Author: Andre Coleman

Part 1: Indicate two sociological theories that can be used to help your understanding of the service users’ situation

In taking the time to observe how sociological and psychological influences may impact on a service user or client group, the social worker can remain mindful of the wider context of a situation and not just take what she sees at face value. This knowledge allows the social worker to remain objective and to make informed decisions in order to maintain professionalism in her work. By applying Sociological and Psychological theory to the ‘Bertram’s’ case study I aim to explore the wider social context, outside influence and psychological implications from the past and present. Through this exploration I will uncover the varying viewpoints and sometimes contradictory nature of these theories. To gain a Sociological perspective on the case study I will be applying Functionalist and Feminist theories. I will be able to scrutinise the Bertram’s current situation and apply the theory in order to gain a wider understanding of the social context. In order to maintain a balanced viewpoint, Psychodynamic theory and Maslow’s hierarchy will enable me to consider the psychological impact with a focus on human and emotional development.

By examining a situation from a Sociological perspective we can take into account how various aspects such as class, social structure, religion, disability can impact people from a wider social context. This is essential in gaining a holistic picture the situation.

Functionalism

By applying a Macro theory to the case scenario it allows us to look at the large scale features of society and how individual actions affect society as a whole and vice versa. Functionalism will enable me to contemplate the structure of society and how the Bertram’s fit within that structure. Functionalist theorists regard society as a system with interlocking parts. It is believed that each part needs to function effectively in order for society, as a system, to work as a whole. It is often rationalised using biological analogy. The social role of individuals is an integral part of the theory. Each person is thought to have their individual role to play within society. From a functionalist perspective it is very clear that Mrs Bertram is not fulfilling her role as a wife. Due to her alzemers she is unable to carry out the duties that would have been expected of her. Durkheim believed that everyone had their place, and a woman’s place was in the home. In the context of the 40’s, 50’s when Functionalism was at its peak, this viewpoint would not have been uncommon, if a little out-dated by today’s standards. None the less, it is not through choice that she has become dysfunctional within society. She has legitimate claim for not being able to carry out her societal role and Functionalism would automatically see her take on the ‘sick role’. This would enable her to function again within the system under a different guise.

It could also be observed that Mr Bertram is a dysfunctional member of society. With his reckless behaviour, his outrageous spending, and the lack of care for his wife’s basic needs he is no longer fulfilling his role of husband. A main proponent of Functionalism was Emile Durkheim (1858-1917). He saw marital vows as obligations. “When I perform my duties as a brother, a husband or a citizen and carry out the commitments I have entered into, I fulfil obligations which are defined in law and custom which are external to myself and my actions” (Durkheim, 1982). He believed that if a member of society was deemed as dysfunctional, then he was considered to be a deviant member of society. Deviance occurs when people are not functioning correctly, according to the ‘norm’. This could be through crime, or anything which affects their ability to carry out their societal role. Deviance needs to be controlled or managed. If it was established that Mr Bertram was in fact deviant then he may need some persuading that by providing the care and attention that his wife needs his wife would not be removed from the situation. Through this resolution, therefore, they would both be able to function appropriately.

It could be observed that Mr Bertram had an alcohol dependency. If this was established then Mr Bertram too may take on the ‘sick role’. In which case a different method for resolving the issues within the house would need to be adopted. Talcott Parsons (1902-1979) believed that sickness was a social concept rather than a biological concept. So being ill meant acting in different, deviant ways to the norm. Being sick was therefore a form of social role (Haralambos and Holborn, 2004). Parsons believed the rights of a sick person to be exemption from normal social obligations, the right to be looked after and blamed for their social deviance as long as they were genuinely sick. Obligations of a person playing the ‘sick role’ would be to understand that they have to ‘get well’ as soon as possible in order to continue their normal function and in order to do this they must receive professional help. Mr Bertram’s condition would need to be treated or managed in order to enable him to function again. In that case Mr and Mrs Bertram would be able to stay at home under treatment and the issues about care could be dealt with accordingly. He would no longer be considered deviant member of society. A criticism of the ‘sick role’ would be that it is very difficult to apply to long term illness like that of Mrs Bertram. It is built on the assumption that the person gain help in order to gain function. This would not be possible for Mrs Bertram.

Feminism

From a Radical Feminist perspective it could be observed that Mrs Bertram has been oppressed by her husband. Through her devotion and his dominance she has succumb to subordination. Radical Feminists use the patriarchal social system as a concept to explain gender inequality. Patriarchy is the dominance of men over women in society. They view men as responsible for the exploitation of women from which they benefit greatly, through free domestic labour, sexual duties and so on. The case study describes how Mrs Bertram was swept off of her feet and totally devoted to Mr Bertram. In their current situation, Mrs Bertram is at home in squalled conditions and desperately in need of help. Mr Bertram is avoiding the situation by using diversionary tactic, selfishly seeking social activity and pleasure through drink. This further increases her oppression as she is fully dependent on her husband to provide the care and attention which she is desperately in need of.

“Shulamith Firestone, an early radical feminist writer argues that men control women’s roles in re-production and child bearing. Because women are biologically able to give birth to children, they become more dependent materially on men for protection and livelihood” (Giddens, 2006). Feminists could argue that for this reason Mrs Bertram has become vulnerable within her setting and just accepts this way of life. Jessie Bernard argued that “Men need marriage more than women” (pg 208 Gender). Perhaps this reliance on the domestic labour, comfort and sexual duties of a wife, which has been lost my Mr Bertram through his wife’s condition is attributing to his behaviour. Mrs Bertram is no longer fulfilling her duties as a wife and this could be disrupting his routine. It would appear that Mr Bertram has never had to control the household, take care of his wife or finances, and may lack the ability or may simply consider it beneath him. It could affect his masculinity to have to carry out such chores and duties believed to be part of a woman’s role. This may also be the reason why he is reluctant to accept help with the situation. He may feel he is being barraged and dictated to by his step daughters which may be resulting in a greater defiance. It is not clear from the case study, the nature of their relationship either. He may feel that family and professionals are undermining his authority as head of the household. Mr Bertram may be compensating for his lack of masculinity at home, by using his social appearance, bravado, drinking and defiance. This time away from the house for him may reaffirm his role as a dominant male within society whilst his dominant role as a man disappears at home. He no longer has command over his wife, no longer gets respect, adoration that he was once used to. Men are considered to have more influence within society; Mr Bertram has no influence over this situation or over his wife.

Part 2: Using the scenario describe two psychological theories that can be used to help your understanding of the service users’ situation
Humanistic theory – Maslow’s hierarchy of needs

Humanistic psychologist Abraham Maslow (1908 – 1970) argued that humans throughout life not only want to have their basic survival needs met they strive for more in terms of personal growth. He believed that once basic needs for survival had been met that human development progressed toward higher psychological needs. He argued that “people are motivated by the conscious desire for personal growth” (Rathus, 2004). Maslow believed what separated us from our so-called lower animals was our capacity for self-actualisation (Rathus,2004). He believed that this self- actualisation was as important as basic needs but could not be met unless other stages of human needs were completed. He organised these stages into the hierarchy of needs, often presented in pyramid format. Each stage must be satisfied in order to progress to the next. At the bottom of the hierarchy are physiological needs. These are the basic human needs we all have in order to survive, like food, water, shelter, oxygen. Once the first basic need has been satisfied, the following stage is safety needs, the need for security. The following stage in the hierarchy is love and belonging; the need to give and receive love, to overcome loneliness and achieve a sense of belonging in life. The fourth stage is ‘Esteem needs’; to feel self-confident, respected and not to feel inferior. Self-actualisation is the final stage in the hierarchy and can only be reached when all foregoing needs are satisfied and the person feels he has achieved everything he wants to in life and is the best that he can be.

In the case of the Bertram’s it is clear that Mrs Bertram is currently not even meeting the bottom of Maslow’s hierarchy of needs. It is noted that their flat is in an appalling state, she is unable to feed herself and left on her own for most of the day. You would expect most of her needs to be met within the context of her marriage to Mr Bertram; however, since he has neglected his role as a husband, he has placed her in a position of significant danger. Since not even her basic physiological needs are being met in the current situation then at present there would not be an opportunity to progress through the hierarchy of needs.

If Mrs Bertram was placed in residential care then her physiological needs would be met. She would have food, water and care of her basic needs. She could then perhaps progress to the following stage of safety. She would no longer be at risk of hurting herself and she would be in a more secure environment. Although it could be argued that for an advance Alzheimer’s sufferer, the unfamiliar setting would disorientate her and she might not actually feel secure there. Because of her diagnosis, Mrs Bertram is unlikely to meet the third stage of ‘love and belongingness’. Her advanced Alzheimer’s may mean that she fails to recognise her husband, family members and have a declining ability to communicate. Mrs Bertram would never reach self-actualisation. The best that could be achieved would be basic survival and safety needs, whether this was achieved at home with the compliance of her husband, or in residential care. Although it could be debated that residential care would not be the best option. As the GP states in the case scenario, “a move to residential care might well kill Mrs Bertram”.

It would appear from the case scenario that Mr Bertram’s basic needs are being fulfilled. However it is uncertain as to whether his s safety and security needs are being met. He certainly would not get a sense of love and belonging from his wife, in the latter stages of sever dementia. I would observe, however, there is some attempt from Mr Bertram to achieve a sense of self-esteem, since he spends the majority of his time with his compatriots at the golf club. It is clear that in this relationship and the current situation faced by the Bertram’s that he too has no way of reaching self-actualisation. Maslow observes that it is mainly social factors that hinder the personal growth of humans. Potentially at least the first two stages of Maslow’s hierarchy could be reached within the context of their marriage, with the right services in place.

Psychodynamic theory

Through the Psychodynamic theory of personality we could speculate about Mr Bertram’s past and how that has influence on his behaviour in the present. It would be difficult to achieve a comprehensive result in regards to Mrs Bertram because of her Alzheimer’s. Since her behaviour is wholly attributed to her condition.

Studying Sigmund Freud’s (1856 – 1939) theories, with a focus on psychosexual development, would be the most relevant to apply to the case scenario. Psychodynamic theory had been developed and evolved over the years. Freud’s idea of Psychodynamic theory depicted humans as largely driven by unconscious motives and desires. He proclaimed that humans come into conflict when their basic instincts come up against social pressure to follow, laws or moral codes. “At first this conflict is external, but as we develop it becomes internalised” (Rathus, 2004). Freud explains the conflict of personality using psychic structures. The id, which Freud believed is present at birth and located in the unconscious mind, and revolves around our basic biological drives and instincts. It operates on what Freud called the ‘pleasure principle’. It demands instant gratification regardless of laws or moral rules. Another feature in the structure of personality is the ego. Formed from the id, developed through learning and experience. This is the part where conscious thought takes place (Beckett and Taylor, 2010). The ego operates on the ‘reality principle’. This takes into consideration what is practical and possible in gratifying needs (Rathus, 2004). When the ego senses improper impulses arsing it can sometimes deploy a number of defence mechanisms. The third psychic structure is the superego. This is formed throughout early childhood and is developed through standards, values, parenting and moral standards. “Psychodynamic theory emphasises the way in which the mind stimulates behavior, and both mind and behavior influence and are influenced by the person’s social environment” (Payne, 2005)

Freud believed there were four stages in psychosexual development. The first stage took place during the first year of a child’s life. This is known as the ‘oral’ stage. Much of the child’s development is explored by putting things into the mouth and sucking, biting chewing. Freud believed it was possible to have arrested development through trauma. And be fixated on one of the stages. From the case study we could surmise that Mr Bertram is fixated on the oral stage of psychosexual development through his ‘drinking’. We could speculate that he may have had a significant trauma at that stage which has left him with a possible alcohol dependency, thus fixated on the oral stage.

It could perhaps be identified that Mr Bertram is using psychological defence mechanisms in order to avoid the situation that he is currently facing.

Part 3: Reflect on your own background describe it and indicate 1 sociological and 1 psychological theory that can be applied to you, giving examples

The relationship I have with my father has often been fraught, difficult and tense. As a sufferer of a severe mental disorder, my father has often displayed irrational, delusional, paranoid and sometimes violent behaviour. Throughout his life he has had frequent hospitalisation. For me this is something I have grown up with and am used to dealing with on a day to day basis. I am acutely aware of how our relationship differs to that of my friends for example. I have as close a relationship as possible with him, and to that end I usually bear the brunt of his paranoia and aggression when he is unwell. I have witnessed first-hand the stigma attached to mental illness. I find it extremely difficult to trust anyone enough to tell them about the situation, and I strongly feel I shouldn’t have to tell everyone that meets him, this only leads to labelling him as mentally ill, thus changing the way in which they treat him; which only compounds his paranoia.

Some Sociological theorists believe that mental illness is a social construction in order to rationalise bizarre or irrational behaviour that cannot be in any other way explained. This is known as labelling theory. Scheff (1966) argued that people are labelled as mentally ill because their behaviour does not make sense to others. “Scheff points out that labelling of a person as mentally ill is facilitated by stereotyped imagery learned in early childhood and continually reaffirmed, inadvertently, in ordinary social interaction and through the mass media. Thus, when a person’s violation of social norms or deviance becomes a public issue, the traditional stereotype of “crazy person” is readily adopted both by those reacting to the deviant person and, often, by the deviant person as well” (Lamb. 2002). Erving Goffman suggests that when someone is labelled as mentally ill then they are treated differently. When an interaction takes place with that person it is with this knowledge of the mental illness, therefore creating what Goffman called a spurious interaction (Haralambos and Holborn, 2004).

From a behaviourist view, Schizophrenia could be viewed as a kind of learned behaviour. “From this perspective, people engage in schizophrenic behaviour when it is more likely to be reinforced than normal behaviour (Rathus, 2004). This could be the result of being raised in an unrewarding or punitive situation. It could also be observed that this kind of behaviour is reinforced within the hospital setting, where the schizophrenic behaviour is reinforced through attention from professionals within that setting. Cognitive theory argues that behavior is affected by perception or interpretation of the environment during the process of learning. “Apparently inappropriate behavior must therefore arise from misinterpretation. Therapy tries to correct the misunderstanding, so that our behavior reacts appropriately to the environment” (Payne, 2006)

I believe the experiences I have had with my father give me the ability to understand mental illness without stigmatising. It also helps me empathise with the sufferer and the family. An empathetic approach to someone who was hearing voices for example, would be to understand that to the person affect, they are very real. I fully understand the importance of having the right services in place in order for that person to thrive. My experience allows me to observe the wider context of a situation and realise that it is not only the primary sufferer of the condition that is affected. The wider family needs to be considered as they have a huge role to play in the well-being of the person concerned.

Introduction

This report will look at service users who suffer with schizophrenia, it will highlight what schizophrenia is. The needs of service users who suffer from schizophrenia will be identified including; personal, interpersonal, social, educational, accommodation and medication needs. The services available to service users which meet these needs will also be identified.

What is Schizophrenia

Schizophrenia is a complex disorder with a number of variants, although the prognosis is well understood by specialists. It is a neuropsychiatric disorder where a number of factors may have impacted upon the central nervous system and which results in a cluster of symptoms that are classified as schizophrenia. It is commonly thought, incorrectly, by the general public to be associated with dangerous and extreme madness and thus carries a stigma which other diagnoses do not (Eldergill 1997).

About one in 100 people will have one episode of schizophrenia, and two thirds of these will go on to have further episodes. Schizophrenia usually starts in the late teens or early 20s, but can also affect older people for the first time. The causes are unknown but episodes of schizophrenia appear to be associated with changes in some brain chemicals. Stressful experiences and some recreational drugs can also trigger an episode in vulnerable people. (www.mentalhealth.org)

Needs of service users with schizophrenia
Personal needs

An individual’s personal needs include;

Good basic personal hygiene; this may include assistance to wash and brush their teeth or the individual may need prompting/reminding do so.

Having clean fitting clothing; help or prompting again may be needed to assist the individual to get dressed.

Food and drink supplies; individuals may need assistance shopping or making meals, to ensure good diet and physical health.

Interpersonal needs

It is important that individuals gain support from their family, friends and professionals.

Awareness of the individual’s illness and needs is also paramount.

