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Chapter 2. Theoretical Perspectives on Human Behavior 2 Theoretical Perspectives on Human Behavior Elizabeth D. Hutchison, Leanne Wood Charlesworth, and Cory Cummingsdistribute or Chapter Outline Learning Objectives Developmental Perspective Case Study 2.1: End of Life Care for Maria Chavez Behavioral Perspective Multiple Perspectives for a Multidimensional Humanistic Perspective Approach post,The Merits of Multiple Perspectives Systems Perspective Implications for Social Work Practice Conflict Perspective Key Terms Exchange and Choice Perspective Active Learning Social Constructionist Perspective Web Resources Psychodynamic Perspective copy, Learning Objectives 2.1 Recognize one’s own cognitive and emotional 2.3 Analyze the merits of a multitheoretical approach reactionsnot to a case study. to human behavior. 2.2 Recognize the major themes of eight different 2.4 Apply knowledge of eight theoretical perspec- perspectives on human behavior: systems, con- tives on human behavior to recommend guide- flict, exchange and choice, social constructionist, lines for social work engagement, assessment, Do psychodynamic, developmental, behavioral, and intervention, and evaluation. humanistic. 31 Copyright ©2019 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. 32 Part I • A Multidimensional Approach for Multifaceted Social Work CASE STUDY 2.1 END OF LIFE CARE FOR MARIA CHAVEZ The hospice social worker met Maria Chavez during the in the area. After Juan died from cancer sometime in initial psychosocial assessment at her daughter’s home the 1990s, Sarah moved to the area to be closer to her in a medium-sized city in the American Southwest. He mother. One of her sisters followed a few years later. had learned from the hospice administrators that Maria In addition to being a proud mother, Maria is also a was diagnosed with end-stage Parkinson’s disease and devout Catholic. The social worker noticed that her faith Parkinson’s dementia. He had also learned that during held significance for her when he met with her in her a recent visit to her primary care provider, the provider room. He recalled seeing a large crucifix hanging on the had talked with Maria and her daughter about Maria’s wall, a statue of Our Lady of Guadalupe in one corner of the prognosis. Her condition was deteriorating quickly, and room, and a Catholic Mass playing on her television set. her provider recommended hospice care. Sarah reported that her mother had enjoyed an The social worker meets Maria’s 65-year-old daugh- impressive career. In 1944, Maria moved to Washington, ter, Sarah, upon entering the home. Sarah takes the DC, and joined the Women’s Army Corps. Sarah shared social worker to a bedroom where 92-year-old Maria memories of conversations she’d had with her mom is lying in bed. After a few minutes of small talk, Sarah about her work. She recalled stories her mother told leaves the room so that the social worker and Maria can about the mood of the country distributeduring World War II and speak privately. The social worker learns during the mentioned that her parents met during a dance for army interview that Maria moved in with Sarah after she’d lost service members. She reported that Maria continued to the ability to live independently. Maria wasn’t able to tell work throughout her marriage, working for NASA in the the social worker when she moved in with her daughter, 1960s and 1970s. or but she thought it was a few weeks ago. Although Maria’s The social worker learned that Maria moved in with short-term memory was poor, her long-term memory Sarah 3 years ago after multiple falls, two inpatient was vivid. She shared numerous stories about her past. hospitalizations, and a recommendation from a hospi- Maria Chavez was born Maria Sarah Gallegos to Sarah tal social worker that Maria could no longer safely live and Raymond Gallegos in 1925 in New York City. The alone at home. Before Maria started to show increasing youngest of nine children, she grew up during the Great signs and symptoms of dementia, which are currently Depression, and her family experienced severe financial post,moderate but not severe, she named Sarah her durable hardship when her father died in 1934. Her mother was power of attorney for all legal, financial, and health care unable to work, and she and her siblings were expected decisions. Even though Maria has moderate demen- to support the family. Maria tells the social worker that tia, Sarah feels obligated to get her mom’s approval on during the Depression (and a bit thereafter) when she financial decisions. Maria has always been frugal and was a young teen, her mother sexually exploited her focused on money, perhaps because of growing up with and her sisters to make money for the family. She never such economic hardship. In addition, there is a will, and believed God