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| Contents: - Introduction - History - PIE Classification System (Overview & Detail) A Holistic Model For Social Work - Case Studies & Examples - |
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The classification system was developed
for social workers to use independently or to complement information from
diagnostic systems used in other disciplines like medicine and psychiatry.
The PIE System has two exciting features:
Although social work emerged as a profession at the beginning of the 20th century, it has taken longer than some of its associated human service professions to develop a standardized classification and assessment system.
Physicians use the International Classification of Diseases (ICD-10) system and psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) system. Clinical psychologists, and clinical social workers to a lesser extent, have been qualified to also use the DSM system. The need for a social work classification systems was recognized by the American social work pioneer, Mary Richmond, as early as 1917, but it not acted upon until many years later.
The growing need for a standardized social worker classification system was made quite specific in the early 1980s by Dr. Janet Williams, social work's lone representative on the many DSM development committees. She challenged her American colleagues in the National Association of Social Workers (NASW) to take the steps needed to develop a social functioning assessment system.
The challenge was accepted by a small group of dedicated volunteers in California, led by Dr. Jim Karls and Dr. Karin Wandrei. With support from Sue Dworak-Peck, President of NASW's California chapter, a small National Advancement grant was obtained from NASW in 1981 to develop a prototype system. Additional small grants were subsequently provided to conduct validity and interrater reliability field tests.
In the 1980s, the major development work focused on the "person-in-environment" construct generally acknowledged to be the articulated domain of social work. This effort was, in itself, a challenge to the former and ongoing dual construct which divided social workers into person-focused or environment-focused competitors.
Challenging the dual construct, however, had begun in 1950s when Harriet Bartlett added a third factor, pointing out the importance of "interaction" between person and environment. She was therefore among the first to clearly articulate the domain of social work as Person-Interaction-Environment, now shortened to the familiar Person-In-Environment (PIE) construct.
Bartlett acknowledged, as did earlier pioneers, that "person" and "environment" are the anchors to the profession's domain. This dual purpose perspective had invited social workers to engage in both micro and macro social change activities, but it was not meant to divide the profession, as it did, into dichotomous camps arguing the superiority of one specialty over the other.
In her search to find a "common base" for the profession, Bartlett was not only one of the first to identify "interaction" as a crucial dynamic in all social systems, but she identified it as the central or primary focus of the work done by social workers. This interaction-focus is now a distinguishing feature of social work compared to other human service professions where client / patient-centered approaches are generally central to their disciplines.
The PIE System project was undertaken
to provide social workers with a standardized tool needed to clarify the
domain of social work problems. The work done by Karls and Wandrei brought
the PIE System through many levels of development.
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Holistic Model of
Social Work
Contents
Holism
Holism, derived from the Greek "holos" (whole) means "everything"; all there is of something. Holism is a process way of thinking as well as a network-like perception of how all things are interconnected.
As a process, you are invited to engage in what is referred to as whole-to-part-thinking. You can contrast this with part-to-whole thinking, common to most of us and usually associated with reductionism and analytical ways of thinking.
Whole-to-part thinking leads to an understanding that the behavior of a whole system can never be fully predicted from an understanding of the behavior of one or all of its parts, commonly summarized as the "whole is more than the sum of its parts."
Part-to-whole thinking suggests that a careful analysis of the behavior of the parts of a system can lead to a full understanding and predictable explanation of the behavior of the whole system. This reflects the assumption that a "whole is [simply] the sum of its parts."
The holistic process allows you to think of the largest whole possible - say the Universe - and then quickly travel in your mind's eye to a local system of interest, for example, the profession of social work. The local system divides the Universe three ways; the system itself, everything inside, and everything outside the system.
Doing this helps you maintain a holistic perspective of all things connected to the local system, inside and out. The holistic process makes it less likely to lose sight of possible known or unknown connections that might be relevant to the system that is your central concern.Social workers familiar with general systems perspectives know that systems consist of "sets of interacting parts." Those who work from an ecosystem perspective, perhaps even more familiar to social workers, know that it can be used to understand social networks and consists of sets of interacting parts between living organisms and their environment.