It would also be useful to the individual if their family and friends have an idea of what causes their episodes and ways of defusing the situation or a point of contact when these situations arise.

Social needs

It is important that the individual does not feel excluded from society because of their illness.

To be able to carry out social activities on a regular basis

Meet other people with the same illness; this can provide an understanding of their illness as well as peer support.

Educational needs

Education about their illness and also education for their family and friends.

What to do or who to contact when experiencing the onset of a psychotic episode.

Education on ways to prevent or control the psychotic episodes.

Accommodation

Stable adequate housing.

Depending on the severity or their illness; supported living or residential accommodation.

Medication

It is important that the service user understands what medication they are taking, if any.

What the medication does.

Side effects of the medication.

Services

The National Service Framework for adult mental health has seven standards;

Standard one covers mental health promotion and aspects of discrimination and social exclusion that is associated with mental health problems.

Standards two and three cover primary care services for people who have mental health problems and include 24-hour crisis services.

Standards four and five highlight what is needed to provide effective services for people with mental health problems. This includes being familiar with the care programme approach and its relation to care management.

Standard six relates to the individuals who care for people with mental health problems, with social service departments being given the lead responsibility in ensuring that all carers’ needs are assessed and that they receive their own written care plans.

Standard seven sets out what is needed to achieve a reduction in suicides. This will potentially involve all social workers in a range of settings. (Golightley 2009)

Social services

Social services are put in place to assist people who are experiencing a crisis or are in need of ongoing support. The adult mental health services would be the provider of this service to individuals with schizophrenia. Golightley (2009) highlights the role of social workers working with sufferers of a mental illness to be;

Educating service users and their families about their illness.

Helping to arrange appropriate low stress accommodation.

Networking with the service user to provide community support.

The use of behavioural techniques to modify behaviours.

Encouraging compliance with medication.

Acting as an advocate for the service user where appropriate.

It is important that social workers are able to identify whether the service user is a risk to either themselves or others. If so it is important to identify the risk and a way to manage it.

General practitioner

MIND the mental health charity state that General practitioners are usually the first point of contact for individuals who believe that they are experiencing the onset of a mental illness. GP’s can offer advice and referral to other specialised mental health services and treatments. It is also possible for them to prescribe anti-psychotic medication once assessing an individual’s situation and they feel the individual would benefit from it.

After diagnosis GP’s still play an important role in individuals’ aftercare and physical health. The GP will be able to provide advice about the medication, what it does and its side effects. “According to the Government, GPs play a central role in the care and treatment of people with mental illness.” (Department of health 2001)

Community mental health teams

Community mental health teams are put in place to assist and treat service users who suffer from mental disorders which primary care teams cannot treat including schizophrenia. Community mental health teams usually consist of professionals such as;

Psychologists

Psychiatrists

Nurses

Social workers

Occupational therapists

Support workers

(www.mind.org.uk 2012)

All of these professionals work alongside each other as part of a multidisciplinary team. They create individual care plans for each service user and assist them to either maintain their disorder or work towards full recovery depending on the severity of their disorder.

To access the services of the community mental health team service users would need to be referred by their general practitioner, social worker or health visitor. These professionals will only refer individuals to this service if they believe that it would be appropriate and their patient would benefit from the services they have to offer. Once the service user has been referred, they will receive an assessment from the community mental health team which will determine the next steps for them to take towards recovery. The assessment will give the service user a diagnosis .Depending on the outcome of the assessment their next steps may include; advice, treatment or ongoing support from the team and in some cases referral to another service which specialises in their disorder. (www.mind.org.uk 2012)

Early intervention service

There is some evidence that early intervention can prevent psychosis and can help to prevent some of the worse consequences of psychosis, such as periods of unemployment, misuse of drugs or alcohol, getting into trouble with the police or becoming depressed. (Care services improvement partnership and national institute of mental health England 2006)

The early intervention team is part of the wider community mental health team framework. This service is specially designed for sufferers of schizophrenia and associated psychotic illnesses. This service aims to assist people who are at risk of experiencing their first episode of psychosis or are in the early stages of a psychotic illness. The early intervention team consists of;

Psychologists

Psychiatrists

Community psychiatric nurses

Social workers

Support workers

They aim to improve the effectiveness of short and long term treatment by; providing prevention strategies, detection of illness, support and treatment in the early stages of psychosis (www.mind.org.uk 2012).

Crisis resolution and Home treatment

To access this service, service users are usually referred by a community mental health team, general practitioner, social worker or health visitor, although it is possible for service users to refer themselves

The team is staffed by mental health professionals including; Psychiatrists

Mental health nurses

Social workers

Occupational therapists

They provide intensive and rapid support for people aged 16-65 years old who are experiencing a mental health crisis and who, without the team’s help, would be admitted to a psychiatric hospital. Sometimes the CRT can support people in their own homes, shortening their stay in a psychiatric hospital. For people in the community, CRTs arrive quickly – ideally within an hour. The team is then available 24 hours a day, seven days a week. Support continues for as long as it is needed or until the person transfers to another service (www.mind.org.uk 2012).

Burton (2009) describes the crisis resolution and home treatment team as the gatekeeper to other mental health services, prompt assessment of an individual suffering a crisis, community based care, remain involved throughout the crisis, undertake crisis prevention planning and work in partnership with the sufferer, family and carers.

Residential care

If service users feel they are not ready to live in the community independently or supported, residential care may be the next step for them to take. Residential care services provide service users with rehabilitation and support if they are suffering with a severe long term mental illness. This service provides 24-hour care by residential social workers, nurses and mental health support workers. Care homes are for people who need a high level of care and find it hard to manage in their own home (www.mind.org.uk 2012).

This service can be accessed by having a community care assessment, service users may have to pay for this service as it is means tested.

Service user groups

Service user groups are put in place to assist service users of all types. Each group is tailored to suite specific service user groups. Service user groups that specialize in assisting individuals with personality disorders, emotional or behavioural difficulties would benefit sufferers of schizophrenia. These specific groups aim to make service users feel; supported, empowered, included and a part of something. New coping strategies are provided which can lead to service users experiencing fewer crises.

‘Self-help and peer-support groups enable people to meet and share information, friendship and support. They often bring together people with a similar mental health issue, on a short- or long-term basis.’ (www.mind.org.uk 2012)

Talking therapies

Talking therapies, such as psychotherapy, counselling and cognitive behaviour therapy (CBT), can help to manage and treat schizophrenia. Talking treatments help individuals to identify the things they have issues with, explore them and discuss strategies or solutions. They can allow individuals to explore the significance of their symptoms, and so to defeat them. (www.mind.org 2012)

Cognitive behaviour therapy can be accessed through the NHS service users can access these service through their GP. Many voluntary associations including MIND offer these services at no cost.

Benefits

There is financial help available to those who cannot work due to a mental illness. These benefits can help towards care, rent and other commitments.

Disability living allowance

Service users who suffer from a mental disability such as schizophrenia may be eligible to claim this benefit whether they are working or not. Disability living allowance is a tax free benefit put in place to help with extra costs you have because of your disability.

To apply for this benefit service users must first apply through the jobcentre plus, their social worker or support worker would be able to assist them with this process. The claimant may then need to undergo a medical examination in order to receive the benefit. Receiving this benefit could increase the amount of other benefits the service user is entitled to. (www.direct.gov.uk)

Housing benefit

Housing benefit can provide individuals on a low income with financial support to pay their rent. How much each individual receives depends on their circumstances. Housing benefit depending on the service users’ income can pay all or part of their rent. Individuals are eligible to apply whether they are working or not, they can apply through their local council or jobcentre plus by filling in a housing benefit form.(www.direct.gov.uk)

Council tax benefit

Service users can apply for council tax benefit through their local council. Depending on individual circumstances service users may be eligible to get all or part of their council tax bill paid. Individuals can get a council tax benefit claim form from their local council.

Summary

http://www.rbwm.gov.uk/web/social_mental-health.htm

http://www.smhp.nhs.uk/OurServices/MentalHealth/CommunityServices/Communitymentalhealthservices/tabid/2538/Default.aspx

www.mentalhealth.org.uk

http://www.nice.org.uk/usingguidance/commissioningguides/schizophrenia/specifying.jsp

http://www.cwp.nhs.uk/OurServices/adult/CrisisResolutionHomeTreatment/Pages/default.aspx

http://suite101.com/article/what-is-a-crisis-resolution-team-a204890

http://www.mayoclinic.com/health/schizophrenia/DS00196/DSECTION=symptoms

http://www.nhs.uk/Conditions/Psychosis/Pages/Introduction.aspx

https://www.gov.uk/housing-benefit

http://www.nao.org.uk/publications/0708/helping_people_through_mental.aspx

http://www.rethink.org/how_we_can_help/our_services/nursing_and_resident.html

http://www.mind.org.uk/help/diagnoses_and_conditions/schizophrenia

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/schizophrenia/

Department of Health (DH), 2001, The Mental Health Policy Implementation Guide, London: DH.

More foster carers are needed in the UK today. Official statistics from the Fostering Network indicate that over 10,000 foster families are needed. Another research by Fostering Network found 82% of local authorities saw a rise in the number of children coming into care and needing foster homes in 2009-10. Family foster care provides substitute planned family care for children who cannot be adequately cared at the own home due to various reasons.

4.1 Foster children:

The number of children coming into foster care has become overwhelming over the years. But the fact is that it has become very difficult to find the families who are ready to meet the challenges of increasing complex behavioural, emotional needs these children experience.

SHORTAGE OF FOSTER HOMES

England: 8,200

Scotland: 1,700

Wales: 750

Region

Shortage

England

8200

Scotland

1700

Wales

750

Source: Fostering Network Website

Chart 1a: National Breakdown: Shortage of Foster Homes in England, Scotland and Wales

SHORTAGE OF FOSTER HOMES IN ENGLAND

North West: 1700

North East: 1300

East: 650

South West: 600

South East: 850

London: 2000

West Midlands: 650

East Midlands: 450

Region

Shortage

North Wales

1700

North East

1300

East

650

South West

600

South East

850

London

2000

West Midlands

650

East Midlands

450

Source: Fostering Network Website

Chart 1b: Regional Breakdown: Shortage of Foster Homes in England

4.2 Motivations for foster carers:

Much research has been conducted on this issue as what motivates people to foster. It is very important to understand this key component because this may help to understand their needs and can be used as a tool in the marketing mix to recruit more carer. In 1996, Denby & Rindfleisch conducted a research on children and youth services. The research was conducted in order to understand what motivates a person to become a foster carer. Some of the findings were, “fulfilling the need for foster homes in the community, enjoying and wanting to help children, providing a companion for an only child and for oneself, increasing family size, obtaining substitute for a child who has died or who has grown and left home, religious reasons and supplementing family income” (Denby & Rindfleisch, 1996). Based on the findings of this research it is very clear that there are various factors that are involved for a person to become a foster parent.

4.3 Foster carer recruitment:

In the recent years, there has been a decline in the number of families able to provide foster care. When a child is identified in need of foster care, the problem of finding placement homes still remains very high. Some of the factors that are related to the shortage of foster carers may be due to the following reasons:

Greater difficulty in meeting the increasing complexity needs to become a foster carer

Lack of public awareness

The poor public image of faster carer.

With these issues, it has become difficult to recruit foster carer and has become an important and yet a challenging task. Recruitment of quality foster carer in an on-going demand for the agency.

4.4 Productive approaches 2008 – till date:

For the past 2 years, the enquiries generated by fostering solutions using the current marketing strategy have increased. Fostering solutions uses different methods of advertising to attract potential carers. These include bill board, bus, community care, exhibition, flyer, internet, job centre, jobs fair, local community booklet, national magazine, newspaper advertisement, passed office, post office, radio, tv, recruitment event, taxi, website, word of mouth, yallow pages etc (Fostering solutions).

Over the past few years, the recruitment focus was on the following factors:

To recruit carers through using fees, and other allowances.

Using messages such as “show you care” to reach the carers.

4.5 Recruitment outcome:
Table 3: FOSTER CARE RECRUITMENT ENQUIRIES – SOURCE OF INTEREST BETWEEN 01/09/2009 AND 04/08/2010
SOURCE
TOTAL ENQUIRIES
Advan
4
Fostering Network
2
Banner
1
Bill board
1
Bus
38
Current carer
8
Flyer
41
Internet
10
Job centre
3
Jobs fair
1
Local community booklet
30
National magazine
2
Newspaper Advertisement
761
Not specified
1
Passed office
78
Radio/TV
28
Recommended
156
Recruitment event
419
Recruitment poster
102
SMS
13
Van
1
Website
1071
Word of mouth
494
Yellow pages
22
TOTAL
3289

Source: FSDocument

Out of these, the most successful advertisement medium for fostering solutions has been website with a total of 1071 enquiries followed by newspaper advertisement with a total enquiry of 761, followed by word of mouth with 494 enquiries between 01/09/2209 and 31/08/2010.

From the above table it is evident that the total number of enquiries during the period 2009-2010 is 3289, but the no. Of approval are only 126 out of 3289 enquiries. This is just 3.82% of the total enquiry. It is evident that 3289 people are interested to know about the fostering care. But the approval rate is very low.

Table 4: FOSTER CARE RECRUITMENT ENQUIRIES – SOURCE OF INTEREST BETWEEN 01/09/2008 AND 31/08/2009
SOURCE
TOTAL ENQUIRIES
Fostering Network
3
Bill board
4
Current carer
1
E-invite
1
Flyer
19
Internet
1
Local community booklet
47
Newspaper Advertisement
591
Not specified
13
Passed office
108
Radio/TV
32
Recommended
173
Recruitment event
168
Recruitment poster
130
Taxi
1
Van
4
Website
1347
Word of mouth
535
Yellow pages
106
TOTAL
3284

Source: FS document

The total no. Approval between 01/09/2008 and 31/08.2009 was 163 and total enquiries received during that period was 3284. When Comparing the current year enquiries and approval rate with the previous year (i.e.) recruitment enquiry between 2008 – 2009 which was 4.96% of the total enquiry, it is clearly evident that there is a decrease in the approval rate when compared with that of the previous year. But we just cannot come to a conclusion that there is a decrease in the approval rate because some of the enquiries may still be in the approval process.

Table 5: Conversion rate

Year
Enquiries
Approved
Conversion Rate %
2008-2009
3284
163
4.96
2009-2010
3289
126
3.83

Source: FS Document

Over the past two years, the conversion rate is found to be reasonably constant with

4.96% in the year 2008-2009 and 3.83% in the 2009-2010.

Chart 2: Enquiries in different region

From the above chart it can be seen that the number of enquiries received from each region varies to a greater extent. For example the highest number of enquiries was received from the midlands with a total of 396 enquiries. Where as on the contradictory there were lower enquiries from various other regions. The reason for so many enquiries in the midlands is because of the strong advertisement campaign with additional newspaper advertisement. Fostering solutions should focus on all the regions equally. This will help to increase the enquiry from different region.

The major problem which is to be considered right now is that the approval rate is very low despite there was 3289 enquiries between 2009-2010. This may be due to various reasons.

Advertisement ? Enquiries ? ROI ? Approval

With reference to the above given table, when an advertisement is made and when it is able to attract 3343 enquirers who have even the slightest idea of fostering has enquired the agency, it is clear that people are interested to know more about fostering. But somewhere as they move further in the process (i.e.) from enquiry to the next stage, the number gets reduced to a greater extent. This can be viewed as a result due to 2 reasons.

There may be a problem in the process from the enquiry stage until the next stage which is the registration of interest. Or

The agency is not targeting the right people.

In order to identify the problem in the process from the enquiry stage until the ROI, a study maybe conducted as what is going wrong in that process. It is very important to focus on this issue right now because the time and cost involved in marketing is very high. Considering that fact, the marketing strategy maybe of good type, but due to some bottleneck in the process, the marketing strategy may seem to be unsuccessful.

4.6 STRATEGY
Objectives:

To successfully recruit the carers, the following objectives must be considered to meet the challenges that are associated with the recruitment activities. They are,

To recruit carers for different age group

To recruit carers for children with disability

To recruit a diverse range of carers to place the children to meet their best needs.

