Factors related to congruence between social worker and client problem definitions in an acute care hospital

Problem definition in social work may be the source of disagreement between social workers and their clients. It can be affected by both client and worker characteristics, as well as the care-giving context. This paper examines the definitions of psycho-social problems by social workers and their clients in a general hospital. It is based on the analysis of interviews with 120 patients and their social workers, which were conducted towards the completion of treatment, shortly before the patients' discharge from the hospital. As expected, differences were found to exist in the ways patients and their social workers define patient problems. These differences were expressed in both the type and the number of problems cited. Social workers tended to identify a larger number of problems than did patients. Congruence was stronger among younger clients of higher socioeconomic status, whose social workers had studied an eclectic approach to practice. The practice implications of these systematic differences are explored.