Ecosystem diagrams typically show hub type interactions between a person-centered core and surrounding environment element; however as you can see this type of diagram does not show all the parts interconnected with each other.
(Insert ecosystem diagram here).
E E E E P E E E E
Whole systems represent systems with
all parts interconnected to each other. A minimum whole system consists
of 4 components interconnected by 6 interactive relationships. Geometrically,
this kind of holistic system pattern is called a tetrahedron. Visually,
it can be pictures as a triangle-based pyramid or as a network of interconnected
parts.
(Insert 3-d graphics of animated
tetrahedron here).
Whole system models can be unfolded
and multiplied to display ever increasing patterns of interconnected parts.
An unfolded tetrahedron reveals the 4 component faces of a minimum whole
system and the 6 relationship connectors between the parts. Physical artifacts
of this kind of part-relationship system can be used to visualize how relationships
hold a system together, much the same way ligaments and muscles hold the
bone components of the human body together.
(Insert 2-d graphics
here).
Holistic Social Work
Using the faces of a minimum whole
system as a model for social work, four interconnected components, essential
to the profession can be listed and displayed in diagram form.
Domain of practice
This component depicts the traditional person-in-environment area where the helping methods of social work are used to serve and advocate for the social welfare of others. Coupled with the profession's dedication to Person-focused social well being and adequate Environment-focused contexts enabling humans to live together free of poverty and social injustices, the domain depicts the Interaction element as the primary focus of social workers' attention.
The PIE System is used to provide
a descriptive classification of:
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Domain of Practitioner
This component is used to acknowledge that social workers, like the people they work with, have their own person-in-environment systems, personally and professionally. These systems affect how they perceive the domain of their clients and how they apply their methods of interventions.
Because social workers identify themselves as a primary "instrument of change," they need to constantly monitor and evaluate the patterns in their own personal and professional domain and the sharpness of their helping skills.
Employers of social workers also need to include this component as part of their holistic understanding of social work in order to recognize the special care and nurturing their employees require to maintain practice standards at an acceptable level.
Although not specifically designed
for this purpose, social workers and their employers can use the PIE System
to constructively help practitioners understand the potential barriers
and strengths that flow from this component to their domain of practice
work.
Paradigm of the Profession
This component addresses the need
for an enduring group of colleagues to organize around a particular view
of a defined domain of practice. As well, the group needs to have generally
agreed upon modes of professional activity related to values, ethics, research
and practice questions, methods of inquiry and practice interventions.
Thomas Kuhn called activities that meet these requirements:
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Social work, like other disciplines, needs a component of this kind to minimize disagreements among those who learn the basics of social work in different cultural contexts. There must also be a common paradigm component for those who use varied interpretations of social work's body of knowledge and multiple intervention approaches to inform their ways of practicing social work.
The paradigm component can be used
by social workers to select practice options appropriately matched to their
PIE System assessments.
Method(s) of Practice
This component represents the need to have a part that depicts the helping process phases and intervention methods used by social work practitioners to put their knowledge, values and skills into helpful actions.
The assessment phase of social work's
general problem-solving method represents the point at which the PIE System
can be utilized. Once the person-in-environment (domain of practice) assessment
is completed and the practice option selected, social workers use the method
component to select from a range of intervention methods appropriately
matched to their PIE System assessment.
Overview
Each of the four interconnected components of the holistic model can be progressively unfolded and multiplied into corresponding sets of four or more interconnected elements.
These elements depict the increasing complexity and diversity of social work practice, without compromising the core components common to all social work.
At first glance, this next level
of holistic practice interconnectedness can appear overwhelming.
(Insert entire holistic map here).
To minimize the need to grasp the
holistic complexity all at once, you are encouraged to explore each component
in a sequential way and then return to the more complex picture to see
how the PIE System is used in the context of a holistic model of social
work.
Domain of Practice
The first component to explore is the domain of social work practice. The holistic depiction of this component identifies persons as one element interconnected with three environmental "otherness" elements. Describing environment elements as "otherness" acknowledges the contextual and relationship nature of social functioning.