Recruit carers based on categories – long, medium and short term carers.

In addition to these objectives to recruit the carer, the fostering solutions should be the best choice for carers. In order to achieve such a position, the following factors plays important role

Benefit packages for carer- what fostering solutions can offer for both carer and young people.

Competitor awareness versus brand awareness of the agency.

Services provided before and after approval.

Raising awareness through advertisement – that carers are still needed , that fostering solutions values the carers, and to create a sense of feeling that they have made the right decision in selecting fostering solutions.

4.6.1 Plan of action:

In order to reach both regional and national audiences, the agency should continue to advertise a multi-layered approach of marketing. The message which the agency tends to convey to its audience must be clear and focused. The agency may use tools ranging from traditional to establishing its own marketing strategy through various opportunities that are available to raise the awareness of the people.

The traditional method includes the regular media advertising which the agency is currently involved and it has delivered results. It is now the right time to think of new opportunities of marketing through using the internet media such as web tools like Linked-in, Facebook, twitter, etc.

By using both the traditional and new methods, the agency can reach and cover a wide range of people from different regions, which will help to educate the people about the basic awareness and understanding about the need for fostering. This also helps to reach the target audience by giving them the information which they require.

4.6.2 Factors influencing the decision making:

There are several factors that influence the decision making of the marketing strategy. These factors help the agency to be alert by keeping them informed about the decisions of the potential carer and the way they react to the recruitment strategies and approaches that are used by the agency. A research maybe conducted in this area so as to find out the following:

What ultimately actuated the potential carer to pick up the phone and enquire about the services that are offered by the agency. This can be done through introducing marketing questions in the initial home visits.

Checking closely the effectiveness of all the resources that are used in marketing and making sure it is being efficient.

Look into the key areas where the potential carers drop out of the process. It is very important to understand this because, this will give an idea as the reasons why they drop out. This will in turn help to influence the potential carers to identify the drop out points. Through identifying the drop out points time and cost that are involved in retaining the potential carers can be kept under good control.

4.6.3 A change in the current communication tools

The information that are offered by the current communication tools are limited. That is the current communication tools which is paper based (information pack) gives idea from where the information is obtained.

Chart 3 : communication route

Enquiry

Information

Follow Up

Resultant

Website

Phone

Information Pack

Phone Call & Postcards

Drop Out

Proceed

This is the normal route through which the information flows from the agency to the prospective carers. This route does not offer flexibility for the carer. Which means the carers contact type preference, individual decision process are not considered in this route. Moreover, the person making a call to the agency maybe quite intimidating.

There should be a change in the current communication routes and channels whereby the routes are open up through which the prospective carer can gather information and be informed about the follow-up and the application process right from registration of interest until the approval.

Information Search

Enquiry

Informed Decision

Follow up

Resultant

Recruitment Stands

Newspaper

Word of mouth

Flyer

Website

Face to Face contact at event

Phone

Website

Information Pack

(Delayed decision) Direct phone and postcard

Drop Out

Proceed

Un-persuaded

Un-persuaded

Prospecting

Proceed or Informed Influencer

Participants or Informed Influencer

4.6.4 ENGAGING THE COMMUNITIES:

To target the right carer, I suggest increasing the chances of finding successful foster carer through designing a planned strategy to engage the communities in foster care. By involving with the community there is more scope to create awareness and recruit many carers. To come up with such a strategy, it is very important to know the agency’s needs and lay down its priorities, thumb rules on how to come up with a specific message for the general public. By engaging with the communities, it helps to inform the public and the potential foster carers about the need for foster care.

The ultimate goal of the agency is to increase the number of qualified foster carers.

In any business concept, designing an effective marketing strategy is a means of trial and error. For a strategy to be successful, it has to be analyzed from various perspectives before it can be implemented. In such a way, before reaching a community for help in recruiting the foster carer, we have to know in particular the needs of the agency and the ways in which the public might be of help to the agency. By needs of the agency here refers to the big question “who is our target customer?”. To kick start this process of finding the target customer the following assessment maybe done by the agency.

Identifying the foster care population in a community

How many foster children are there in the community?

Their age group

Age group under one year

No. Of children (between 1-12)

No. Of teenager (between 13-18)

No. Of youngsters (over 18)

Based on the agencies past experience say for example previous 2-3 years, how many children does the agency expect will require foster care during the next year?

The racial composition

White

Mixed race

Asian

Black

Other

Identifying the foster carer population in a community

How many qualified foster carers are there in the community

Identifying the children in the community

Up to what extent the following elements contributed to placement of children in foster care

LOW

Moderate

HIGH

Substance abuse

Poverty

Mental illness of parent(s)

Poor parenting skills

Incarceration of parents

Children’s emotional or behavioral

health needs

Knowing the needs:

After the above mentioned needs assessment is reviewed by the staff, the agency can come to a specific needs conclusion. The next step may be to rank the needs. The rankings should be based on their priorities as shown below

Example needs

Ranks

To provide more adequate support for foster families.

3

To recruit foster parents for teenagers.

1

To provide better training for foster parents so they can handle

children’s special needs.

To recruit foster parents for teenagers.

2

To educate the public about the impact of welfare reform on children

in foster care.

Once the needs are prioritized, the next step is to develop a community action plan. This can be done through the following ways

4.6.5 Engaging the wider public :

At the national level, the foster care fortnight event is conducted by the Fostering networks helps to engage the wider public and to spread the awareness about the need for fostering and the young people at care. However, this may help to engage the wider public, the major drawbacks in these kinds of events is that the agency does not get the chance to engage directly with the wider public on the assumptions and views to inform how we move ahead to spread the awareness. In order to overcome this problem the agency may preferably engage with the residents from the communities to inform them about the messages and the promotional approaches of the agency through which the awareness of the need for foster care can be increased.

This can be done through engaging services in a county wide arts and photography competition. This helps the agency to find out more ways to engage with the communities and encourage them to take part in fostering. The photography competition can be conducted through collecting pictures from different age group categories – young people in care, people who have experienced foster care. The competition must be judged by the agency; the winning photography must tour around the county and be visible in libraries and other common places for short period. A separate budget maybe required for this competition.

4.6.6 Working with the mass media:

Mass media is the most common and effective medium of advertising. However, for an advertisement to be effective through mass media, it is very essential for the agency to know what kind of information or message should be conveyed to the public. For example in the case of targeted recruitment, the focus is on the families where they can accommodate children and teens with specific needs. In this case community based recruitment would be very effective rather than a general media campaign. However, media campaign may be very effective and most suitable for general outreach.

Strategies for getting the message out to the public and spurring the community to take action.

4.6.7 Invite community leaders to help you get the message out:

Engaging with community leaders to spread the awareness is one of the best ways to reach the people in a particular community. This is due to the fact that the leaders may approach the public with a message which would be very effective rather than the agency conveying the message by itself. The community leaders may not have the special knowledge about the system of foster care as that of a social worker. However, what they do have is the ability to attract the public and press. It is very advantageous for the agency to form a link of network with the community leaders for they be very sympathetic the cause and would come forward to help the agency. These leaders may be invited to speak at the campaign events and they may be requested to mention about Fostering Solutions in their own events. In such a way the community becomes aware and lot of people might come forward to foster. The main advantage is that a minimal support from one community councillor or a child advocate can quickly raise the status of the issue.

4.6.8 Using the help of current foster parents:

The most effective means of advertising is to get help from the current foster carers to recruit more new foster carers. Gratified foster care parents are the better tool for recruitment and retention. The advantage of Working in with foster parents to increase recruitment will help to improve the retention as well. Foster parents can be of great help in the following ways:

Through sharing their personal experiences, the current foster carer may help the new foster carers to explain as what takes to be a good foster carer. This will also give an opportunity for the new foster carers to meet the children in care even before they get placed with a child.

The current foster care parents may help the new carers to complete the applications by way of providing pre-service anf training in collaboration with the agency.

The current foster carer may act as a middle man between the agency and the prospective foster carer by way of following-up with a phone call or a personal visit.

Through engaging with the current foster carers, the new carers may get individualized mentoring and it may in turn be a great motivation for both the new and the current foster carers.

4.6.9 Carer benefit package:

Carer benefit package may help to attract more carers. It is great way to communication through which the awareness can be increased. A detailed list of benefits and opportunities maybe listed, this will in turn help the prospective foster carers to take up fostering. The fact is that the more we offer and promote ourselves as the agency, the satisfied and happier will be our carers and are more likely to stay with us. This maybe one of the retention strategy. This strategy helps to gain competitive advantage over the competing agencies because, the carers are very happy with the benefit package. Regardless of whether the benefits are being used by the foster carers or not, the list of available benefits on the website maybe seem real and more tangible.

4.7 Resources

In order to implement the above mentioned strategies effectively, resources are very important keys.

4.7.1 Human Resources:

In the current organizational structure, the marketing department is very centralized. With the ambition of developing the marketing strategies for both the national and regional level, it is very important to increase the hierarchy level as shown in the above chart. In order to strengthen the regional marketing strategy a new post namely marketing assistant may be appointed region wise. The main work of this job will be to spread the awareness of fostering in their region and attract more carers. They will be reporting directly to the Marketing and public relations manager. The main reason to implement this change in the organization structure is because just having a marketing department at the head office will not work. Division of work is very essential in such cases. But for time being with limited resources, the main challenge is to stay focused in the priorities of the service that are provided by the agency.

Chart 4: Organizational Structure – Marketing Department.

4.7.2 Financial Resources:

To corroborate the current level of enquiries and conversion, it is essential to continue to invest funds in recruiting advertising. A sustainable budget allocation will help the agency to be efficient and effectively plan the time and resources which are very valuable. This will also help to improve response rate, and to reach all communities as well as effectively plan the response resources.

For long term planning, a planned annual budgeting will help to place the agency in a better position to cope up with the increasing preferential rates and spends of the promotional activity. There is also a need for the agency to invest in high profiled activities such as web advertising, website development and so on in order to maintain the profile of Fostering Solutions as the agency of choice for the carers.

Currently, Fostering solutions uses all feasible media which will enable the agency to touch the hearts and minds of many potential carers and make them aware about the need for fostering. More funds should be invested in the areas of community publications, editorial media and recruitment campaigns.

4.8 Recommendations:
Considering the above discussed strategies the following maybe summarized as the strategic recommendations
4.8.1 Short term recommendations:

– Maintain year round awareness for the need foster carers across England, Scotland, Wales and in communities.

– As discussed in the strategy using the current carers and their positive stories of children will help to attract more carers and it also helps to retain the existing carers.(refer 4.6.8)

-Work with the community leaders to spread the awareness(refer 4.6.7)

– With reference to the conversion rate issue raised in this report, it is essential for the agency to conduct a study on the effective procedures that are implemented by the agency in the process of responding to enquiries and registration of interest with prospective foster carers. Because, this is where lot of people drop out. So it is essential for the agency to conduct a research and find out the reasons as why the conversion rate is very low. (refer table 5)

– As discussed in the resources, it is essential for the agency to have dedicated marketing staff at each regional office to make advertising more effective.(refer 4.7.1)

– With the help of the demographic information and analysis of the community assessment by the agency a better targeting of recruitment and advertising can be achieved.

4.8.2 Long term recommendations:

– As discussed in the short term recommendations, statistical data on foster carers maybe collected using the community assessment in order to make better recruitment decisions. This will help the agency to have a continued sustainable investment at national and regional level in the recruitment of foster carers.

– Have ongoing high quality campaigns across England, Scotland and Wales on both national and local level to attract more foster carers which will help to maintain enough carers to meet changing demands

– The agency should put as much effort in order to retain the foster carers as in recruitment. The agency should work on the factors such as carer benefit package, and other benefits that can improve the retention of foster carers. (refer 4.6.9)

– Develop a comprehensive foster care recruitment website to promote awareness and interest in fostering and permanent care

-Focus should be to improve local capacity through working in close relation with the communities in order to recruit locally

I will discuss both the personal and professional values that influence social work practice and discuss a particularly challenging experience I had with two service users who came for counselling where myself and a qualified social worker was to assist the service user. The names of the service users have been changed to ensure confidentiality.

An important thing to recognise regarding values in social work practice, according to the Central Council for Education and Training in Social Work (CCETSW) is that “values are integral to rather than separate from competent practice. Therefore there can be no such thing as value free social work practice. Such is the influence of values in social work practice that CCETSW set out six core values, that the student must demonstrate competence in, before she/he can be awarded the Diploma in Social Work. The first of these values is: “to identify and question their own values and prejudices, and there implications for practice”.

It is not easy to recognise your own values, as often they are unconscious ideas or views, which can only be challenged or changed, when brought to the conscious level.

Personal, societal, political and cultural experiences influence the values that an individual develops, so it is important to become aware of these influences. The values people hold affect the way they act and treat other people, without an awareness of this people can unconsciously act in what may be perceived as an oppressive and discriminatory way.

Another of the core value requirements of CCETSW 1995, and one, which highlights one of the dilemmas faced by Social Workers, is: “Promote people’s rights to choice, privacy, confidentiality and protection, while recognising and addressing the complexities of competing rights and demands”. (CCETSW 1995). To illustrate this difficulty what follows is a description of a challenging practice I have experienced, during a counselling session I had with a women whom I shall call Jane. Jane came for counselling because she was in a violent relationship. She described how her husband both physically and mentally abused her, and that she had a history of abuse from controlling men. She had returned to London from Pakistan where she and her husband lived, after he had once again abused her whilst she was in the process of deciding whether to stay in Wales or return to her husband in Pakistan. Her husband has two children from a previous relationship, for which he has custody, although this was not a particular concern for Jane, for me there could be a conflict of competing rights. Jane had a right to privacy and confidentiality, but the children had a right to protection. Confidentiality in instances such as this “…may be breached, where it is demonstrably in the client’s interest or where there is an overriding concern for the rights of other people, when for example the behaviour of the client may endanger others”. (Social Care Association 1988).

Had my role in this been that of a Child and Family Social Worker the rights of the Children would have been paramount. As I worked with Jane I became aware of my own values which were urging me to protect her, and wanting to encourage her to remain in London . Only by reflecting on my practice did I become aware, I could have become another controlling male figure and missed the opportunity to enable her to take control for herself.

Jane made her decision to return to her husband in Pakistan, I did not hear from her again for one months, after which time she made another appointment to see me – this time with her husband who I shall call Bill.

When they came to see me and my colleague I was aware that I had seen Jane on her own previously and was careful to ensure the things she had talked about were kept confidential, and that I did not accidentally disclose these to Bill . Jane had told me her story from which I had developed my own picture of Bill, before even meeting him. Bill was a large man, very loud and appeared aggressive at first, I was a little concerned about the safety of Jane, myself and my colleague, in that first meeting. When writing my notes after the session, and analysing what went on, one of the questions I had of my practice was: What had Bill done to make me feel threatened? He did not verbally or physically attack me, or make any threats, after reflection, I felt it could have been because he was different. Bill was from a different culture of Pakistani Pataan descent, he was tall and a heavily build, and his way of communicating was to shout as that is how he got attention. If I were to work positively and constructively with Bill, I needed to act in an anti oppressive and anti discriminatory way, to ensure that he received the same respect that all clients have a right to, and that I treated him as a unique individual.

According to Egan (1990) respect means prizing the individuality of service users, supporting each service user in his or her search for self, and personalizing the helping process to the needs, capabilities, and resources of this client. Effective helpers do not try to make service users over in their own image and likeness. On the other hand, respect does not mean encouraging service users to develop or maintain a kind of individualism that is self destructive or destructive of others. Egan (1990 pp65)

Having recognised my own personal prejudices, I was able to identify more clearly the strengths Bill had and to build on them. This had quite an impact on future counselling sessions. Bill valued being listened to and respected, his voice level lowered and he stopped to listen to Jane which gave her the opportunity to tell him how she felt. As we progressed the counselling relationship became more of a partnership, we looked at the different ways they communicated, Bill began to ‘own’ the violence he had previously denied and Jane grew in confidence, and was able to express her own needs and expectations. We agreed to set tasks and goals each week that enabled them to check their progress, which further empowered them.

