The intent of this assignment is to foreground the method of societal work intercession which I used with a service user ( Miss A ) in pattern. Within this essay, I will include the assessment procedure and a principle for taking the appropriate method of intercession. I will besides supply a societal history of the service user, portray the strengths and failings of the intercession, and besides place underlying theory to the societal work procedure. I will try to critically analyze and measure the effectivity of a method of intercession. Throughout my assignment I will endeavor to integrate my acquisition and bespeak how I adapted cognition, accomplishments and values to show anti-discriminative and anti-oppressive pattern. I will besides endeavor to place policy and legislative context appropriate to a learning disablement scene.
Evidence based pattern ( EBP ) refers to incorporating professional expertness with the best available external research, and integrating the positions of service users ( Beresford, 1996 ) . Evidence based pattern has received its repute by analyzing the grounds why intercessions are necessary ( Duffy, Fisher and Munroe, 2008 ) . Within my arrangement EBP was of import for polishing my pattern so the service user was provided with appropriate support for her single demands. I used my EBP to transport out research to find what grounds supported or rejected the usage of a specific intercession ; within this instance I used a counseling attack.
The rule of societal work intercession is to supply good pattern and should be based on a decision-making model ( Preston-Shoot and Braye, 2009 ) . This model operates on four constructs: –
The statute law that informs a determination ;
Social work moralss and NISCC codifications of behavior ;
Information to guarantee a intelligent determination ;
Knowledge drawn from research, theory, pattern and other professionals.
In add-on to powers and responsibilities of societal workers, statute law embeds impressions of partnership, regard, rights and anti-discriminatory pattern, which are cardinal elements in societal work pattern ( Preston-Shoot and Braye, 2009 ) .
My pattern larning chance involved working with grownups with a larning disablement in a twenty-four hours attention puting. The benefits of the twenty-four hours center were to supply a service for local people to entree support in life with, or caring for person, with a learning disablement. Northern Ireland statistics show that in 2008 there were 9,460 people with a larning disablement in contact with Trusts ( www.northernireland.gov.uk ) . From the 9,460 people with a learning disablement there were 2,574 profiting from attention direction, 42 % ( 1,086 ) of whom were being supported in their ain places and 35 % ( 898 ) being cared for in residential places entirely for the usage of people with larning disablements ( www.northernireland.gov.uk ) .
This grounds based instance survey is based on Miss A, a 35 twelvemonth old adult female, who has a learning disablement and Spina Bifida ensuing in her utilizing a wheel chair for mobility. Within the past few old ages Miss A ‘s household life has changed dramatically. In old old ages Miss A had lived in the community with her aged parents, who cared for her. She is one of three kids and has two older brothers. Miss A ‘s female parent, after being diagnosed with Dementia, was admitted to a residential attention place. Her male parent after holding been moved to residential attention himself passed off in November 2008 due to his physical wellness. Miss A now resides in a private nursing place and attends twenty-four hours care three yearss per hebdomad. In March 2008, there were 75 residential places in Northern Ireland entirely for people with a acquisition disablement supplying 898 topographic points ( www.northernireland.gov.uk ) .
Miss A has been antecedently diagnosed with MRSA ; it is presently located in her toe, holding been antecedently present in her piss. Treatments from the residential attention staff have the infection under control, nevertheless the infection still remains.
The recent decease of her male parent plays a important function in Miss A ‘s life and continues to impact her socially and emotionally.
Some of the stereotyped premises I had before meeting Miss A were that because she had a physical and learning disablement that she would be difficult to pass on with, that she would hold limited apprehension and limited verbal accomplishments. I have challenged this sentiment and realised that Miss A is a really competent person with good communicating accomplishments, and can show her likes and disfavors proficiently. As for her physical disablement this does non impact her cognitive or intellectual maps. I had besides made the premise that as Miss A had MRSA that it could easy be cross-contracted due to a deficiency of cognition and instruction. After researching the issue and reaching infection control within the Trust I deducted that MRSA is a job within clinical scenes but can be easy controlled with proper preventive processs. This can be identified as a hazard, but should non be a ground to suppress or know apart Miss A.
After holding ab initio met Miss A, liaised with her societal worker, accessed her instance file and Tuned In to her life issues, I met with Miss A to fix for the initial appraisal and gather information into how best to back up her. My function with Miss A was to supply a reappraisal since the alterations in her fortunes and the decease of her male parent. My function was to find what back up she may necessitate, and to include her wants and feelings.