The presence of otherness is assumed to be a necessary condition for any social organism, including human beings, to be alive. Without otherness there is nothing to relate to. Without something to relate to there can be no awareness. Without awareness the social functioning capacity of a person is severely compromised.
The person element of social work's
domain of practice is interconnected with three environment elements:
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Person (P)
This element identifies a person (individual) or grouping of persons (couple, family, community, and so on) in different size and kinds of social arrangements. It also allows one to explore social role functioning, physical, mental, spiritual and developmental experiences of the person.
Three of the four factors of the
PIE System provide person description information:
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Validator Otherness (VO)
This element identifies proper and relative norms - expressed as values, beliefs, ideals, customs, traditions, laws, policies, sometimes collectively defined as culture - used by individuals and other societal groupings to govern their interconnective relationships with others.
These norms serve as culture-specific guides and/or constraints to regulate, control, socialize or otherwise affect the qualitative nature of particular person-in-environment relationships.
Proper validators are typically centralized
norms in the form of :
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They are considered to be invariant or unmodifiable "truths" that all persons in a defined group or society are expected to follow.
Relative validators are more typically decentralized and tolerant of differences, for example, rights guaranteeing freedom of speech; freedom of assembly, etc., allowing for diverse and variant, but respectful, relationships between people.
Validator norms are present in all person-in-environment systems and directly affect the nature and quality of interconnective relationships between all other elements in the system.
Validator otherness is not
a specific part of the PIE System's environmental factor but it may be
a very helpful element when exploring sources of discrimination that social
workers may identify when using the PIE System.
Personal Otherness (PO)
This element represents the personal social support relations that usually are defined as intimately close or a "significant other" to an individual or family, but also to a group, community or even a nation. Personal other can be an individual (friend, relative, etc.) or a grouping of persons (family, friends, groups, community, etc.).
Validator influences on personal others affect the nature and quality of their relationship with person elements. For example, parent beliefs about homosexuality will directly affect the relationship between parents and a child in the process of discovering his/her homosexual orientation.
In turn Validator influences on resource
elements will affect the way resources are provided or offered to personal
others. For example, service delivery policies that only serve Alziehmer
disease persons will ignore the need for support services to personal other
caregivers such as a spouse or other family members.
Resource Otherness (RO)
This element consists of all the
other opportunities, resources, goods and services of a political, social,
spiritual, geographical or economic kind that can sustain, enhance or impede
the social role functioning of a person in relationship with others in
their life. These typically include the institutionalized resources in
a given society:
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Validators in the form of societal
attitudes, legislation or service delivery policies influence the way resources
respond to individuals and groups of people with similar problems. For
example, domestic violence was not so long ago considered outside law enforcement
jurisdictions, resulting in few if any resources for persons abused by
their personal other spouses.
Domain of Practitioner
The second component to explore is the domain of social work practitioner. The holistic depiction of this component is exactly the same at the domain of practice component. This indicates that social workers experience the same person-in-environment elements in their personal and professional lives that the people they work with experience.
At the professional level, they are expected to ingest the relevant codes of professional conduct that apply to their practice activities and adhere at all times to their standard of care tenets. As they are frequently referred to as the primary "instruments of change" in social work practice, social workers are expected to vigilantly monitor and evaluate their competence to serve others.
At the personal level, they are guided
by patterns of
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that collectively affect how they carry out their professional practice obligations, functions and roles.
It is just as important for professionals
to focus on the social relationship patterns in their lives as it is to
assess person-in-environment domains of those they are working with or
on behalf of, directly or indirectly.
Paradigm of Profession
The third component to explore is the paradigm of the social work profession. The holistic depiction of this component identifies a range of practice system options available to a social worker, either in the form of their own expertise or through the expertise of colleagues, within or external to the discipline.
Social work includes both generalist and specialist practitioners. Social workers generally speaking divide their practice activities into micro (including clinical and other forms of direct client work) and macro (including various forms of community development work and other forms of working on behalf of groups/categories of people).
The paradigm component can be unfolded
to depict four commonly recognized practice option elements (Pincus and
Minahan, 1973):
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Three of these elements (client,
target and action) contribute directly to the effective use of the PIE
System.