Empowerment is a term widely used, and often misunderstood as giving your power to someone else; there are several definitions but this one, I think, describes it well:

It is commonly assumed by many that empowerment involves taking away the worker’s power, However, if this is done, it will of course make him or her less effective and therefore of less value or use. Empowerment is a matter of helping people gain greater control over their lives, helping them to become better equipped to deal with the problems and challenges they face – especially those that involve seeking to counter or overcome discrimination and oppression. (Thompson, 1998b, p9)

To empower is to enable people to increase control of their lives, not to control others, Bill needed to recognise that by taking control of his life, he also needed to control his behaviour not to control others. Empowering is also helpful in letting clients see their problems in the wider socio-political context as in the case of Jane.

-for example, by helping a woman who has experienced violence at the hand of her partner to become aware of the broader social problem of domestic violence and it’s links with male power in society, so that she does not see her own situation as simply an unfortunate development or, worse still, something she has brought on herself (Mullender, 1996).

Through this experience Jane found the confidence to stand up to Bill, telling him she would only return to the marriage if things changed. Bill found a more constructive way of communicating, he became more open to looking at change, and I learnt a lot more about my own personal and professional values and their influence on practice.

There are a few theories that explain the development of our own attitudes and values. Thompson (1993) developed a “PCS model”. The P level is our thoughts, feelings, actions and attitudes although an individual can also be shaped by the culture we live in. The C level is showing the interests and influence of society as reflected in the values and norms we receive during socialisation. Finally the S level is basically the structure of society we live in. Even though we have individual thoughts and attitudes, the people we share our lives with shape them and they in turn are shaped by the norms and values passed to them by society.

As I have discussed, values have a major influence on Social work practice, the personal values we have affect the way we act from birth through to old age, and our values can change as we develop, both personally and professionally and they can conflict with each other. The core values set by CCETSW underpin the work and enables Social Workers to work in an anti oppressive and anti discriminatory way and these values have changed over time and I would suggest, will continue to change when necessary in the future. It is essential that Social Workers have and awareness and knowledge of these values as they have a significant affect on the vulnerable service users they work with.

Children and young people vary enormously in their responses to the same experiences and those who suffer adversity either develop coping strategies to get through it and emerge relatively unscathed whilst others do not, in other words they sink or swim. This essay puts forward bodies of research and theories of resilience that influence thinking in social work and look at the way in which those theories inform contemporary social work to promote resilience in children and young people. It will also examine some of the ways in which issues arise which could hinder these approaches.

Frost and Hoggett (2008) say the psychological and the social elements of the child’s world cannot be understood as two parallel paradigms that influence and impact development. Holloway and Jefferson elaborate cited in Frost and Hoggett (2008),

Subjects whose inner worlds cannot be understood without knowledge of their experiences in the world, and whose experiences of the world cannot be understood without knowledge of the way in which their inner worlds allow them to experience the outer world.

It is evident that it is through a child’s psycho-social experience that they learn to make sense of the world and their place within it. Rutter (1999) informs us that for a child to be determined resilient they must have encountered an experience with the risk of psychopathology for example those who have been living with domestic violence.

There is no one universally accepted definition of resilience however Masten et al (1990) define resilience in generalised terms, as the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances. However an International Resilience Project, set up to study how different cultures and countries promoted resilience, adopted the following definition of resilience:

Resilience is a universal capacity which allows a person, group or community to prevent, minimize or overcome the damaging effects of adversity (Grotberg 1997, p 19).

Masten and Coatsworth (1998) identified the characteristics of resilient children as ‘good intellectual functioning, appealing, sociable, easygoing disposition, self efficacy, self- confidence, high self-esteem, talent and faith; with a close relationship to a caring parent figure and extended family network support and socio-economically advantaged’. These definitions provide useful starting points for the purposes of this essay.

Contemporary society has been described by Beck(1992) as a ‘risk society’ and early research concentrated on how children and young people responded to risk and became casualties of adversity. Ferguson (1997) points out that following the work of Foucault and the concept of ‘governmentality’ post modernist critics argue that the traditional role of social work has suffered from family case workers seeking out and working with ‘dangerous families’ and children at ‘high risk’. A study of children at risk was undertaken by Garmezy and Rutter (1983). The study of 200 children from USA appears to conclude that despite the high risk environments in which they grew up some children appear to have ‘self righting’ tendencies which allow them to develop into well adjusted young adults. It would seem that everyone has the capacity to be resilient at some times and in some circumstances depending on their mental state and level and duration of the stress in the given event.

In order to recognise resilience it is important to understand the factors that lead children and young people to succumb to adversity and to realise that resilience and vulnerability are at opposite ends of a continuum reflecting susceptibility to adverse consequences (Anthony 1987). The response to adversity and stress can be affected by one or more variables from psychological and/or social aspects.

Freud (1910) developed a psychoanalytical theory in which the unconscious is seen as a central concept on which all other aspects of mental functioning are based. The focus of his research was mainly on the individual’s personality. Social workers have to be aware that unconscious processes may conceal or distort memories or even produce responses disproportionate to the situation, giving hints of underlying issues.

Erikson (1959) differs from Freud in that he described eight stages of psychosocial development. In these stages he suggests that we encounter expectable crises which create conflict within ourselves and with significant others in everyday life. Personality and behaviour are influenced by the way in which these crises are dealt with. The people who manage to move through Freud and Erikson’s stages of development are more likely to become resilient people.

John Bowlby(1969) was a psychologist, doctor and psychoanalyst ,who specialised in working with children. He believed that attachment behaviour is a biologically originated response to anxiety and stress stimulated by physical needs such as pain or hunger, separation from or rejection by the primary caregiver or external threats such as a loud noise. He believed this response arises from the infants desire to seek security and protection through proximity to a caregiver. Aldgate(2007) surmises that an attachment relationship is part of a wider affectional relationship: that one person sees the other as stronger and wiser and someone to turn to when he or she is afraid. Through combined nature and nurture individuals begin to establish relationships and understand and begin to manage emotions. By making sense of the caregivers both psychologically and socially, (if they respond in times of need) the infant begins to see them as a dependable and reliable. Such mental models help individuals organise their expectations about other people’s availability and responsiveness (Howe 1996). When the caregiver does not respond in the way the infant expects they experience anxiety and this can lead to insecure attachments. Bowlby’s work was later built on by Ainsworth et al (1978) who through the ‘Strange Situation’ study revealed profound effects of attachment on behaviour and went on to describe patterns of attachment (secure, avoidant, ambivalent, and disorganised added later on). Trevithick (2009) confirms that over the years the work of Bowlby and others has been important within social work making links between children’s behaviour and the quality of their relationships with their parent(s) and other attachment figures. Furthermore Howe (2009) confirms that attachment theory is also playing a major role in the resurgence of relationship based social work. It is therefore of great relevance to social workers to know how parenting styles,culture, family life and the social environments have affected the child’s psychosocial development.

The notion of a secure base is of vital importance for children and young people. In a useful analogy Gilligan (2001) uses a tree putting down roots to elaborate on the idea of a secure base. It is through continuity, quality and consistency of relationships that a child may find their secure base. Relatives, friendship groups, a teacher or even a social worker may provide a secure base in an otherwise complex and chaotic world. If the child is looked after (a child who enters the care system either informally or legally) they may need to learn to develop new relationships and have the opportunity to develop a secure base.

It is not always psychological processes that shape resilience, sometimes a particular episode or situation may occur that may be problematic and have far reaching consequences. Giddens (1991) described these episodes as fateful moments, saying that these are times when events come together in such a way that an individual stands, as it were, at a crossroads in his existence; or where a person learns of information with fateful consequences. A fateful moment will have implications for the individual which may threaten their ontological security. Fateful moments however do not always result in adversity they can signal a change for the better, a potentially empowering experience, however it is the risk that things may go awry that poses the challenge. Within this context it is important that social workers assess the extent to which they make sense of society and people’s experience.

Similar to fateful moments, life events, ongoing adversities, personal stress, interpersonal problems or familial situations, can affect levels of stress or anxiety. Rutter (2000) used the example of a divorce in the family as a staged process of a life event, rather than a one off event. The divorce may be preceded by a long period of unhappiness, followed by the divorce itself and the uncertainties that accompany it such as the knowledge and burden of financial worries, possible loss of a parent, introduction of new family members, housing worries etc. Social workers working with Giddensian ideas, (that multiple choices are available to all through abstract systems) are able to help vulnerable children and young people who are on a developmental pathway to make positive choices about the direction their lives will take in their life planning. However, those who criticise Giddens say that he is too optimistic in his view of the positive capacity of individuals to understand their lives and always know why they act as they do (Ferguson 2009). There are families who work with social workers who may not have the ability to analyse their lives in this way, and social workers should be mindful of this in their work with people.

The negative impacts of poverty, lack of social and cultural capital and impact of marital discord can cause children, young people and families to be characterised as at risk according to Hoffman (2010). Poverty can have serious and possibly grave consequences for families. Nonetheless, it is important to recognise that not all poor families, or even most poor families experience these deleterious outcomes. Many impoverished families beat the odds and have stable, loving relationships ( Seccombe, 2002)

Skeggs (2001) in her study with young women revealed that they were continually making comparisons between themselves and others and were sure of what they did not want to be but were less sure of what they wanted to be, thus illustrating how the constraints of class and gender are some of the structures that inhibit who we can be and how we can behave. However this does not appear to mean that structures should be accepted per se but by accepting their existence and realising that they are given meaning through human action and interaction it is possible to work with service users and their families. Frost (2003) illustrates the harsh reality for young people stating that the

‘structural inequalities of class and poverty connect into the emotionally quite brutal lived realities of young people themselves- the power of the pecking order, popularity or unpopularity, and in-group membership or exclusion- via the conspicuous display of expensive consumer goods’.

For some young people, the friendship groups they form, sub-cultures they belong to, the styles they wear dictates the way in which they present themselves and gain a sense of who they are in society. Being part of the group increases self esteem and resilience, conversely being different in some way may attract adverse reaction and stigmatisation for example a disabled child may be affected by the negative perceptions of being different.

According to Howe (2009) social workers in the late 1980s began to feel that the service users with whom they were working were the victims of their own biographical narratives, or their place within the social structure. Service users became service users because they had problems, pathologies or weaknesses and that this defined them in some way. The social worker viewed them as a case which then depersonalised them. By introducing a method of assessment whereby they could look at the strengths of people rather than their pathology and problems it was possible for social workers to recognise the resilience and resourcefulness possessed by many people living in adversity. By being interested in and listening to the service user the social worker could begin to uncover where someone’s strengths lie. Saleebey (2002) identified some types of questions that can lead to the discovery of strengths; survival questions, exception questions, possibility questions and esteem questions. It may be difficult to tease out strengths however as many people have had years of self doubt or blame from others to carry around with them however it is on these positive elements however slim the potential for progress lies.

It is crucial to the safety of children and young people that social workers can identify risks in a child’s environment and remove or reduce such a risk. This may ultimately mean removing the risk from the child or removing the child from the risk which could, depending on the level of risk, involve the child becoming a looked after child. In this case the social worker can work with the child to prevent social isolation by maintaining or re-introducing contact with family members, if appropriate. The social worker should also ensure that a child is able to attach the correct meaning to an outcome, if for example, a looked after child has to move to a new placement the social worker must explain in clear language what has happened and why. Schofield and Beck (2005) studied risk and resilience in children in long term foster care and concluded that specific changes or single events in a child’s life such as a new attachment relationship, a change of school, a change of contact arrangements or the discovery of a child’s particular talent do have the potential to alter the direction significantly for better or worse.

Howe et al (1999) state that good quality care giving is the most potent form of self enhancement of children confirming that it is a positive building block on which resilience to build resilience. Therefore the social worker needs to ensure that a child’s caregivers are able to provide a secure attachment through their relationships to ensure that self esteem is promoted. Any relationship break-down will impact on the child’s self esteem thus reinforcing their belief that they are not loved or lovable. A child needs to experience relationships with their caregivers that promote secure attachments. If a child has had a difficult time they may display behaviour or emotions that are not what is expected or are disproportionate to the situation. Atwool (2006) confirms that attachment theory adds weight to resilience theory by clearly outlining the significance of relationships as the key to all aspects of resilience- culture, community, relationships and individual. A social worker can work with the caregivers to explain the child’s behaviour using a theoretical framework and their knowledge of the child and their social situation.

Contemporary social work can help promote resilience in the vulnerable in society however Ferguson (2009) states the discretion social workers once had has diminished because of the rise of bureaucracy, managerialism and targets. This may impact on the time a social worker is able to devote to those they are trying to help. Furthermore Gilligan (2004) queried whether there is to be stress on valued practice principles, for example focus on strengths in clients or is the emphasis to be on what agency management deem important, for example their latest policy or set of procedures. It is also clear that social workers spend a majority of their time at their desk rather than with service users, as Ince (2010) points out in recent child abuse cases the social workers became victims to the point where they have much more familiarity with the computers they use than the children in need they have responsibility for; however this is an opinion and does not appear to be backed up by research..

In conclusion it is clear that relationships and attachment theory is significant to our understanding of resilience. Social workers who work with families to make sure they take full account of their religion, racial, cultural and linguistic background in their work with them are demonstrating the link between social policy and socially inclusive practice. Psychosocial practices should be carefully though out and tailored to the needs of each service users unique circumstances. Access to social and cultural capital enables children and young people to cope with stressors and adversity and increase resilience. Theories of resilience are useful tools to call upon when dealing with the complex and chaotic lives of children, young people and their families/caregivers. However there is no one skill or theory to fit all but many approaches and skills are required to inform and manage effective contemporary social work practice.

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A profession means a group of people that are specialised in a particular occupation. For example, an individual that is a doctor can be specialised in children, therefore their occupation would be called paediatricians. Profession consists of professionals that have the same interest, skills based on theoretical knowledge. Therefore it is important that professionals should have extensive period of education to influence the competency of their profession. Hodson and Sullivan (2005, p. 258) implies that profession is a ‘high status and knowledge-based occupation that is characterised by the ‘Hallmarks of a profession’. The hallmarks of profession suggest profession is split into 4 main components that are based on abstract, specialized knowledge, autonomy, Authority over subordinate occupational groups and a certain degree of altruism.

Specialized knowledge consists of theoretical, practical and techniques. The theoretical knowledge would focus on theoretical guidelines as to what is expected by professionals. In relations to social work, theoretical knowledge is a crucial element to their profession as putting theory into practice; it helps socials workers develop to think critically and analytically. Oke (2008) suggest that one way of linking theory into practice is known as issue-based approach to learning (IBL). IBL encourages meaningful learning as for example, processing information from a source can help encourages a reflexive process of thinking as it explore further on about ideas and speculate in ways you can put the theories into practice. By means of social workers applying the IBL effectively, it would enhance social workers to work proactively as they would be capable of empowering strategies support the needs and wishes of the service users. The competence of knowledge is a key to profession as Payne (2005 p. 185) suggests professionalism, associated with increasing organisation alongside increasing knowledge and power. Therefore, this may link to entry of qualification, the higher the qualification the more competent on their understanding of putting theories into practice. Learning new information constantly develops the self-knowledge and enables to go in-depth of understanding.