History has shown that there has ever been an importance to assessment in societal work, but since the 1990 ‘s there has been specific importance to a new signifier appraisal to include hazard. The National Health Service and Community Care Act 1990 stresses the importance of inter-agency coaction and a multi-disciplinary appraisal procedure ( Trevithick, 2000 ) . The intent of an appraisal may look apparent ; that is, to measure the demands of persons who may necessitate aid and/or support. In recent history nevertheless assessment seems to intend a relationship between demand and available resources ( Whittington, 2007, p23 ) taking to a inquiry if this is ethical or effectual pattern?
There are many intents of an appraisal, for illustration to measure hazard, to measure demand, to move as an advocator for person and besides to implement bureau and authorities policy ( Whittington, 2007, p25-26 ) . Coulshed and Orme ( 2006 ) explain that appraisal is an on-going procedure where the intent is to understand people in relation to their environment ; it is a footing for be aftering what needs to be done to keep, better or convey about alteration with the service user ‘s engagement.
The initial readying for the appraisal with Miss A included sing her societal worker and analyzing her instance file. This enabled me to garner information to chase away any prepossessions I had about run intoing this service user. The societal worker passed on her cognition of Miss A, such as medical conditions, household fortunes and fundss, and besides any old jobs that had occurred. I felt it was of import to work in partnership with Miss A ‘s societal worker so I could maintain her up to day of the month with events, and besides reach her if I required advice about Miss A. The intent of Miss A ‘s single appraisal was to garner information by interacting and pass oning with Miss A and others involved in her attention, this was besides to derive a holistic position to her demands. Her appraisal was guided by statute law such as, the Chronically Sick and Disabled Persons Act ( NI ) 1978, which places a responsibility on wellness and societal services to look into a degree of demand, and besides the Health and Personal Social Services ( NI ) Order 1972 which stipulates a duty to supply personal societal services for the publicity of societal public assistance for the general populace ( hypertext transfer protocol: //www.understandingindividualneeds.com ) .
As a theoretical account of appraisal I used Smale ‘s ( 1993 ) Models of Professional Care which were utile in garnering of import information about Miss A. I used the procedural and oppugning theoretical account to garner information into how Miss A felt about certain issues in her life, such as the mourning of her male parent, contact with her other household, and other issues she felt were working or non working. I used these methods of appraisal as this followed Trust guidelines. I used The Model of Professional Care to derive a holistic apprehension of information. I besides included the Exchange theoretical account in the appraisal as I considered Miss A to be the expert of her ain life. I feel the usage of the Procedural theoretical account was utile in certain facets of the appraisal as it worked in coaction with the Trust ‘s format of appraisal and worked as a signifier of garnering information, but feel I could hold used more of an Exchange theoretical account to pass on efficaciously with Miss A instead than merely organize make fulling. I feel Smale ‘s method of appraisal provided me with tools to assist Miss A identify factors that were of import for her to keep, but besides issues she would wish to alter. By working in partnership with her I felt we would hold an unfastened and swearing working relationship.
I besides focused on Person Centred Planning ( PCP ) in respects to the appraisal with Miss A. Person Centred Planning, which evolved from the White Paper ; a authorities policy known as Valuing People, suggested four cardinal rules ; Rights, Independence, Choice and Inclusion as a proposal of altering services ( Thompson, Kilbane and Sanderson, 2008, p9 ) . This policy besides helped inform guidelines for Northern Ireland ‘s Equal Lives Policy ( 2005 ) . Person Centred Planning focused on happening out what is of import to and what is of import for ( wellness and safety ) Miss A. I found PCP a continual procedure of listening and larning, by concentrating on what ‘s of import to Miss A now and in the hereafter ( Thompson, Kilbane and Sanderson, 2008, p27 ) . By utilizing individual centred tools, such as a one page profile, I gained cognition of what was of import to Miss A including her household, her fellow and her independency, every bit good as cognizing what was of import to maintain her safe and healthy. I used a individual centred attack to do others cognizant of Miss A ‘s great personality features every bit good as the aid and support she would wish. I feel this was cardinal to show that Miss A is a individual behind her disablement. I found by utilizing this attack was an indispensable accomplishment in understanding Miss A and helped me to be anti oppressive and actively back up her demands
One peculiar piece of statute law which I found to be important in the appraisal of Miss A was the Human Rights Act ( 1998 ) , which identifies Miss A ‘s right to household life. Since the decease of her male parent and the institutionalisation of her female parent due to her mental wellness, Miss A has been sing decomposition of her household and has lost the support connected to it. The Human Rights Act could hold a great significance as Miss A needs emotional and physical support to see her female parent and has non been having it ; therefore her right to household life is being impeded. The appraisal identified that contact with her household and friends are imperative for this right to be upheld. Therefore as a consequence my function was to ease this right, and aid to back up Miss A in retaining household contact.