Client System
This element identifies the decision
to work directly with people who request or are willing to be in a client
role to address a social functioning problem. The service could be in the
form of individual, couple or family counselling, crisis intervention,
social support services, and so on. It could also be in the form of community
development services requested by a community group.
Target System
This element identifies the decision to work with part of the person-in-evironment domain that needs to be influenced or persuaded to be helpful toward a client system or in some cases to help a potential client system decide to assume a client role.
The practice actions could be in the form of -
This element identifies the decision to work with part of the person-in-environment domain that has already agreed to be cooperative or serve as an ally to those who are providing client system work or carrying out target system activities.
The practice actions could be in the form of -
Change Agent
System
This element identifies the employer or self-employment systems used by social workers. The system is guided by mission and function constraints that generally define the type of services to be provided.
A family service agency works with individuals and families; a drop-in centre works with the homeless; child welfare services work with children in need of protection and in-home support, and so on.
In some circumstances, the change agent system can be the subject of one of the other three practice options by one of its own social workers. It -
Method(s) of
Practice
The fourth component to explore is the method of practice. The holistic depiction of this component is presented in the form of the systematic phases described in the problem-solving process of helping.
The four elements of the component are rearranged in a way that depicts the minimum number of phases in a helping process to be three or four. Each phase will have a number of tasks and activities identified that are deemed important to advance the helping process from problem identification to a satisfactory social functioning solution.
Four commonly recognized helping
process phases are:
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Use of the PIE System instrument
takes place in the assessment phase and leads to the selection of appropriate
practice options and intervention approaches to be implemented in the intervention
phase.
Summary
Now that the holistic model components
and their interconnected elements have been explored separately, their
composite connectedness can be viewed again.
The domain of practice and paradigm
of profession components can be animated graphically or in one's mind to
make a variety of quarter turn movements to depict different practice option
possibilities. For example, the person element of the domain of practice
component facing the client system element of the paradigm of profession
component depicts the client system option with an individual, family or
community.
If the resource other element is rotated a quarter turn to face a similarly rotated target system element, it would depict target system work with people in a client's community resource network. If the person other element and action system elements were quarter turned to face each other, it would depict action system work with a member(s) of a client's personal other network.
The unfolded interconnectiveness of the holistic model depicts the complex network of inter-element relationships that must occupy the primary focus attention of social work practitioners. It also provides a bigger picture understanding of the social work profession and offers a context for a social worker to use the PIE System.
Summary:
The PIE System is used in the assessment
phase of social work helping to provide a holistic four factor assessment
description of the person-in-environment domain of practice, leading to
the selection of an appropriate practice option(s) and intervention strategies
of helping.
The PIE Classification System
Note: This section closely corresponds to the PIE System information supplied in the Karls and Wandrei Person-in-Environment book and in the PIE Manual. A brief summary of its history is located in the Introduction. The holistic nature of the system and how it fits within a larger holistic perspective of the profession of social work is presented in the Holistic Model section. After exploring any or all of these sections, your ability to use the system may be tested in the Cases section.
The four-factor PIE System was designed to help social workers prepare a holistic description of social role, social environment, mental health and physical health dimensions that contribute to the overall health and social functioning of a person. It may be used independently in social work practice, or in multidisciplinary situations to provide the social work perspective as a complementary contribution to perspective(s) from other helping disciplines.
The primary emphasis is to help social workers construct a descriptive classification of factors required to implement practical next steps of helping, and an easily communicated explanation of why particular helping methods or approaches are being selected. This social assessment system is not a diagnostic system in the sense of providing a fixed label for a person's state of social functioning.
The PIE System is used by social workers to identify a number of problem and/or strength description circumstances to choose from in deciding priorities and options. It helps the social worker make clear and succinct classification assessments that allow for greater accountability of what methods are selected to be helpful and what outcomes are achieved. Although it provides a numerical coding system, the narrative classification descriptions are always considered to be priority. The expected ease or short-hand of communication between practitioners and/or colleagues in other helping disciplines is in the narrative descriptions, not in the development of a coded numbers system.