Harris (2003 pp.133-4) argued that social work training helps social workers become a ‘competent and accountable professionals’. This may be a combination of educational institution and social work agencies. The Central Council for Education and Training in Social work (CCETSW) supported the training scheme financially through the central government. Before the mid-1980’s when the CCETSW introduced the certificate in Social Services (CSS), the tendency was students that obtained the CSS were more likely to become social workers. Higham (2006, p. 16) argued that this meant people that worked within social care didn’t fit in with the framework with social workers in the 1970’s. This is because obtaining the qualification became demanding between social work and social care, therefore the CCETSW was worried if there was suitable amount of training resources available for social care staff that was desired to become a qualified social worker. Corresponding to Horner (2009 p.94 -5), he signified that since the emergence of the Diploma in Social Work (DipSW) in 1989 there has been an increase of social workers. This could relate to the discontinued of the CSS qualification in 1992 ended and the start of training courses including worked-based vocational qualification emerged such as National Vocational Qualification (NVQs). In 1992 the National Standards for Training and Development introduced the Worked-based vocational qualification which was made with a difference as there was no set curriculum, specified programmes or examination- it was assessment based. Before there were social care workers that were already employed but did not achieve a formal qualification as it was not regarded at that time. Higham (2006) argued that statistics shows in the year 2000 around 80% of the workforce didn’t not obtain a qualification or had qualification that was not related to their occupation. This shows there was lack of competency within social care professions which may have compelled issues associated with inadequacy of reporting and recording procedures, maintaining confidentiality, accuracy of information and taking into account of the current policies and procedures. The DipSW does not exist any longer; people that are training to become social workers would now need The Social Work degree course to become a qualified social worker. Primarily, the formalisation of training based on social work emerged from social care. Traditionally, society viewed social work and social care as a synonymous profession. Steadily social work had developed recognition in relation to their profession which had gained them distinctive characteristics than the social care profession. However, both professions overlap each other and form a relationship together to facilitate people with their quality of life.

Autonomy is another part of a ‘profession’ according to the four hallmarks. It is common that professionals have a tendency to control their own affairs based on their professional skills and knowledge. Social work values autonomy in terms of decision making. For example, social workers may demand autonomy in terms of building a relationship with the service users more than the heavy caseloads they may encounter as the inequitable caseloads can prevent social workers from tackling effectively the issues that may lead to risk upon service users. Roe (2006, p.15) report emphasises with social workers because he argues that they are ‘… constrained by line management arrangements that require escalation of decision making up a chain of command in order to manage budgets or risk’. This argues that social workers are refrained from professional autonomy as the result of pressure of their line management; this suggest that line managements’ main priority in terms of decision making is to insure appropriate decision making takes place (taking into consideration manageable budgets and the prevention against risk towards service user). Others may argue that there is lack of professional autonomy within social work because of the restriction from the public and within the service demands. Social workers are perceived as authorised professionals that are entitled to autonomous decision making in order to meet the needs of service users; Harkness and Kadushin (2002, p 468) suggest that professional autonomy is about having responsibilities to themselves and the services they offer. Therefore, if there was a deficiency of autonomy within the social workers, this would strongly broad services and social workers would consequently feel greater pressure from the public and other agencies of delivering their full potential due to the boundaries of what they may encounter. An issue that may arise for a social worker is it acceptable to follow their instinct to protect and meet the needs of the service user, even though it may be unacceptable within the rules and regulations of the profession. Sustaining autonomy in a social work profession is imperative as it promotes social workers to actively engage with other multi- agency professionals which would boost their self-confidence and helped them reach their full potential.

In relation to a degree of altruism, there are codes of ethics for professionals within any occupation that are put in place for professionals to seek guidance through competency, practice and acknowledging the complexity of situations. In other words, it is recognised as a systematic framework as to what is ethically acceptable. On the other hand, code of ethics within professionals offers guidance for every believable situation, which means it can be perceived as generic and not the use of specific rules. Despite the codes of ethics being generic, it plays a role for the social work provision. The British Association of Social Workers (BASW) introduced the codes of ethics for social work, values and principles that established the five main key principles such as human dignity and worth, social justice, service to humanity, integrity and competence; they were put in place to ensure that in relations to conflicts and disclosure is honest, fair and accurate. Also to make sure professionals are compliant with the legislations and regulations. Despite, codes of ethics can be misinterpreted or ignored by professionals; not only may the risk of disciplinary action, but this as a result put the service users at risk. However, it is important within the social work profession for social workers to make mature decision as well as understanding and taking into account the value of issues that social workers may face. It is crucial for professionals to adopt the knowledge and skills gained through experience and qualifications in order transfer the skills achieved to help promote new roles and approaches to meeting the needs of the service users.

Within a profession there are codes of practice which is expected by employees to follow and put into practice; it usually consists of the outlines of behaviour. The significance of the codes of practice would ensure high standards of their job roles are being met. This would not only benefit the profession as a whole but also the employees, employers and the wider society. Comparison to the social work profession, they have a similar concept as a range of organisations had been put in place to ensure that it promotes high standards within the profession. To maintain the assurance, regulation within the service (including education and training) and matters of misconduct was a high priority according to the UK government. These organisations included The Social Care Institute for Excellence, 2000 (SCIE), The Commission for Social Care Inspection, 2004 (CSCI), The General Social Care Council, 2003 (GSCC) and Skills for Care – this was known as ‘the big four’ Horner (2009, p 118). Each of regulation has their own purpose to ensure high standards of care were priority. The SCIE main responsibility is to ensure that social care professionals are able to identify and widen knowledge about good practice such as guidance and developing professional standards. The CSCI main duty is ensure that inspection and monitoring services within the health and social care services were affirmative quality of protecting service users or patients from potential risk of the service users or patients needs. Moreover, The GSCC regulates social workers including social care professionals by situating them onto a register. The register ensures only professionals with the required qualification and adhered the occupational standards are genuine to working with service users especially the vulnerable. Furthermore, the Skills for Care regulate the training processes within the social sector. This may include developing qualifications and assessing the social sector training needs to ensure competency within knowledge is constant throughout the training that is supplied to the social care and social work professionals. Overall, the regulatory frameworks may have different missions but they all form a relationship that supports and promotes quality standards to the staffs, services and training within the social care provision. Regulations are important within a profession to ensure professionals are fulfilling the roles satisfactory and sensitively according to the public interest. It is important that the Social work profession should be able to identify when the standards are to some extent failing, it should take instant action as it is their responsibility as a profession to take the leading role in professional governance. This will prevent drastic dilemmas which can damage the profession status.

To conclude, to an extent social work can be said to be a professional as compare to a profession with a social work profession there are similarities. In relation to knowledge, the social work professionals would have some degree of theoretical knowledge. For example, according to Payne the power of professionalism involves the competence through knowledge. This may argue that social workers who obtained a social work degree would have higher qualification alongside increasing knowledge and authority as they more understanding of putting theoretical claims into practice. In relation to training profession require training to keep up to date with current skills, legislations and knowledge so that they can provide a better service to their clients. Social work profession has a history of different approaches to training and development to a point of needed a degree instead of a diploma to become a social worker. Professional autonomy within profession is about professionals dealing with their own affairs. Corresponding, social work is between decision-making and taking into consideration ethical views as to what is acceptable. To a degree of altruism professionals would seek guidance through competency, experiences and understanding complexity of dilemmas. This concept is the same factor for a social work profession as social workers would need to follow their code of practice coherently. To ensure that the profession is meeting the codes of practice, regulation is maintained through organisations including the SCIE, CSCI, GSCC and Skills for care. In general, social work can be recognised as a profession. Furthermore, throughout the years Social work profession reputation has been damage to extent as qualified social workers leaving the profession as they feel it is demanding profession.

The aim of this assignment is to discuss the contribution of medical, sociological and psychological models to understanding emotional health and examine the impact of race, class and gender on emotional health. Furthermore the assignment will discuss appropriate theories to understanding the emotional health linking them to race in case study one.

According to World Health Organisation, 2005 “Mental health and mental well being are fundamental to the quality of life and productivity of individuals, families, communities and nations, enabling people to experience life as meaningful and to be creative and active citizens”. Hales ( ) defines emotional health as the ability to express, acknowledge how one feels, their moods and be in a position to adapt to situations and be compassionate to others.

The medical model views the diseases as coming from outside and invading the body, causing changes within the body. It can also originate as internal, involuntary physical changes caused by chemical imbalances and can also be genetic (Nolan 2009). This model considers the mental malfunction of schizophrenia to be a consequence of chemical and physical changes in the brain. Environmental factors may be the causation of illness, but the disorder might still be influenced by hereditary factors (Tyrer and Steinberg 2008). The abnormal behaviour in an individual is a result of physical conditions such as brain damage, meningitis and others. The treatment given is aimed at controlling the root cause of the disease by changing the individual’s biochemistry. This approach does not account for the occasions this evidence can be found in mental disorders such as such bipolar and unipolar depression and schizophrenia.

The sociological model of health places more emphasis on the individual’s environmental, social and economic causes of disease rather than solely focusing on the biological aspect (Duggan 2002). The socio-cultural aspect refers to the role socio-cultural environments play in a given psychological phenomenon such as parental and peer influence in the behaviours or characteristics of an individual. “Social factors encompass a discrete subject matter because, as collective representations, they are independent of psychological and biological phenomena, although we have individual actions, thoughts and feelings we tend to live our lives through institutions: family, corporation, church, school and nights” (Hadden 1997 p 105).

The Psychological model suggests that human behaviour is strongly affected by experiences from childhood and also that behaviour is the result of interaction between the conscious and the unconscious (Nolan 2009). Mind (2010) points out that cannabis may cause psychological effects that lead to psychotic experiences such hallucination, depersonalisation and paranoid ideas. Rack (1982, p. 124) points out that Cannabis is readily available throughout the Caribbean and the northern parts of the Indian subcontinent its use is not restricted to any particular age-group. In support of this point Cockerham (2007) observes that living in a household with both parents who smoke or having a spouse who smokes can promote smoking behaviours. A psychological model is based on the assumption that conscious thought mediates an individual’s emotional state or behaviour in response to stimulus. The model suggests that people may create their own problems through interpretation.

The psychological model will look a lot deeper into the individuals and not merely the symptoms in which they are showing. It suggests that our thought may cause the disturbances or it may indeed by the disturbances causing our thought. The model refers to the role that cognition and emotions play in any given psychological phenomenon, such as the effects of mood, beliefs and expectation on an individual’s reaction to the event. The biological aspects refer to the role of the prenatal environment on brain development and cognitive abilities or the influence of genes on individual’s dispositions (Rogers and Pilgrim 2000).

Hatty (2000) in Barack (2006) observes that Gender refers to nature and the psychological, social, and cultural components that summarizes the leading ideas about feminine and masculine characteristics and behaviours dominating in any society at one time. According to Pilgrim (2009) gender is a social description. Rogers and Pilgrim (2005) points out that men are prone to be involved in antisocial behaviour and can be categorised as dangerous and criminally deviant, which leads to their removal. The idea of danger to society is always attributed to men than women. There is evidence to propose that men are often sectioned under Mental Health Act 1983 and referred to psychiatric hospitals by the police under section 136 removal to a place of safety. Men are more likely to be hand cuffed and detained in cells more than women (Rogers (1990) cited in Rogers and Pilgrim 2000).

Gove (1984) in Rogers and Pilgrim (2005) shows that there is now a general consensus among social scientists that women experience more psychological distress than men and that this is largely due to aspects of their societal roles. Another view point is that, throughout the life span women report greater psycho-social malaise than men and the gap between sexes increases in older people with self-reported factors like depression, worry, sleep disturbances and feelings of strain. There have used the societal role to explain why women experience psychological distress than men. Women’s unstructured roles tend to be more domestic than men which contribute to their vulnerability to mental distress because they have time to dwell on their problems (Blaxter (1990) cited in Rogers and Pilgrim 2005).

Women’s natural disposition is known to be maternal, caring, passive and home centred. Their inferiority, instability and lack of control are increased as their biology takes over (Jones 1994). WHO (2010) states that while childbearing and motherhood are often positive and fulfilling experiences, for many women these are associated with suffering, ill-health and even death. The estimation of illness is different between men and women, the peak age for men is 15-24 and for women is between 25 and 34. According to Rogers (1990) cited in Rogers and Pilgrim (2000)

Class remains a predictable correlate of mental ill health. Basically the poorer a person is the more likely they are to have a mental health problem. A class gradient is evident in mental health status across the bulk of the diagnostic groups but it is not a neat inverse relationship. For example affective disorders are not diagnosed evenly in all social classes whereas a very strong correlation exists between low social class and the diagnosis of schizophrenia. In the case of depression and anxiety the underlying assumption has been clearer cut, perhaps because minor morbidity is less strongly identifiable as biologically derived illness (Jones 1994). They found a complex relationship of social class to anxiety and depression linked to changing employment status they furthermore examined three different ways of describing social position: income; social advantage and lifestyle; and social class.

Poor accommodation produces stress reactions in inhabitants (Hunt 1990; Hyndman 1990). Social and environmental causes are those factors around us such as where we live, whether we have strong family support networks, our place of work and how and where we can relax (Royal College of Psychiatrists, 2004). Social class is one of the determinants of health which includes; wealth, culture, background, family, financial constraints, accommodation and lifestyle WHO (2010).

According to Barak et al race is socially defined by a collection of traits such as; physical characteristics, culture and religion, national origin and language. King et al (1994) and other authors cited in Kaye and Lingiah (2000) states that there is evidence that, with the intervention of the police and social services, African -Caribbean people are more likely to be admitted to psychiatric hospitals compared to whites. There is a belief that African-Caribbean people are not provided with preventive and supportive measures before there is a crisis, but when the crisis starts and escalates the emergency services get involved which leads to compulsory admission (Bhuil et al (1998) and other authors cited in Kaye and Lingiah 2000). Rogers 1990 in (Rogers and Pilgrim 2005) states that Afro-Caribbean people are found to be less frequently referred by relatives or neighbours but by strangers and passers-by of other ethnic groups. In support of the above statement Reiner 1996 in Rogers and Pilgrim (2005) suggests that there is a process of transmitted discrimination in the way in which black people’s behaviour is viewed which is interpreted in a more negative way. Furthermore the Department of Health (DH 2005) states that the black and minority ethnic groups who live in England are deprived of the quality of mental health care that they need. Black and minority ethnic patients are more likely than the white British to be detained compulsorily, to be admitted to hospital rather than treated in the community, to be subject to measures like seclusion in hospital, and to come into contact with services through the criminal justice system. This leads to a vicious circle of BME people refraining from seeking care early in their illness. According to Rogers and Pilgrim (2005) most blacks including African-Caribbean people who live in the inner cities suffer from recurrent racism and are over represented in psychiatric records.

Looking at what the medical model says and comparing to Daniel’s behaviour, it may be suggested that he was suffering from schizophrenia which is more dominant in African Caribbean people, which could have been caused by substance abuse. Royal College of Psychiatrists (2004) states that there is a causal relation between substance misuse, particularly alcohol, cannabinoids, hallucinogens, and stimulants (such as amphetamines), can produce psychotic symptoms directly without mental illness. They may also precipitate psychotic disorders among people with a predisposition. Kaye and Lingiah (2000) points out that African Caribbean people have a higher rate of admissions for schizophrenia and effective psychosis compared to their white counterparts.

Hales (2010-2011) states that social health refers to the ability to interact effectively with other people and the social environment in order to develop satisfying interpersonal relationships and fulfil social roles. Looking at the changes in Daniel’s behaviour it may be suggested that it was down to living on his own, lack of support, change of environment and financial problems. Frederick 1991 in Rogers and Pilgrim (2005) observes that the various factors identified by Afro-Caribbean mental health users are; coping with adolescence and education system; building up relationships and then dashes their expectations; growing up in a hostile environment with few positive images of black people, parental and with British white cultural input leading to confusion and conflict over identity. Argyle (1994) states that there is a theory that failing to learn correct social skills during the early stages of life can contribute to social rejection there by cause one to fail to cope with life events and can cause anxiety, depression or other symptoms.

Hales (2010-2011) points out that those who are psychologically fit normally share the following characteristics: they have high self-esteem and aim towards happiness and fulfilment, they establish and maintain close relationships, they accept their own limitations in life and they feel a sense of meaning and purpose of life. Daniel started neglecting himself and acting on the voices that he heard, which may be suggested he had a problem with his psychological well-being. African Caribbean people are likely to be offered physical treatments, strong medication and not likely to be offered psychotherapy and counselling.

In conclusion analysing approaches to health and illness in terms of medical versus a social model henceforth the medical model is a key concept in both medical sociology and medical anthropology (Chang and Christakis 2002). A lack of social support also can be due to social stigma which is the main reason why mental people’s social network becomes narrow. Also because of schizophrenia’s pervasive effects on daily functioning a range of psychosocial approaches has been developed to improve emotional and psychological well-being.