The chief aims we ( Miss A and I ) identified within the appraisal were ;
That Miss A had limited support to assist discourse the decease of her male parent.
That Miss A was non having contact with her female parent or other household and would wish to.
From the designation of aims Miss A and I decided to work towards solutions by fixing a work program.
After the initial appraisal was carried out with Miss A we proceeded to work towards explicating a attention program and aiming her aims. A attention program provided clear information for everyone involved with Miss A and helped work in partnership with her and the Trust. For a individual centred attention program the word ‘support ‘ is used in penchant to ‘care ‘ because the verb implies that support is at that place to assist people achieve their ends and aspirations ” ( Thompson, Sanderson and Kilbane, 2008 ) . “ A support program is developed by the individual with aid where necessary, and it describes how the individual intends to be supported in order to populate their ain life ” ( Thompson, Sanderson and Kilbane, 2008 ) . I feel the usage of a support program with Miss A, instead than a attention program is an anti-oppressive method, as it incorporates Miss A ‘s feelings and sentiments into how she wishes to be supported.
I used the preparation of a support program with Miss A to enter the aims she would wish to run into and used these to explicate an intercession. It was clear from the appraisal and one page profile that limited contact with her female parent was an issue, and that the decease of her male parent had a important impact on her life.
I so proceeded to look into theory of loss and heartache as I had ne’er experienced a loss of Miss A ‘s magnitude before. I found the Kubler-Ross Model and the 5 responses to grief to be peculiarly enlightening. ( Goldsworthy, 2005 ) . This theory helped inform my cognition and in bend helped me be empathic to Miss A. I was able to place that Miss A can see the 5 phases of heartache and that they are non needfully in a specific order. I felt Miss A was at two phases of heartache, some yearss she experiences choler at her male parent departure, and other times she has deep feelings of depression of losing him. I was able to utilize Kubler-Ross ‘s theoretical account to place these phases in Miss A, and besides to rede her that these feelings were portion of the normal procedure of heartache.
The appraisal besides identified that Miss A had a deficiency of support in discoursing her feelings of heartache. Research suggests that people with learning disablements experience many of the emotions of mourning but are limited in the chances they have to decide their feelings of heartache ( Cathcart, 1995 ; Elliot, 1995 ; Read, 1996 ) . There are many grounds for this and Murray et Al explains that historically, professionals, parents or carers of persons with larning disablements believed that those in their attention did non understand the construct of decease and therefore were unable to sorrow for the loss of a loved one ( McLoughlin, 1986 ; Elliot, 1995 ; Read, 1996 cited in Murray et Al. 2000 ) . Kitching ( 1987 ) and Bradford ( 1984 ) highlight that the capacity to sorrow is non dependent on a individual ‘s rational ability, but that a individual with larning disablement may see heartache in the same manner as a kid. Therefore research shows that people with a learning disablement experience heartache and loss but have a limited support web to discourse it with. I used this research to explicate a program for the intercession with Miss A and we concluded that I could be support for discoursing her heartache.
From the appraisal and attention program with Miss A, and following treatments my pattern instructor, I discussed that I would utilize reding accomplishments to assist back up Miss A with her feelings of heartache. I felt Miss A needed her emotional demands met since the feelings of the decease of her male parent were so dominant. Miss A and I besides decided that I would ease visits to her female parent for emotional and physical support, as her female parent was in the latter phases of dementedness and Miss A found it difficult to pass on with her.
Rationale for Reding Intervention:
After holding conducted an appraisal and attention program with Miss A, and constructing a resonance over legion meetings, it was decided that a guidance intercession would be the most appropriate signifier of support for heartache. My pattern instructor and I felt that if Miss A had the chance to discourse her feelings this would assist her grieve more efficaciously and possibly assist her header better.
The two theoretical accounts of reding that are outstanding in societal work are the work of Carl Rogers and Gerard Egan, who base their guidance attacks from psychodynamic work about interior ideas and feelings. Both reding theories “ reflect the societal work values of accepting the person, utilizing accomplishments in listening to the information that is given, and work towards a joint apprehension and determination doing about ways frontward ” ( Coulshed and Orme, 2006 ) . I focused on researching reding theory to assist me understand how I could assist Miss A through her heartache. Trevithick explains that within societal work, humanistic attacks to reding hold been peculiarly influential, specifically with the work of Egan ( 1990 ) and Rogers ( 1961 ) , chiefly because they promote personal freedom and are consistent with anti-discriminatory pattern and anti-oppressive positions ” ( Trevithick, 2000 ) . I found that the Roger ‘s ( 1961 ) Person Centred guidance informed me that I could demo unconditioned positive respect for Miss A and understand that she is the expert of her ain heartache.
