dimensions form a system of bipsychological functioning which involves several hierarchical systems (Ashford, LeCroy & Williams, 2017). The social worker is supposed to gather information about a client from as many sources as possible because it is important to apply more than one dimension of the multidimensional framework.
Information can be acquired from the family members, behavioral observations, key informants, psychological tests and client’s interviews among others (Ashford, LeCroy & Williams, 2017). The information helps the social worker to know whether to foster or limit client’s right to self-determination. In case they find out that the client’s potential actions may put them in danger, or they pose a foreseeable and imminent risk to them and their families according to their professional judgment, they are supposed to limit it.
These dimensions help a social worker choose the best strategies to handle each client who is subject to paternalism. They are supposed to organize client’s presentation into precipitating factors which include client’s personal concerns, perpetuating factors which reinforce a client’s problem, predisposing factors which pose risk to the client’s development history and protective factors which include the client’s strengths and assets (Ashford, LeCroy & Williams, 2017).
Social workers must utilize the multidimensional framework to provide the best interventions for their clients. First, they must establish a hypothesis for the four P’s for each dimension including psychological, social and biological dimensions so that they can understand why the client has the problem (Ashford, LeCroy & Williams, 2017). They must submit a summary of evidence based analysis of the biopsychoogical factors influencing a client’s concern and finally they must determine how the assessment of the client’s problem and case formulation provide an intervention solution for them. Social workers must understand that they should respect clients’ right to self-determination. However, they should consider paternalistic intervention if they foresee extreme circumstances that provide compelling evidence of serious risk may require in order protecting clients from serious harm (Reamer, 1983).
References
Ashford, J.B., LeCroy, C.W., & Williams, L. R. (2017). Human Behavior in the Social Environment: A Multidimensional Perspective. 6th Ed. Pacific Grove, CA: Brooks/Cole
Reamer, F.G., 1983. The concept of paternalism in social work. Social Service Review , 57 (2), pp.254-271.