Developmental testing has shown that
the PIE System can be used in all fields of social work practice. It can
be used by social workers with a variety of theoretical orientations and
approaches to their methods of helping. Although social workers using it
must construct their own professional assessments (not the client's for
example), it is not restricted to any particular style of social work practice.
It may be used independently or collaboratively with their clients and
others they serve.
The PIE System is
defined by four factors and their relationship to each other
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social roles, relationship types severity, duration, coping |
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social environment institutions and resources severity, duration |
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mental health, DSM-IV information |
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physical health, ICD-10 information |
Factors I and II are sometimes cited as the core social work descriptions. While this is correct, any downplaying of the interconnective nature of all four factors will eliminate the holistic structure of the PIE System and diminish the social worker's ability to construct a comprehensive picture of the client's person-in-environment social functioning.
Presented in a network form, as follows,
outlines the holistic structure of the system and serves to remind us of
the importance of the interconnective links (in this case - 6) between
all parts of a "whole system" perspective.
Factor I: Social Role Functioning
As outlined in the PIE Manual, social role difficulties often bring people to a social worker for assistance or what social workers identify as social environment barriers to rightful social role opportunities.
The Two Features of Factor I:
The social role
elements of "Factor I" listed under four headings:
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Each heading lists a number of recognized
roles and provides for an "other" description and code if needed. The Manual
provides descriptive definitions of the identified roles and brief examples
for each role. The Examples section of the program provides additional
illustrations of the role and corresponding relationship connections.
"Factor I" Roles
and Corresponding Code Numbers
xxxx.xxx
Role Group and
Specific Role
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Familial
Parent Spouse Child/Adult Sibling Other Family Significant Other |
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Other Interpersonal
Lover Friend Neighbor Member Other (specify) |
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Occupational
Worker (paid) Worker (home) Worker (voluntary) Student Other (specify) |
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Special life situation
Consumer Inpatient/client Outpatient/client Probationer/parolee Prisoner Immigrant (legal) Immigrant (undoc.) Immigrant (refugee) Other (specify) |
Role Experiences Types
"Types" is used in the PIE system
to describe the kind of interpersonal relationship dynamics occurring -
or have occurred - between someone in a particular social role and another
person. It is generally assumed that the nature of this relationship is
now strained, disrupted or broken. As social work is a relationship-centered
profession, a social worker must describe social role problems in a relationship
context to facilitate the determination of recommended interventions. Nine
problem types are identified and coded:
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Power
Ambivalence Responsibility Dependence Loss Isolation Victimization Mixed Other (specify) |
Severity Index
The Severity Index is used to indicate
whether a change in a client's social functioning is extensive, rapid and
problem-producing or not problematic. The severity indicator is coded to
the right of the decimal point in the PIE coding system (xxxx.Xxx). For
example, Factor I, 1210.4xx is Family , Spouse Role, Power Type, High Severity.
The six (6) "Severity Index" levels:
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No Problem
Low Severity Moderate High Very High Catastrophic |
Duration Index
The Duration Index indicates the
length or recency of the Social Role or Environmental problem. It helps
to alert the practitioner to the degree of urgency of the problem. It is
recorded as the second digit after the decimal point (xxxx.xXx). For example,
Factor I, 1210.44x is Family, Spouse Role, Power Type, High Severity, One
to Six Months duration. The six (6) Duration levels code numbers are:
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> 5 years
1 - 5 years 1/2 - 1 year 1 - 6 months 2 - 4 weeks < 2 weeks |
Coping Index
The Coping Index is used only for
Factor I. This measures the client's ability to manage a problem with his
or her own internal resources. The client's coping skill level can guide
the practitioner to appropriate interventions. The coping index is recorded
as the third digit to the right of the decimal point (xxxx.xxX). For example,
Factor I, 1210.445 is Family, Spouse Role, Power Type, High Severity, One
to Six Months duration, Inadequate Coping Skills. The six Coping levels
and their code numbers are:
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Outstanding
> Average Adequate +/- Inadequate Inadequate No Coping Skills |
Summary
At this point, it is assumed that
you have been working back and forth between this program
and the PIE Manual, and that you
now have a reasonably good understanding of the social role and relationship
type elements in Factor I.