I besides analysed Egan ‘s ( 1990 ) Skilled Helper Model and found it to be an effectual theory for an attack to reding. I found that the construction and model of the theoretical account and the three phases were utile as a usher to follow. I found that although this method of reding may non be as individual centred as Roger ‘s it could be more effectual in assisting Miss A understand her ain heartache as it followed a certain model, could authorise her and could be evaluated over clip. This theory helped inform my pattern by assisting me gain that I do non necessitate to be a qualified counselor to back up person ; I merely necessitate to be able to actively listen, to utilize empathy and be reassuring cognizing that Miss A ‘s docket is overriding. I consider this in itself to be a individual centred manner of guidance.
I decided to follow a combination of Rogerian method and Egan ‘s attack to assist back up Miss A as an intercession. I decided I would utilize the construction of Egan ‘s theoretical account to assist construct a logical, consistent model to the intercession, while utilizing the nucleus rules of the Rogerian attack to show my accomplishments and values, such as working with regard, empathy, genuineness and good active hearing ( Coulshed and Orme, 2006 ) .
Egan ‘s Skilled Helper Model signifier of reding provides a structured and solution focal point footing. It is a three phase theoretical account in which each phase consists of specific accomplishments that the assistant uses to back up the service user travel frontward ( Nelson, 2007 ) . Egan ‘s theoretical account is described as a three-stage procedure: designation of the service user ‘s current issue ( s ) ; designation of the service user ‘s coveted state of affairs ; and the preparation of an action program to accomplish this. This procedure is facilitated by the “ skilled assistant ” utilizing the accomplishments lineations by Egan ( Nelson, 2007 ) .
The end of utilizing Egan ‘s theoretical account with Miss A was to assist her manage her heartache and better understand the “ norms ” associated with it, such as choler or depression harmonizing to the Kubler-Ross Model. Egan ( 1998 ) claims his theoretical account is to ‘help people go better at assisting themselves in their mundane lives ‘ . To supply Miss A with the authorization to assist herself sorrow.
The usage of Egan ‘s Skilled Helper Model was to research how Miss A felt about her mourning. I used it to inquire unfastened inquiries about how Miss A felt about her male parent. We explored her yesteryear and discussed her relationship with her male parent before his decease. I besides used this phase to concentrate on facets of her male parent before he died and what she missed about him, this was to research and garner information about what her relationship was like with her pa. I was able to utilize a scope of accomplishments to garner information about Miss A ‘s heartache. Trevithick ( 2000 ) explains that societal work accomplishments are “ the grade of cognition, expertness, opinion and experience that is brought into drama within any given state of affairs, class of action or intercession ” ( Trevithick, 2000 ) .
Some of the accomplishments I incorporated into Egan ‘s guidance were active hearing, I used this accomplishment with a scope of non verbal cue ‘s to bespeak to Miss A that I was interested in what she was stating. I concentrated on active hearing as Miss A was portraying feelings and cognition of the decease of her male parent which was a sensitive topic and needed my full concentration. I portrayed active hearing by nodding, giving oculus contact and confronting Miss A which were successful in assisting construct a resonance with Miss A, therefore assisting her unfastened up. Another accomplishment I feel I used good with Miss A was empathy. I feel I portrayed my feelings of empathy by reacting suitably to her replies and reassuring her that her ideas and feelings around heartache were normal. I found myself utilizing Empathy a great trade with Miss A as I had ne’er experienced mourning before and she helped me understand how it felt. It ‘s easy to conceive of how person feels, but when you ‘re faced with assisting them I felt I truly needed to put myself in “ her places ” .
I besides found I made good usage of silences with Miss A, I used these to give her clip to reflect on her ideas and replies. I have found by making this that the meetings were paced better, and showed that she was the expert of her ain heartache and I was merely at that place to listen and to reassure her. I found that by utilizing Rogerian individual centred accomplishments like genuineness, empathy, communicating and active hearing I was able to understand Miss A and demo her that I was at that place to back up with her docket. Throughout the treatments of heartache I feel Miss A was able to vent a batch of her feelings that she had since her male parent ‘s funeral. I feel I was able to back up her understand those feelings and assist her recognise that choler, depression, or denial are normal feelings that many people in her state of affairs suffer.