Introduction

Social work is an established professional discipline with a distinctive part to play in promoting and securing the wellbeing of children, adults, families and communities. As an established professional discipline, social work has its own theories and knowledge. The essay will begin by defining what a theory, models and method is, with reference to different authors. I shall then explain how I applied the particular model or method to practice as well as providing a critique. I will then conclude by relaying this to my practice development.

Theories in social work are often set out as a list of different approaches, including, for example, person-centred counselling, family therapy, task-centred work, cognitive-behavioural therapy, networking, group work, psychoanalytical theory, anti-discriminatory/oppressive practice and feminist theory (Davies, 1997). Alternatively: crisis intervention, the psychosocial approach, behavioural social work, working with families, etc. (Coulshed and Orme, 1998). What they have in common is that the approaches and associated theories do not originate from and are not specific to social work.

Practice theories are relatively discrete sets of ideas prescribing appropriate social work actions in particular situations. Psychological or social explanations of human behaviour are applied to social work situations, and actions are prescribed, based on the worker’s assessment of the situation. Practice theories are usually informed as separate, relatively complete and coherent sets of ideas. However, aspects of them are often used eclectically, in combination (Payne, 2000, p. 332-3).

Models describe what happens during practice in general way, in a wide range of situations and in structured form, so that they “extract certain principles and patterns of activity which give practice consistency” (Payne, 1991). Models help to structure and organise how to approach complicated situations. Methods represent the more formal written accounts about how to do the job of social work (Sibeon, 1990). This occurs when theory or a combination of theories, is made concrete and applied in practice. Pincus and Minahan (1973) argue that models should avoid conceptualizing social work practice in such terms as person-environment, clinical practice-social action. They believe that strength of the profession lies in recognizing and working with the connections between these elements. In the social sciences theoretical knowledge is highly contested because different theories offer competing explanations. Very important question here would be about the nature of the explanation, why something is as it is, according to Thompson, this is what distinguishes a theory from model. “A model seeks to describe…how certain factors interrelate, but it will no show why they do so” (Thompson, 2000, p. 22).

Case study

GC is a 43 years old man who suffers with severe learning difficulties and Autism. GC moved into residential home for people with learning disabilities in 1993. Before that he lived with his parents. For the past 13 years he attended Day Centre 5 days a week. GC has parents and a sister who he remains in contact with and family relations towards GC remains positive. GC participates in different sorts of activities in the residential home as well as in a Day Centre where I am on placement. There are times when GC is agitated, hyperactive and very vocal. He has difficulty in accepting change and demands regular routines with his lifestyle. There are lots of behavioural issues around GC. This can fluctuate in relation to the onset of epilepsy. He can become agitated and hyperactive prior to a seizure. He needs regular monitoring as seizures can be life threatening. GC lacks awareness of danger; these include road safety and strangers. Apart from seizures he also suffers from high blood pressure, asthma and insomnia. However, the last one might have been caused by the recent change of his medication to control his seizures more effectively. Recently, the local authority decided that the Day Centre GC attends will be closed and all clients, including GC, are going to be moved to different Day Centres.

I am a student on placement at this very Day Centre and during my placement I was assigned to be GC’s key worker. In order to work effectively with him I decided that the theory I would use will be systems theory. In the next part of my essay I will justify the reasons for choosing this theory.

Systems theory and implications for practice

Systems ideas in social work originated in general systems theory developed in 1940s and 50s in management and psychology, and were comprehensively formulated by Bertalanffy in 1971. This biological theory sees all organisms as systems. Bertalanffy says, that human being is part of society and is made up of, for example, circulation systems and cells, which are in turn made up with atoms, with are made up with smaller parts. The theory is applied to social system, such as groups and families, as well as biological systems. Hanson (1995) argues that the value of systems theory is that it deals with wholes rather than with parts of human or social behaviour as other theories do. Mancoske (1981) shows that important origins of systems theory in sociology lie in the social Darwinism of Herbert Spencer. Systems perspectives are important to social work because they emphasise its social focus, as opposed to counselling, psychotherapy or many caring professions, whose importance is on individual patients or clients.

The “broadest possible definition of a systems is that it is ‘anything’ that is not chaos” (Boulding, 1985, p. 9). Conversely, a system could be defined as “any structure that exhibits order and pattern” (Boulding, 1985, p. 9). The common definition of a system, is that a system is “an aggregate of elements considered together with the relationships holding among them” (http://wikipedia). In this sense, a system may be considered “as any entity, conceptual or physical, which consists of independent parts”

Systems theory has been developed in to models by Germain and Goldstein, but above all by Pincus and Minahan, which is centred on the individuals systems. Preston-Shoot and Agass (1990) argue that systems theories showing how the public and private interact, how various change agents might be involved, and that workers and their agencies might themselves be targets for change. National Occupational Standards also stresses an “ecological approach”- ‘an individual must be located within the context of the family & the groups/networks to which they belong, & of the wider communities in which they live’ (Key role 1, Unit 1- Key Concept).

The focus of social work practice is on the communication between people and systems in the social environment. People are dependent on systems for help in obtaining the material, emotional or spiritual resources and opportunities they need to realize their goals and help them cope with their daily tasks. The concept of life tasks was highly structured by Harriett Bartlett who states:

“As used in social work, the task concept is a way of describing demands made upon people by various life situations. These have to do with daily living, such as growing up in the family, learning in school, entering the world of work, marrying and rearing a family, and also with the common traumatic situations of life such as bereavement, separation, illness or financial difficulties. These tasks call for response in the form of attitude or action from people involved in the situation. They are common problems that confront many people. The responses may differ but most people must deal with the problems in some way or other” (Bartlett, 1970, p.96).

Hearn (1958) made one of the earliest contributions, applying systems theory into social work. However, the greatest impact came with two interpretations of the application of systems ideas to practice, one from Goldstein (1973), who describes his theory as unitary, and the other one from Pincus and Minahan (1973) who describe it as an integrated theory.

In my essay I will mainly discuss the model that was formulated by Pincus and Minahan (1973). They identify three kinds of resource systems. First, informal or natural system: family, friends, neighbours, fellow workers. The help given by such informal relationship includes emotional support, advice and information. Second, formal systems, consist community groups, trade unions, membership organisations. And the last one is societal system: day centres, hospitals, schools, etc.

In terms of social work and in relation to systems, social work is concerned with the interactions between people and their social environment, which affect the ability of people to accomplish their life tasks and realise their aspirations and values. Pincus and Minahan talk about the purpose of social work in this aspect, which is to enhance the problem-solving and coping capacities of people, link people with systems that provide them with resources, services and opportunities, promote the effective and humane operation of this system and contribute to the development and improvement of social policy.

As social workers we must decide on purpose and relationship, in working with various people. The activities of the social worker can be viewed in relation to four types of systems according to Pincus and Minahan: these are the change agent, client, target and action. In most cases there is a one primary change agent who carries out major responsibilities, though two change agents might share the same responsibility. According to Pincus and Minahan, the change agent is a helper who is specifically employed by the system and pays the salary for the purpose of creating planned change. This differs from view of Roland Warren (1971) who defines a change agent as “any person or group, professional or non-professional, inside or outside a social system, which is attempting to bring about change in this system”.

The client system is about people, groups, and families, communities who seek help and engage in working with the change agent system. They believe that change agent should attempt to obtain sanction and a working agreement or contract from the expected beneficiaries of his change efforts. They also say that people have the right to self-determination and participation in decision that affect them. Warren (1971, p.51) argues that “social workers not only are constrained by agency controls…they are constrained by their own attitude towards the client; they identify with him as a person who needs help and not like citizen demanding his legal rights”.

The target system talks about people whom the change agent system is trying to change to achieve its aims. An important aspect here is to establish the goals for change and then determine the specific people-the targets-that will have to be changed if the goals are to be reached. Some of the targets may agree to make changes and some of them might not or might be resistant. Pincus and Minahan discuss two important aspects in such a situation. First, the client system is not always the target to reach change goals. Second, it cannot be assumed that the target system always will be resistant to the change efforts. Client and target system often partially overlap. e.g, GC who is a target, and mother who is client’s system. The last, but not least social work system by Pincus and Minahan is the action system. It describes those whom the social worker deals in his efforts to accomplish the tasks and achieve the goals of the change effort. An action system can be used to obtain sanctions and a working agreement or contract, identify and study problem, establish goals for change or influence the major targets of change. Roland Warren was one of the first who used the term “action system” to describe new systems created to perform community action tasks. Depending on a situation, the action system could be a new system so members of that system can directly interact between each other.

When talking about a change it is very important not to forget the issue of values and ethics. It is impossible to structure an effective change effort in which an implicit or explicit imposition of values is totally absent. Thompson (2005) says that “values are an important influence in our actions and attitudes, they will encourage us to do certain things and to avoid certain others (…) they are very strong force in shaping people’s behaviour and responses to situations”. Values are beliefs, preferences or assumptions about what is desirable. Values like those that call for the worker to respect the client, maximise client’s self-determination, maintain a non-judgemental attitude, observe the confidentiality of the client’s communications and be honest in dealing with client can be seen as primary social work values. Knowledge and values serve different functions, technical and ethical issues are often complexly interrelated in practice, and separating them is a difficult job. The distinction between knowledge and values should keep social worker aware of their own values. The awareness is an important first step in coping with the value dilemmas that are inherent in the change agent role. To cope with ethical doubt of the change agent role, the social worker must maintain a balance between flexibility and integrity. Self-awareness, technical expertise and tolerance will help in this task.

Case study- Implementing Theory to Practice

As a social worker I need to decide on purpose and relationships in working with GC and his surrounding network. GC’S natural system would be his mother who lives nearby and visits him every Sunday to take him out for a day, his father who lives in Scotland comes to see GC every three months and his sister who currently lives in Australia keeps up to date with news via e-mails and post. He also has a niece, who sends him photos and cards. His societal system is a Day Centre he currently attends.

My role was to link GC with systems that would provide him with resources, services and opportunities. GC is a very active person and there are days when he can hardly sit down. He likes to walk around the unit. My idea was to find him some sort of walking club where he could go out for a day and do some walking. Luckily, there was a local club, which organizes “walking activity” every other week. I thought it could be a good idea to sign him in and link him with a new formal system in order to help him with a new experience. I then discussed this with GC as well as his mother and we all decided that it would be a good idea for someone from his current network system to join him for the first session. It was thought that this might minimise stress and anxiety of being in a new environment. In this task I acted as a change agent, as a person inside a social system, who attempts to bring about change in this system. I deliberately described myself as a person “inside” the system, because immediately when I started to work with GC, his family and other professionals, I became a part of GC’s system.

About a month ago I found out that the Day Centre GC attends will be closing this summer. It will be a very stressful experience for GC as well as his natural system, which will be disturbed. I contacted GC’s mother and father and informed them about this matter. We had spoken about different possibilities and other day centres that may be available for their son. New informal systems may not provide the help that GC needs. After being moved to the new Day Centre, he may lack an informal helping system e.g. being new in a community and not to having any friends around him. Also, societal systems might be disrupted. GC might stop going to the walking club because of the location of the new day centre and distance between those two resources.

In general informal, formal and societal systems may not provide resources or services or opportunities, because the needed resource might not exist or may not provide appropriate help. People also might be unaware that such a resource exists or might hesitate to turn for help. The question was: what tasks GC will face in making the transition from one environment to another? In an attempt to answer this I note that he has informal helpers, such as family, who can support him throughout the process. Major change in GC’s societal system (Day Centre) is largely influenced by his natural, informal system. There will be a significant change to GC’s existing system and the new Day centre will become his new system, a system where members are not engaged in direct interaction with one another but whom a worker will coordinate and work with to change a target on behalf of a client. Therefore change agents may work with a number of different types of action systems at different steps in their change efforts. I advocated on behalf of GC to keep him in a current walking club, he attends and enjoys the most (formal system). Therefore, the first dimension of the social work frame of reference directs attention to the tasks people are confronted with, within social situations and the resources and conditions necessary for facilitating the performance of these tasks. This is the reason I used systems theory for GC. I also mentioned above about the target and client system overlapping. GC’s medication has been recently changed and his behaviour dramatically altered. He started showing aggressiveness and indifference towards his mother. Ms C asked me to somehow help GC to deal with the changes in his medication. I discovered that her behaviour contributes to GC’s problem. She was very sad and anxious recently and GC clearly noticed that. Before starting to work with GC I had to explain to Ms C that her negative emotions have a negative impact on GC’s behaviour and possibly she could use some help as well. In this case she became a target. It is also important to work with GC’s GP and community nurse who are part of his system. I urged medical professional to work closely with the family and myself to ensure everything is going well.

There is also number of criticism around systems theory. In social work interpretations of systems theory, however, and particularly that of Pincus and Minahan, Evans (1976) argues that there is a hidden assumption that all systems are independent. Devore (1983) argues that the life model is better at dealing with social class, ethnic and cultural differences and lifestyle than many other theories, but still lacks specificity in dealing with issues affecting black people.

Siporin (1980) criticise systems theory for not taking into account incompatibilities of class interest in capitalist societies and how these prevent any integration in such a society. The theory itself was also criticised for providing a framework of understanding that does not specify clearly the level and type of interventions required in particular circumstances.

System theory tends to assume that conflict is less desirable than maintenance and integration, which may not be true in practice (Leghninger, 1978). He also says that not everything is relevant and many things may not fit into a general plan, deciding on boundaries could be complex or even impossible, and it may be assumed that things are related in a system without checking to see if they actually are.

Nevertheless, Mancoske argues that in its social work formulations, the criticisms of systems theory as ‘static’ are weak, because usually considerable attention is given to change both individual and social.

Conclusion

I have to admit, that at the very beginning of my work with GC I was very apprehensive about using systems theory. After reading Pincus and Minahan’s “Social work practice: model and method” I found some of the aspects very complex and terminology used by them, difficult to remember and sometimes to understand. Surprisingly, Germain (1979) shares my anxiety and thinks that systems theory and technical language very often alienates social workers from using this theory as a result.

Payne (2005) argued that systems concepts were brought into social work as a reaction against psychodynamic theory, which focused on the human mind. In my opinion systems theory is very holistic framework, which helps social workers to view their workplace, agency in much wider concept. I think that out of all concepts that constitute general systems theory, the concept of boundaries is the most useful for social work practitioners. Boundaries are defining limits within this theory. They signify what is inside and what is outside system. GC has lots of emotional issues which could have been much more resolved with different approach, e.g. like task centred approach. I also observed that system theory has a number of limitations, for example it does not adequately deal with things like class, race, gender, power relations or conflict. I learnt that no single theory can explain a person’s situation. System approach also helped me to understand how families act and what the dynamics within the family are. On GC’s case I also learnt how important environmental changes can affect family dynamic. Social work is about having knowledge of a wide range of theories which gave me a more holistic understanding and how to be eclectic in my approach. I am finding very important drawing upon multiple theories, styles, or ideas to gain complementary insights into a subject, or applies different theories in particular cases. Applying systems theory into practice has also added dimension to my personal and professional values and have had a major impact on my work within my practice placement.

Social work involves working in profoundly emotional events in people’s lives, its practice is demanding and challenging and perhaps one of its most unique qualities is the balance it holds between understanding and working with the internal and external realities of service users (Bower, 2005).

In 1935, Charlotte Towle, a pioneering social worker, deeply influenced the profession recognising that social workers needed to secure knowledge of human behaviour to understand service users. She distinguished between knowing people and knowing about people, suggesting the core of social work to be the interaction between the service user and the social worker (Towle, 1969). More recently, literature has expressed a continued relationship based approach to social work, which emphasises the importance of the social work relationship and the quality of the social work experience provided (Trevethick, 2003, Howe, 1998). Understanding how to best facilitate relationships and work with service users requires acquisition of knowledge from a range of disciplines, theories and skills (Strean, 1978, Hollis, 1964).

