Dangers of Dual Relationships in Therapy

Often, people who seek the help of a therapist are vulnerable in a number of ways, and the unique relationship of client and therapist is built on a great deal of trust and openness where a number of issues are exposed. This situation can often leave a patient or client feeling more vulnerable than ever before, and depression, anxiety, and other mental health concerns can easily cloud a client’s judgment. Because the client-therapist relationship is a relationship of power, it is more important than ever that therapists do not give into seduction or sexual attraction that may exist for a client, and that sexual relationships with clients and patients not be allowed to develop.

Although some studies have been done on the existence of client therapist sexual relationships, it is evident that many of the results of these surveys are unreliable due to the nature of the situation. Even when confidentiality is assured, many therapists are fearful of the repercussions of being exposed and are reluctant to divulge such information. Still, these studies confirm that sexual relationships still often do occur between therapists and clients, more frequently in male practitioners than females. Furthermore, these studies have also revealed that these kinds of relationships can be further detrimental to clients and patients who seek the help of professional therapists.

Sexual relationships between counselors and clients has existed probably since the beginning of time, being noted as far back as the fifth century B.C., when the Hippocratic Oath originated, stating, “In every house where I come, I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially from the pleasures of love with women and men.”

However, recent studies and even court cases have confirmed that this phenomenon continues and in many cases, is further detrimental to the mental health of the clients who enter into these types of relationships. For clients who are dealing with issues related to domestic violence, abuse, rape, or incest, the abuse of trust and power that occurs with sexual client-therapist relationships can increase feelings of trauma and psychological distress, often triggering symptoms of post-traumatic stress disorder. Even in clients who are not dealing with these kinds of issues, increased depression and anxiety can occur, and a patient who has been involved in a sexual relationship with a therapist is often more likely to attempt suicide and further resistant to additional treatment.

Also, studies have revealed that sexual relationships between therapists and patients are frequently associated with cognitive dysfunction, feelings of emptiness and isolation, an impaired ability to trust, increased feelings of guilt, confusion regarding boundaries, and suppression of anger. Although these types of symptoms are not noted in every client who has been involved in a sexual relationship with a therapist, many of these symptoms were seen as common in clients who had engaged in this type of relationship. In short, therapy is the most successful when boundaries and trust of the client are not violated and a professional relationship is maintained, and in nearly every jurisdiction, it is the responsibility of the therapist to maintain this professional relationship.

In fact, the legal consequences for therapists who do enter into a sexual relationship with a client can be severe in many states. In order for therapists and other mental health professionals to maintain their professional licenses, most states not only mandate that there be no sexual relationships with clients, but also that there is no sexual relationship with a former client as well. While in some states the requirement is that the client has not been a patient for at least two years, in others the guidelines stipulate at least five years. In addition, the mental health professional may be obligated to prove that the relationship is not exploitative in nature and that the client is fully capable of making their own decisions regarding the relationship.

For therapists and mental health professionals who do engage in a sexual relationship with a client, the penalties can be severe. Not only can a therapist lose their professional license for such acts if the relationship is discovered, but they can also be sued for malpractice and violation of trust in many instances. Maintaining a professional relationship at all times is not only in the best interest of the client and their mental well-being, but also in the best interest of the practitioner and their professional reputation.

Social Construction of Childhood Essay

In order to consider how child protection policy and practice has been shaped, a definition of child protection and significant harm and abuse is required. The Department for Education (DFE, 2011) defines child protection as the action that is carried out to safeguard children who are suffering, or are likely to suffer, significant harm. Furthermore the Children Act (1989) defines harm as ill-treatment including neglect, emotional, sexual and physical abuse. Interestingly, Parton et al (2012) suggested that determinations of what should be considered child abuse are socially constructed, and are therefore reflective of the culture and values at a specific moment in time.