Throughout Egan ‘s Skilled Helper Model and each of the Sessionss with Miss A I found that she responded good to being able to discourse her feelings with person. The Rogerian influence on the intercession enabled me to construct trust, partnership and a good resonance with her easing an unfastened working relationship and supplying her with support.
Some of the values I tried to integrate into my guidance and so my relationship with Miss A were empowerment and self-advocacy, by allowing her know that her docket was cardinal. I wanted to make a balance of power and to supply a encouraging function instead than a dictator function, which I feel I achieved by being able to listen to her positions and integrating PCP. Social work has a typical value base with beliefs and rules playing an of import function in pattern ( Thompson, 2005 ) . Challenging my values has helped me to handle Miss A with unconditioned positive respect, and with the regard and self-respect she deserves. I have challenged my values anti-oppressively by researching MRSA and non doing premises about the status ; I have challenged my stereotyped attitude around larning disablement showing that Miss A is first and foremost a individual with feelings and issues before recognizing she has a disablement.
On rating of the Egan ‘s Skilled Helper Model and my intercession with Miss A have shown that her docket was cardinal to the Sessionss, a balance of power was necessary to accomplish the trust and regard of one another and that listening is paramount to supplying effectual guidance. I entered the Sessionss with Miss A being unaware of what to anticipate, I was troubled that I would non hold plenty cognition about heartache to assist back up her. After the initial session I shortly realised that I did n’t necessitate to be a qualified counselor to do a difference to her apprehension of heartache, I merely needed to be able to explicate her feelings to her and reassure her that they were normal and non as she phrased it “ being mental ” . I found that by working with Miss A utilizing the Skilled Helper Model I was able to use my accomplishments of hearing, communicating and empathy to assist her understand her feelings. I have ne’er personally had a mourning of Miss A ‘s graduated table before but experience as a direct consequence of working with Miss A I have learned that heartache is a powerful emotion for anyone to see and it can take a important sum of clip to retrieve from. The lone sorrow I have of utilizing the Skilled Helper Model was that I feel I did non hold adequate clip to to the full assist support Miss A, I feel as I had a arrangement of merely 85 yearss I did non hold adequate clip to to the full advocate her for the best result.
I feel throughout the intercession procedure I tried to keep individual centred rules with Miss A by supplying her with the chance to discourse what was of import to her. Research shows that the usage of Egan ‘s theoretical account is non individual centred as it incorporates the counselor to inquire all the inquiries, and hence have the control ; but I feel by working in partnership with Miss A to discourse the decease of her male parent was of import for her emotional well being and empowered her to assist decide her heartache. I besides incorporated Roger ‘s nucleus accomplishments of genuineness, regard and trust to accomplish this
Through working with Miss A I have found the experience to be priceless larning. I have discovered that there is a spectrum of ability with grownups and their learning disablement. I have found that each individual is an single, and that group attention is non needfully recognizing of this. In respects to Miss A I have learned non to do premises or stereotypes before run intoing the individual, as this can take to subjugation and even favoritism. Miss A is an single, with single demands, and at this appraisal and intercession her emotional demands were outstanding.
I feel I completed the purposes I had intended to by back uping Miss a through her heartache utilizing Egan ‘s Skilled Helper Model. I incorporated Roger ‘s nucleus skills into this theoretical account to assist ease individual centred Sessionss, and make an apprehension that she was the expert, and I was at that place to listen and back up her. If I was to reiterate the intercession I would utilize Egan ‘s theoretical account once more as it provided me with a structured, logical model to work with and provided me with the designation of the accomplishments I needed to do the Sessionss successful and efficaciously advocate Miss A.
I feel my hereafter larning demands from working with Miss A are to utilize more formal linguistic communication as I identified I talked to her informally utilizing words such as “ wee ” . I feel I did this to look more friendly instead than her societal worker, but realise this is non a professional mode to work. Other larning demands I identified were to gait the Sessionss more suitably and guarantee that Miss A understands the conversation. I feel during the initial Sessionss with Miss A I spoke more to prosecute her in the treatment, and experience this was more of a nervous reaction to holding to advocate Miss A. During ulterior Sessionss I was able to take this accomplishment into consideration and settle quicker into Sessionss to give Miss A the chance to discourse what she wished.
Overall I feel my relationship with Miss A was good, I feel the appraisal and intercession were successful, and I feel I worked in a individual centred manner integrating cognition, accomplishments and values to inform my pattern. I feel Miss A felt positively about our work together as her feedback from Sessionss indicated that she was satisfied with the support I provided.