Trevithick (2000) discusses that the insight derived from psychoanalysis, the psychodynamic approach and its theories on the unconscious can assist the social worker in offering a framework for understanding complex human relationships. The approach has had a major impact on social work’s development as theories on the unconscious have impacted on ways of working with service users (Pinkus et al, 1977)

The psychodynamic approach derives from Sigmund Freud’s psychoanalysis, a method of inquiry, theory of mind and body of research. Contrary to the prevailing thought at the time, where the assumption of psychology was that human behaviour was rational and the key to understanding human behaviour was to focus upon human consciousness, Freud (1936) believed that human behaviour was irrational and much of our personality, motives and behaviour were unconscious. Central to Freud’s theories was the idea that certain experiences during childhood that are too painful to remember and are unconsciously repressed. According to Freud, these repressed thoughts give rise to states of anxiety or depressions which can be expressed in physical symptoms (Freud, 1986).

In the 1920’s social work practice shifted dramatically as they began working in hospitals and clinics, extending their exposure to psychiatric thinking (Goldstein, 1995). In a publication in 1940, Annette Garret became one of the first social work authors to comment on the impact of Freud’s work on social work theory and practice, advocating for psychoanalytical ideas to be used by social workers (Brandell, 2004).

Freud and his colleagues came to realise that symptoms, such as depression, anxiety and other psychological disorders could be expressions of unconscious conflicting impulses and unresolved issues (BPS, 2007). They explored the idea of transference, the projection of unconscious feelings of unresolved issues from the service user onto the worker. The issues were connected to significant others in their past. The service user experiences the worker through this lens and sees the worker as if he or she is the person from their past. The unconscious remembers feelings from the past and projects them into the present. The feelings from service user to the worker are the transference and the workers feelings towards the service user are the counter transference. Freud noted that transference and counter-transference were experienced in the therapeutic relationship (Freud, 1986). This notion has implications for social work in that it allows the social worker to be aware of his/her unresolved issues that may impact on the working relationship with a service user and also allows the social worker to be mindful of hoe the service user is viewing the working relationship. Payne (1991) discusses how a social worker’s unconscious feelings can be awakened while working with a service user who perhaps reminds him/her of an experience or time in his/her own life.

Freud’s theories relating to the unconscious show that rational human choice may be overridden by our unconscious inner conflicts (Brandell, 2004) and can aid us in understanding human behaviour. The theories encourage social workers to have an open mind when working with distressed service users, enabling them to individualise the person in their environment, suggesting that each service user is unique in personal experience, strength and weakness (Strean, 1993). Transference and counter transference recognise that both service users and social workers are human beings and that to work effectively together involves acknowledging the emotions associated with all relationships (Trevithick, 2000).

Schon (1983), Fook and Gardner (2007), Thompson and Thompson, (2008) advocate the importance of being a reflective practitioner. I feel that the psychodynamic perspective can assist social workers in acquiring the self knowledge it takes to become reflective. Trevithick (2003) describes this self knowledge as being what we learn about ourselves over time, including practice wisdom, our ability to be honest with ourselves about strengths and qualities while at the same time accepting our limitations.

However, Freud’s theories have their limitations in respect of social work practice. As Freud used non scientific methods in his research, it is difficult to prove or disprove his ideas. Freud did not have any concrete data, but undertook many individual assessments, mainly with older upper class women and for this reason, his work is considered sexist (Mitchel, 1974) and also euro and ethnocentric (Robinson 1995, Trevithick, 2000) as the studies on white populations. Fernando (1991) suggest that Freud saw other cultures as primitive in comparison to western white society implying a racist slant and Strean (1979) goes further to state that Freud had limited cultural assumptions and deviations from this cultural norm were considered abnormal and worthy of his treatment. However, in spite of this, Cameron (2006) points out that the psychodynamic approach has been taken up in many cultural contexts, most notably in Latin America, India and Japan.

In light of criticism, however, the psychoanalytical concepts put forward by Freud and developed by later analysts have enriched our knowledge of mental functioning and human relationships and informs the relationship aspect of social work. It not only assists in informing the social work/service user relationship but also the relationships that service users have had in the past, experience in the present and will have in the future. Social work is about working with people and the psychodynamic perspective brings an extra skill of awareness into the mix.

Freud began to understand, through this stage development theory for children, that the child’s relationship to parental figures is the prototype for all subsequent relationships in the child’s life (Freud, 1986). These can involve emotions such as rivalry, jealousy, guilt, love and hate. Freud felt that our sexuality began at a very young age and developed through various fixations. If each stage was not completed, we would develop an anxiety and late in life a defence mechanism to avoid that anxiety (Freud 1986). Freud developed the first stage development theory which acknowledges the issue of attachment between mother and child, a theory which later would be developed by other psychoanalysts and disciplines. The traumatic effects of prolonged separation between mother and infant are widely recognised today and this has led to radical changes in the management of children in hospital (BPS, 2007). Later followers of Freud, such as, Erik Eriksen and John Bowlby, came to realise, particularly through their work with children, that experiences of early infancy, though lost to the conscious mind in adulthood, nevertheless live on in the unconscious and continually affect and shape relationships and behaviour in everyday life (BPS, 2007).

Bowlby (1951) developed Freud’s theory, agreeing with Freud’s emphasis on the importance of the child’s attachment to the mother as a basis for later emotional relationships. His attachment theory describes how our closest relationships begin in infancy and set the stage for subsequent development. When the relationships are secure, they promote self reliance, confident exploration of the environment and resiliency in dealing with life’s stresses and crises. Lack of secure attachment can lead to emotional problems, difficulty relating to others and a vulnerability to psychological distress (Sable, 2004, Bowlby 1951).

Bowlby believed that a mother inherits a genetic urge to respond to her baby and there is a critical period after the baby is born during which the mother and baby form an attachment. One of the most controversial aspects of Bowlby’s theory was the claim that babies have an innate tendency to become attached to their primary caregiver, usually the mother, and that this attachment is different from other attachments. Any disruption of this bond in this period can have serious long term consequences. This has been criticised by other theorists who state that the attachment does not have to lie with the mother, it can be with any care giver (Schaffer & Emerson, 1964).

Mary Ainsworth, a psychologist devised a laboratory experiment called the “Strange Situation” (Ainsworth, 1978) which showed that Bowlby’s evolving ideas could be tested and given a research base. A baby was observed in a set of seven situations, with the mother, with the mother and a stranger, with just a stranger and on its own. The baby’s reactions were observed (Ainsworth and Bell, 1970). Ainsworth found that psychological health is related to the positive quality of these attachment experienced, both present and past and the personal meaning attributed to them. Psychological distress is perceived as a distortion of the attachment systems and symptoms of anxiety, depression or anger reflect the internalisation of adverse affection experienced resulting in dysfunction (Sable, 2004). The behaviour of the parents towards the child, whether they are sympathetic and respond to the child’s needs is important and according to Ainsworth, the more parents accept the child on the child’s terms, the more securely attached the child is (Ainsworth and Bowlby, 1965).

In applying Bowlby’s theory to social work, we can see how social workers can construct an understanding of service users’ early lives and guide managing the relationship in the future (Sable, 2000). Bowlby (1982) proposed that children internalise the relational experiences with their primary care givers during their first year and develop internal working models, which help to predict and understand our environment. The bond that we create with our primary care giver shapes how we respond to others in later life (Bowlby, 1982). Studies from Ainsworth (1967) and Ainsworth et al (1978) support this theory. In social work with children, it is common to see a child’s challenging and disruptive behaviour being understood as an attempt to test whether adults are reliable or consistent than previous ones (Payne, 2005). The psychodynamic approach offers an explanation for relationship behaviour in the service users we work with.

Bowlby’s attachment theory and the concept of resilience has also been used in social work with children to achieve positive outcomes for looked after children where care provided to looked after children aims to provide a secure base, self esteem and self efficacy (Gilligan, 1998). The policy document, Caring for children away from home (DoH, 1998) explains that children in the care system will often have had a long history of family problems and an emotionally turbulent life, leaving their personal development damaged and their capacity for basic trust in people severely compromised. This document highlights that social workers will have to work with service users who display patterns of insecure attachments. The ability for carers to provide secure attachment and emotional warmth is part of policy guidance in the Framework for the Assessment of Children in Need and their families (DoH, 2000). Bowlby’s attachment theory allows social workers to make the link between emotional development, behaviour and the quality of relationships with their carers (Trevithick, 2000). Howe (2000) states that attachment theory can guide and inform social work interventions with children. It can act as a framework of theory and patterns of thinking.

Bowlby’s attachment theory can also help social worker’s make sense of the way in which service users engage with services. Most social workers have worked with service users who say that they would like support but cannot make use of the services on offer. This difficulty can indicate experience of distress in early childhood and can be understood in terms of their history of attachment bonds (Howe, 1999). Some service users seek to exert control in the relationship with a social worker, perhaps refusing support or making unrealistic demands. Social workers could view this as the service user being difficult or alternatively with consideration to attachment theory this could be understood in terms of the service users previous experience of rejection from their carers which has left them cautious of accepting help (Trevithick, 2000).

In critical analysis of attachment theory, Schofield and Beek (2006) explain that although attachment theory can offer assistance, service users lives need to be considered uniquely, drawing on their wider environment, education, experiences of racism and economic background. For example, attachment to carers is central to working with looked after children but must be understood within a range of other factors (Schofield and Beek, 2006).

It can also be argued that attachment theory does not incorporate enough consideration of issues of oppression that result from differences of race, gender, culture, sexuality and social-economic factors (Milner and O’Byrne, 2002). In a society where due to globalisation, colonisation, immigration and asylum seekers, families are having to travel great distances to secure attachments, Bowlby’s eurocentric theories do not go far in explaining cultures or social work from a black perspective (Robinson, 1995).

This highlights again that psychodynamic thought should not be used in isolation. Human nature is such that no one theory can account for the infinite range of difference amongst individuals. For example, difference in learning abilities and other problems in development such as autism can be mistaken for attachment disorders if examined in isolation (Rugters et al, 2004)

The central ideas of the theory used today are that the quality of close relationships (or attachments) has a bearing on personality, emotional and social development not only in childhood but across the lifespan (Howe, 2001).

In conclusion, it is evident that there are weaknesses to a psychodynamic approach in social work. Theories of the unconscious can partly explain human behaviour but it fails to take into account environmental, social, economic factors and issues of culture and race. It is also deterministic in its approach and does not leave much room for agency and change. However, there is not just one body of knowledge used in social work practice. Social work knowledge is derived from different approaches but what they all have in common is that they do not originate from or are specific to social work itself, recognising that social work theory is a political and social process (Payne, 1997). Briggs (2005) states that the overall the contribution of psychodynamic research is to bring in another point of view which enhances the reflective psychosocial space in which social work takes places. Psychodynamic insights can in part assist the social worker in the difficult and complex human situations in which they are involved.

As a core component of social work, the ability to respond to people’s emotional needs, to their impulse for emotional development and to the difficulties they experience in forming or maintaining relationships, the psychodynamic perspective can assist in giving us another point of view.

In terms of recent policy, high profile investigations since 2000 have highlighted the importance of effective relationship building in social work ( Laming, 2003 and Laming, 2009) These cases have caused nationwide concern beyond the professions and services involved, causing a frenzy of media comment and public debate, putting the social work profession under the microscope. Social workers need good observation and analytical skills in order to be able to understand the nature of the relationship between a parent and child, to understand signs of noncompliance, to work alongside a family, and to come to safe and evidence-based judgements about the best course of action (Laming, 2009).

As social work continues to be very much under society’s microscope, it is essential that it encompasses a body of knowledge from a wide variety of disciplines, always remaining open to new theory and knowledge while considering perspectives from other professions.

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The field of psychology has vast areas of interest, and Human growth and development is one of the most popular topics being studied by social workers today. The purpose of this report is to show how essential it is for a trainee social worker to attain a firm understanding of human growth and development, and to ultimately achieve a foundation of knowledge in this area. This report will show that, with practice, preparation, assessment, reflection and finally application, this foundation of knowledge can be effectively used in positive intervention methods. (Crawford 2006)

There have been many great theorists over the years, all of who had different ideas on human growth and development. This report will highlight and discuss 3 theories based on the work of Erikson, Bowlby and Bronfenbrenner. Furthermore, the report will also throw light on the pros and cons of these theories, identifying and discussing potential issues that may arise from failure to mature, as described in each theory.

Finally, the report will identify the role of social workers in relation to their intervention with a client or family.

The outcome of this report will be a sum-up of the key identifying points of each of the 3 theories. Using practical examples, the report will explore the effects of the theories and outcomes that may arise from failure to mature.

The practical examples used will aid, guide and shape the discussion by highlighting the life span of the individual problems or issues, and will provide an underpinning reason for using each of the theories. Each theory chosen in this report is taken from a different discipline of social science; psychodynamic, sociological and psychosocial. These three disciplines all have a different emphasis, but structured in all of them is the core principle of determining what can potentially influence life course development.

The first theory outlined in this report is Bowlby’s ‘attachment theory’. This theory fundamentally sees the earliest bonds formed between children and their caregivers as a key factor in human growth and development, having an immense impact on progression and continuing throughout life.

This theory will be examined, using social work examples with infants. There will be an explanation of how the theory is vastly important for attaining a firm understanding of the foundational relationships infants build for a healthy development.

The second theory discussed in this report is Bronfenbrenner’s ‘theory of ecological development’. Bronfenbrenner’s theory describes the influences of further environmental factors on children, and their positive or negative development.

For this theory, social work examples will be chosen from older adults in order to help attain an understanding of how environmental factors, at micro and macro levels, can influence social workers in relation to the stages of development.

The final theory discussed in this report is Erik Erikson’s ‘model of life stage development’. This theory addresses identity as an individual moves through the stages of life, and how they negotiate crisis points in a successful or unsuccessful progression, this effecting healthy development.

For this theory, examples of middle-later stages of life will be discussed, and how progression through the life stages can successfully or unsuccessfully result in a healthy or unhealthy development of the individual.

So, what can human growth and development be determined as? Before we discuss in depth the main theories, it would be appropriate to give a definition of human growth and development, and highlight why it is so fundamentally important for social workers to have a firm understanding of the various theories.

According to Baltes cited in Crawford (date), human development is multi-dimensional; it is made up of biological, cognitive and social dimensions. Physically, from the moment we are conceived till the moment we die, we are developing biologically. Our bodies are consistently moving from one biological change to another. Subsequently, the growth of our intellectual and social development comes. This begins from very early stages in the course of life and continues across the span of each life. (Thompson)

Both Freud and Erikson agree that every individual is born with a number of basic instincts, that development occurs through stages, and that the order of these stages is influenced by biological and sociological maturation (Sigelman, and Shaffer 1992).

The Requirements for Social Work Training state that all social work programmes must: “Ensure that the teaching of theoretical knowledge, skills and values is based on their application to practice.” (Department of Health 2002)

Theorists, such as Bowlby, Bronbenfrener and Erikson, have different perspectives on life span development stages and the individual’s evolved behaviour as a consequence or a response to developmental milestones crises. These theories are rooted in the disciplines of sociology, biology and psychology. Each theory provides an explanation, in line with development, for arising issues and problems that individuals face and are all relevant to an understanding of the life course development. (Thompson)

Social work practitioners need to have a wide range of knowledge from a span of theoretical disciplines to ensure that all aspects of an individual’s make-up are considered and appreciated when working with them. (Crawford and walker) Using theory can give an explanation as to why an action resulted in a particular consequence. This can help us review and possibly change our practice in an attempt to make the consequences more effective. (Beckett)

Developmental theory provides a framework for ordering the lifecycle and accounts. For factors that may shape development at specific stages. It discusses the multiple. Bio-psycho-social factors impacting development, explores the tasks to be accomplished. At each stage and considers successes and failures in light of other stages. Developmental theories also aim to recognise individual differences in development. Journal

The course of life is different for each individual, and is influenced by the events and experiences that people go through throughout their lives. (Crawford and Walker, 2003) Understanding the impact of transitions within a person’s course of life is important for social work practice, as it aids the social worker in attaining a firm understanding of other people’s lives, so they can effectively intervene with appropriate measures. Using theory can help justify actions and explain practice to service users, carers and society in general. The aim is for this to lead to social work becoming more widely accountable and ultimately more respected. (Beckett )

The use of theories in social work practice underpins how social workers approach their tasks. As social workers, we need to recognise the opportunities to work with people through transitions as an opportunity to grow. We need to try to enable people to use these events to trigger change, move on and develop. (Crawford) When a social worker works with an individual, utilising theories which may relate to a specific situation, will give us more direction in our work. It is clear then that theory is important in practice – both for work with service users and for social work to be more valued in society. (Beckett)

After the definition of human growth and development and the brief discussion of why a theory is important in social work practice, this report will now discuss the attachment theory and will explain why it can be positively used in approach and effectively in practice.4

So, what is the ‘attachment theory’? To start with, let’s define the word attachment; it means a strong emotional bond between two people.