If you have worked through the Introduction
and Holistic Model sections, you have a general understanding of how the
PIE System was developed, and a sense of how a holistic model provide
a reasonably comprehensive context to use the instrument. Recommended reading:
Chapters 1, 2, and 14 of the PIE Book.
The PIE System Training
workshops produced several tips helpful in accelerating one's mastery of
the system:
Recommended Reading: PIE Manual,
Chapter 3: Factor I: Social Role Functioning, and Chapter 5: Severity,
Duration, and Coping Indexes.
Factor II: Environment
Overview
Factor II is used to describe the social institution and social systems situations that impinge on the social functioning and role performance abilities of people in their environmental contexts. If you are interested in integrating the PIE System, Holistic Model and Practice Options sections, Factor II draws attention to the environmental dimensions of social work's "person-in-environment" domain. It helps to remind clinical social workers that practice options in addition to direct client system work may be required. It helps to remind macro practice social workers that direct client system work in addition to social change interventions may be required.
Although environmental problems are generally described as factors outside of the client or outside an identified category of people that affect social functioning and well-being, the holistic perspective reminds social workers of the interactive and interconnected nature of these outside factors.
The focus of this section is on identifying problems that are systemic in nature, affecting not only individuals, families and communities, but entire groups of people with similar characteristics or circumstances. By clearly identifying a problem in the social system and environment, the social worker can make a considered decision about whether to intervene directly or to engage others in the social role-relationship type problem, the systemic environmental problems, or both.
Six subsystems are identified. The coding system is the same as Factor I except that the coping skills code is not used, which makes it a six digit system (xxxx.xx). The first two digits identify the general system and subcategory problem (50xx.xx. The second two identify specific problems in the category (xx01.xx). Each subsystem has a section to identify systemic discrimination problems that effect entire groups of people (56xx.xx).
Factor II situations are those that
affect Factor I descriptions. There may other systemic environmental problems,
but only those relevant to a specific client are recorded.
Economic/basic
Education/Training
Judicial/Legal
Health/Safety/Social Services
Voluntary/Associations
Affectional Support
Duration
Severity
Examples
Summary
Cases
Practice Options
Overview
The client system option is selected when direct work with people in the person element of the domain of practice is appropriate.
Greater option specificity can be
described when the client system is unfolded to identify social work classifications
described by:
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Unfolds to identify individual, family,
group, community types of clients.
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Unfolds to identify poverty, housing, social security issues, and so on. |
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Unfolds to identify child welfare, school social work, family services, corrections, medical social services, and so on. |
Unfolds to identify children, youth,
families, elderly, disabled, young offenders, minorities, and so on.
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The target system option is selected when some parts of the person-in-environment domain need to be persuaded to work on a social functioning problem, individually or societally. In some cases, this may mean helping a person agree to receive client system services. In other cases, it means influencing some part of a person's environment to make the changes needed to assist a client or groups of people with similar problems.
The action system option is selected when team work or other forms of collaboration are in place. In some cases, this involves the social worker through a natural or substitute family member willing to be the client's primary caregiver. Other cases would involve working through community resources with already established partnership agreements, formally between agencies or informally between staff members.
The change agent system option identifies the social worker within a service delivery context, as an employee or self-employed practitioner. The system unfolds to identify the complex patterns of an organization which at times may be open to and/or subject to intervention strategies associated with client, target, or action system options.
An organization may therefore be unfolded to identify Service Provision, Management, Support Services and Policy-Making elements. Policy-Making may then be unfolded to identify board, government, profession and funder units; they are all under the influence the "Change Agent System" management and its professional service providers.
Examples
Summary
Cases
Interventions
Overview
interpersonal
intrapersonal/intrapsychic
environmental
Examples
Summary
Cases
[law of whole system=
knowledge of whole and one or more parts makes it possible to discover
other parts; what separates a local system from the Universe is a tetrahedron;
local system is minimally tetrahedral; have the system itself; all that
is inside and all that is outside. Inside and outside have different degrees
of relevance]
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