loved her, and she was terrified she’d go to the sisters are concerned that Sarah not spend too much hell. The social worker made a note to ask the hospice of Maria’s money. Maria still has a house that she does chaplain to make a call on Maria ascopy, soon as possible. not want to sell, and she has a savings account. And yet After a few stories about her early life, Maria was Sarah reports that she is struggling to make ends meet. tired and needed to rest. The social worker left Maria’s She is divorced and doesn’t receive any financial sup- room and continued the assessment with her daugh- port from her ex-husband. She says that her siblings ter, Sarah, who was in the kitchen making lunch. Sarah don’t provide any assistance, financially or instrumen- filled the social workernot in on details about her mother’s tally. She also reports that they come for visits, complain family, religion, and work. First and foremost, Maria is about the bad job Sarah is doing, give advice about how a proud mother of five children: four daughters and one she could do better, and then they leave. son. Juan, her only son, died in a car accident when he As she talks about her current financial difficulties, was 16 years old. Sarah and one other daughter live in Sarah starts to cry. She states that she was manag- the area,Do and the other two live back East: one in New ing financially for the first few months after her mother York City and one in Washington, DC, where Maria once moved in with her because her son, David, had moved lived. Maria and her husband, Juan, moved to the South- in to be Maria’s full-time caregiver. With that assistance west in the late 1980s because Maria had many relatives she was able to continue working full-time as a certified Copyright ©2019 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. Chapter 2 • Theoretical Perspectives on Human Behavior 33 nursing assistant (CNA). Being a CNA has been a life- treatment program where he seemed to do well. After saver because she knows how to help her mother with leaving the treatment program, he moved back in with all her daily living activities. However, she quit her job Sarah to provide care for Maria so Sarah could return to 6 months after her mother moved in when she learned that work. However, 2 months after he was discharged, David David was stealing Maria’s anti-anxiety and pain medica- overdosed on heroin and died. Now, on top of all this, Sarah tions. When she confronted David, she learned that he’d is beginning to have her own health problems, including been using opiates and benzodiazepines for years. Sarah hypertension, and type 2 diabetes. She expresses fear convinced David to go into an inpatient substance abuse about her own future health and financial well-being. —Bryan Norman Multiple Perspectives for a and critically evaluate and apply this knowledge” to facilitate Multidimensional Approach • engagement with (Competency 6), As you think about the details of the unfolding story of Maria Chavez and her daughter, Sarah, you may dis- • assessment of (Competency 7), cover that you have some theory or theories of your distribute • intervention with (Competency 8), own about what is happening with them and what can and should be done to be helpful to them. If we asked • and evaluation of practice (Competency 9) you what caught your attention as you read the story, or we would begin to learn something about your theory “with individuals, families, groups, organizations, and or theories of human behavior, as you have devel- communities” (Council on Social Work Education, oped it or them so far. There is much information in 2015, pp. 8–9). the case material as presented, but the case may have Although different theories have been considered raised questions for you as well, and left you wanting essential knowledge for social workers in different peri- more information. What you see as gaps in the infor- ods of time, there is general agreement that contem- mation might also tell us something about yourpost, theory porary social workers must use a range of theories that or theories. Theories help us organize vast and multi- draw on a number of disciplines to help us understand faceted information. The purposes of this chapter are the practice situations we encounter and to see the pos- twofold: first, to help you identify and refine your own sibilities for change. As we have come more and more to theory or theories of human behavior and, second, to recognize that human behavior is multidimensional, we help you think critically about commonly used formal have also recognized the need for multiple disciplines theories of human behavior that have been developed and a multitheoretical framework to understand it (Bell, by behavioral science scholars and used to guide social 2012; Melchert, 2013; Sapolsky, 2017).
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