Forming an attachment is based on a two-way interaction. The behaviours from an infant, such as crying, reaching, grasping and making eye contact, and the response of the caregiver both work as a reciprocal process to develop and strengthen attachment. (Woods) According to (Crawford), children use the people they are attached to as a safe base to explore, a source of comfort and a source of encouragement and guidance.

According to (Fahlberg, 1991, cited in Howe), attachment aids children in attaining their full intellectual potential, sorts out what children perceives, assists them in logical thinking, helps them develop a conscience, teaches them to become more self-reliant, aids them in coping with stress and frustration, helps them handle fear and worry, assists them in developing future relationships and helps reduce jealousy.

In 1953, a psychoanalyst named John Bowlby wrote the book Child Care and the Growth of Love. In this book, Bowlby put forward his theory that the relationship between a mother and her child, during the child’s first year, is of vital importance and can greatly affect the development of the child in later life.

This theory is known as the attachment theory, and it is still being used and discussed today, although it has been altered and adapted to suit the modern day economic environment and the change in the family unit over the past 50+ years. (Jeremy Holmes, 1993)

Bowlby believes that attachment begins at infancy and develops throughout an individual’s life, and that there are many distinctive behavioural control systems needed for continued existence and proliferation. The attachment and exploration systems are the main central points in Bowlby’s attachment theory. (Elliot & Reis, 2003)

(Crawford) Bowlby’s “Maternal deprivation Hypostasis”, the forerunner of the attachment theory, believes that if an infant was unable to develop a warm, intimate and continuous relationship with his or her mother or permanent mother substitute, then the child would have difficulty forming relationships with other people, and would be at the risk of behavioural disorders. Bowlby says: “Mother’s love in infancy and childhood is as important for mental health as vitamins and proteins are for physical health.” (Cardwell)

(Bowlby 1988) goes on to say that without a secure base of first attachment relationships, children will not be able to cope with separations of normal life. For Bowlby, the impact of prolonged separation on children is viewed as maternal deprivation. Bowlby describes this as being the temporary or permanent loss to children of their mothers’ care and attention. Bowlby believes that prolonged separation of children from their mothers, especially during the first five years of their lives, is a major cause of delinquent behaviours and mental health issues. (Crawford)

Mary Ainsworth developed a method, whereby a child’s behaviour is observed when reunited with his or her mother after a short separation. This is known as the ‘strange situation’, and it has become widely used to determine whether the attachment was secure or insecure. Ainsworth’s strange situation is used to measure Bowlby’s hypotheses that early relationship experiences affect later adult functioning. The strange situation procedure consists of eight three-minute episodes that have been arranged so as to create increasing levels of stress for a child that will activate attachment behaviours that researchers can then observe.

The resulting behaviour was used to classify the child into one of three categories. These categories are insecure avoidant attachment, secure attachment and insecure resistant attachment. Securely attached children were able to balance their need to explore the environment with their need for comfort and support from their caregiver in relation to their feelings of stress. Insecure avoidant attached children, when stressed, continued to explore the environment, showing minimal need for comfort and support. The children who were classified as having insecure resistant attachments stop their exploration and return to their care giver show the maximum amount of attachment behaviours. Main (1991) has since identified a fourth category that of the disorganised/ disorientated child. (Cardwell)

According to Bowlby a central tenet of attachment is that:

People developmental representations,

Or internal working models, that

Consist of expectations about the self, significant

Others and the relationship between the two. (Bowlby, 1969, 1973)

The main criticism of Bowlby’s attachment theory came from J.R. Harris. It is often assumed that hard working, kind, honest and well-respected parents will have children who will turn out to be like them. On the other hand, in the case of parents who are bad role models, rude, and disrespectful, the children will end up the same when they become adults. According to Harris, this may be far from the truth.

Harris (2008), believes that a parent does not determine a child’s personality or character, and that a child’s external social factors have more influence than anything else. A good example of this taken from Harris is a child from an immigrant family. Although the parents may well pick up a new language, they will still have an accent from their native language. The child, on the other hand, will learn the new language, and will speak it without an accent. Children are more influenced by their peers than their parents. (Harris, 1998).

Criticisms were also levelled at Bowlby’s theories because of his ideas that he concluded from work he had undertaken with juvenile delinquents who had been separated early in their lives from their mothers. The criticism is that the theories are unrepresentative of the general population, and involved too small a sample.

It was also argued that not all maternally deprived children became juvenile delinquents. But in agreement with Bowlby, Stroufe (1979) stated: “We cannot assume that early experiences will somehow be cancelled out by later experiences. Lasting consequences of early inadequate experiences may be subtle and complex.” (Cardwell)

Research has shown that, contrary to Bowlby’s idea of monotropy (one primary caregiver), children can form more than one significant attachment, and these need not be towards the biological parents, and can be of either sex, although there is often a definite hierarchy. An infant’s attachment to his or her father is as strong as the mother’s in the first few days of life. Then the attachment changes because of the different amount of time available for the parents to interact with the infant, given the work commitments. Both the mother and the father are important attachment figures for their infants, but the circumstances that lead to selecting the mother or the father may differ. For example, the father is usually selected for playing. (Schaffer & Emerson 1964)

According to Parke (1981), “Both the mother and the father are important attachment figures, the father is not just a poor substitute for the mother.” (Cardwell)

When looking at how attachment theory is applied to social work practice, Coulshed (1988) proposed that “psychology has been useful in the degree to which you can apply some of the theories, if you are prepared to see theoretical contributions as ways of enriching your thinking and understanding. You will gain a broad framework of information through which you will recognise the complexities and possible causes of human suffering.”

The attachment theory provides a valuable model in understanding relationships of families in need and promoting new and healthy attachments (Daniel et al 1999). The attachment theory has had an impact on many areas relating to how children are cared for, including the legal framework it operates under and how services for children have developed. Some of the areas, where clear links can be made to practice being underpinned by the attachment theory has effected changes, are;

When negotiating contact between children and their families it is undertaken from a child centre perspective rather from the adults involved. This may include having closer links with grandparents, relatives and any other persons who the child considers significantly important to them. (Howe)

Attachment theories underpin the policies that are relevant to the development of children in public care, and form the basis for assessing their needs, such as pre-placement and post-placement support systems. The effects of separation and loss that children have experienced can be taken into account when assessing their needs. (O’loughlin)

Social Work as a profession can promote the needs of children through influencing policy and practice e.g. acknowledgement that delays in placing children may be detrimental to their wellbeing should ensure that the adoption and fostering processes can be as speedy and efficient as possible. Likewise, it is clear from research that children are adversely affected by the loss of familiar peers. Children who maintain friendships over time are seen to have greater social skills and better social adjustment. This should also be promoted. (Aldegate et al)

The attachment theory has allowed optimism to develop towards caring for children, as a less distorted and confused picture of child development has emerged. It is now apparent that a healthy development can occur in many different family environments. There are many ‘right’ ways of meeting children’s needs. (O’Loughlin)

The second theory discussed in this report is derived from the discipline of sociology. Sociological theoretical perspectives explain human development by examining the interactions between people and the society in which they live. Sociologist theorists research this by looking at influencing factors at different levels of society. (Crawford)

Unlike other disciplines of human development theories in which service user’s problems are conceptualized on individual terms, sociological perspectives on human development seek to gain a full understanding by locating the person’s problems within his or her experiences in a broader picture of social and historical circumstances. In other words, rather than directly focusing on the problem and the person’s inability to cope, the problem would be assessed in terms of the impact of the economic and political conditions of the day. (Cunningham and Cunningham).

One theorist whose theory has being particularly influential in the study of human development is Uri Bronfenbrenner 1917 – 2005.

Bronfenbrenner developed a theory to explain how everything in a child and the child’s environment affects how a child grows and develops. His theory is known as the ecological systems theory, and it approaches a child’s development by looking at different levels of interaction, from family, local communities and schools to economic and political conditions that are all influential to the development of the individual in his or her course of life. He uses the terms Microsystems, exosystem and macrosystem. He suggests that there is a reciprocal process of interaction, in that the child is both influenced by and influences his or her environment at each of the levels. (Crawford)

The ecological environment is thought of as:

“Nested structures encircled within and inside the other like a set of Russian dolls. Starting with the most inside to the outside, these networks are described as micro systems, meso systems and macro systems” (Brunfenbrenner, 1994).

The work of Bronfenbrenner has been particularly influential in social work practice and is the model that underpins the framework for the assessment of children in need and their families (department of health, 2000 cited in Crawford). The theory also encourages social workers to grasp the concept and understanding of the sociological imagination, and develop this in relation to service users’ own lives and practice. As social work intervenes at the points where people interact with their environments (NOSS), this approach, therefore, helps social workers to locate service users within an understanding of the bigger picture that underlies their lives. (NOSS)

Applying an ecological approach can be best understood as looking at persons, families, cultures, communities and policies, and identifying and intervening upon strengths and weaknesses in the transactional processes between these systems. A practical example of this in practice would be the use of the ecological perspective when carrying out assessment and for planning intervention for older adults in the community. Although it is theoretical, it is very practical, as it provides a kind of a map to guide us through very confusing terrain Stevenson 1998 cited in aldegate)

The population of the UK is ageing. Over the last 25 years, the percentage of the population aged 65 and over increased from 15 per cent in 1984 to 16 per cent in 2009, an increase of 1.7 million people. (Gov statistics)

Elderly individuals are vulnerable and in need of social services because they often live alone, and can be subject to numerous health difficulties, such as difficulties in functional ability.

As senior adults experience an increased need for care, it is predicted that, in many cases, family caregivers will begin to have a higher level of physical, emotional and financial burden. All of these issues combined warrant an increase in research related to meeting the needs of the elderly and their families living in our communities (Crawford).

EST is an ideal approach for assessing the needs of elderly adults living in communities. Given the rapidly increasing numbers of baby boomers reaching retirement age and beginning to require extended support, it is important for communities and families to address the best fit for the senior adult later in life. EST addresses the micro, meso and macro systems that are an extension of the individual, and works to obtain resources in order to improve support and expand networks necessary to maintain good quality of life for senior adults. (Journal)

The ecological perspective analyzes how well the individual or family fits with their environment, and is based on the assumption that when a person or group is connected and engaged within a supportive environment, functioning improves. In order to determine the best fit, usually for an individual, there is an examination of the difference between the amount of social support needed by the person and the amount of social support available in the existing environment. Once this assessment has taken place, the social worker engages with the individual and works together with him or her to offer the support needed. One unique feature of the ecological model is its distinguished concept of human development within an environmental perspective. (Bekett)

Social work practice has an overarching meta-paradigm that emphasizes the person in the environment. This meta-paradigm is linked with an ecological systems perspective as a focus of attention. EST is compatible with this belief system and helps support a theoretical approach for practice at the micro, meso and macro levels with individuals, families and communities.

Social workers need to be aware of how the changing needs of families will affect psychosocial and emotional factors for the elderly individuals and their family caregivers. Examples of such issues include geographical location of family members when the senior adult is in need of care, role reversal when there is a shift in the family system and a parent becomes more dependent upon an adult child, and the anticipated grief and bereavement as spouses and adult children care for elderly family members over an extended period of time.

The final theory of discussion is Erick Erikson’s eight stages of man. Erikson’s theory is an extension and modification to Freud’s psychoanalytical theory on explaining the development of the personality through childhood stages of psychosexual development. Erikson, however, provides a more comprehensive framework for human lifespan through a series of genetically influenced sequence of psychosocial stages. “The term psychosocial describes an approach that considers the impact of both the individual psychology and the social context of people’s lives on their individual development.”(Crawford) Each stage involves a battle between contradictory resultant personalities, and each stage has either adaptive or maladaptive qualities. To develop into a healthy, mature adult, the adaptive must outweigh the maladaptive. (Richard Gross, 2005). In other words, he suggests that people confront a series of developmental challenges or conflicts, each occurring at particular and predictable times or stages in their lives.

One of the main elements of Erikson’s psychosocial stage theory is the development of ego identity. Ego identity is the conscious sense of self that we develop through social interaction. According to Erikson, our ego identity is constantly changing owing to new experience and information we acquire in our daily interactions with others. In addition to ego identity (Quote), Erikson believes that a sense of competence also motivates behaviours and actions. Each stage in Erikson’s theory is concerned with becoming competent in an area of life. If the stage is handled well, the person will feel a sense of mastery, which he sometimes refers to as ego strength or ego quality. If the stage is managed poorly, the person will emerge with a sense of inadequacy. (Quote)

In each stage, Erikson believes people experience a conflict that serves as a turning point in development. In Erikson’s view, these conflicts are centred on either developing a psychological quality or failing to develop that quality. During these times, the potential for personal growth is high, but so is the potential for failure.

Erikson’s eight life stages:

1. Basic trust versus mistrust

2. Self-control versus shame and doubt

3. Initiative versus guilt

4. Competence versus inferiority

5. Identity versus role confusion

6. Intimacy versus isolation

7. Generativity versus stagnation

8. Ego-integrity versus despair

Erikson suggests that whereas the outcome of moving through a life stage is unfavourable, the individual will find it more challenging to meet the trials of the next stage. Erikson further suggests that if individuals fail to develop through a stage, they may return to unsettled earlier points in their lives. (Crawford)

Stage five is commonly associated with adolescence Erickson 1995 recognised this as the critical crisis of adolescence in the eight stages of development – identity versus role confusion. He believes that a successful transition through childhood would lead to a progressive success to resolve this stage (Crawford). Erikson considers the fifth stage, that of adolescence, in the developmental process to be of particular importance. He considers that by the end of this period of psychosocial moratorium, adolescents should have achieved ego identity, that is the integration of their own ‘self’ perceptions into their core identity which is both psychological and social. But he notes that some young people experience difficulty or find it impossible to commit themselves to adult roles, thus characterizing this as a period of identity crisis. When adolescents fail to achieve ego identity, it is considered to be identity role diffusion.

Applying Erikson’s model to social work can help identify with individuals whether or not they have progressed successfully at previous life stages. It can also help individuals clarify and address their strengths, expectations and limitations, a duty expected of the social worker according to NOSS Key role 1(Crawford).

The psychosocial perspective enables social workers to consider the influences of the relationship between the internal world of the service users and the social environment in which they live. (Howe 1987 cited in Crawford)

However, Erikson’s stages are criticised alongside other psychosocial stage approaches to human development because they do not incorporate difference and diversity. They are culturally specific and differences between sexuality and gender are not easily explained, because the theory was developed from a male perspective. Crawford

Being too fixed and deterministic in real life, it is not possible to divide one’s life into neat stages. The theory also does not consider the significance of social change in different societies and across different cultures. The model suggests there are universal experiences that all people encounter. Anthony Giddens 1991 cited in Crawford argues that modern society is continually changing, and that people pursue many different paths through their lives.

Erikson describes the concept of a life cycle as implying some kind of self completion (Erikson, 1982 p. 9 cited in Crawford). This use of the word cycle can be criticised for implying a circular process whereby, in the later years of life, there is a return to the dependency of childhood. (Crawford)

In conclusion this assignment has looked at

Social workers need to develop an understanding of theories from a range of disciplines in order to take a holistic approach to their practice. (Crawford)

Whilst it is important for social workers to have knowledge of these theories, none of the theories can be easily applied to explain a person’s course of life. One theory may be relevant to a particular person at a particular moment in time. For example, one theory may be useful for child development, but not so useful in explaining the challenges of life events that influence growth and development in later life. (Crawford and Walker, 2003) All people are individuals and deserve the right to be treated as such. To do anything less would be seen as an act of oppressive practice. Social workers need to draw on many different resources and theories available to them in order to truly meet service user’s needs. (Beckett 2007)