To begin, childhood is a status that is documented worldwide and throughout history, which sometimes sees the child as innocent ,vulnerable, a consumer, a worker alongside other household earners, a threat to society and it is a construction that changes over time and place (Prout, 2005). Historians of childhood have argued over the meaning, such as Aries (1960) cited by Veerman (1992, p5) stated the concept of ‘childhood’ didn’t exist before the seventeenth century; therefore children were mini adults with the same rights, duties and skills. This idea was supported by the poor law (1601) which was a formal system of training children in trades to contribute to society when they grew up (Bloy, 2002).

Another example came from Locke (1632-1734) and the ‘Tabula Rasa’ model. This proposes that children were morally neutral and were the products of their parents (Horner, 2012). The nineteenth century showed it was the parent’s responsibility to offer love and pertinent correction, to bring out the good in their nature thus helping them to become contributing members of society. This could easily lead to blaming the parents as good or bad based on the behaviours of their child, since the child was not considered as his own agent. Legislation such as the 1834 Poor Law Reform Act would support Locke’s idea as children who were sent to workhouses, would participate in schooling to imprint knowledge. Evidently a number of scandals occurred from inmates eating rotting flesh from bones to survive. The government’s response implemented sterner rules for those operating workhouses, along with regular inspections (cited by Berry 1999, p29). Fox Harding (1997) described this era as ‘laissez faire’ which was based on the family being private with minimal state intervention around children.

An alternative concept from Rousseau (1712) suggested the idea childhood being about innocence and a child was born angelic until the world influenced them. This was significant in terms of child protection with the implementation of children’s charities such as Save the Children (founded in 1919). They portrayed children in a variety of adult situations and as poor victims worthy of being rescued using contemporary ideas of childhood (Macek, 2006). Interestingly the Children and Young Person’s Act (1933) was also introduced to protect these children from any person legally liable and likely to cause injury to their health. What is obvious is that harm was not clearly understood, considering caning in schools was common until 1987 and stopped because of corporal punishment being abused in schools (Lutomia and Sikolia, 2006).

Moving into the twentieth century took a wide shift from the ‘laissez faire’ approach and along with the concept of childhood, became the notion of state paternalism. Child protection practice was based on extensive state intervention to protect children from poor parental care (Fox Harding, 1997). These changes led to a sharing of blame with their parents for children becoming anti-social (a demon) or a great achiever (an angel) in society. The demonic model illustrated by Pifer (2000) was already seen in childhood construction but blamed society, not the child, when as Rousseau noted is the romantic discourse that becomes tainted with the crooked outside world. These historical concepts dictated that children should be seen and not heard and every aspect of the child’s life should be determined by their parents or guardians. Although the shift is evident, it could be argued that the laissez faire and paternalist perspective shared a common view of children having limited capacity for independence and decision making. Pollock (1983) would argue that children were not miniature adults as Aries (1960) claimed, but actually were at a significantly a lower level of development and so had distinctive needs from adults. This suggests as immature people they could make mistakes and be excused from full responsibility for their actions.

Given the current high profile debates on children, it is public outrage and moral panics in the media that frequently changes the way things are seen. The research into child deaths has prompted changes in legislation (Parton et al, 2012). Key events such as the death of Maria Coldwell (1974) and Jasmine Beckford (1984), led to specialist workers instead of generic workers. The immediate bureaucratic response which reframed child protection practice was no longer intervention into preventative work but became more focused on assessing risk. Serious case review’s in to a child’s death was undertaken as a way of discovering how the tragedy occurred, who was responsible, what professionals were involved, rationalising individual actions and learning lessons for future practice (Rose and Barnes, 2008). The public’s perception of social workers placed more pressure on this notion of identifying risk before the child died which developed many theories and models for the professional to practice.

In contrast to the numerous child deaths, the Cleveland case in 1988 evidenced the over enthusiasm of state intervention. Children were removed from their families based on medical assessments grounded on uncertain scientific knowledge (Hawkes, 2002). The inquiry recommended greater rights for parents and children and suggests the separation from families was seen as abuse itself (Ashden, 2004). This, and proceeding enquires into the deaths of children, offered dilemmas for social workers representing the most visible agencies within the child protection system, in terms of whether a child should be removed or not. This event was a major policy driver to the Children Act 1989, where parent’s rights have been replaced with responsibility and ensuring children turn out to be good citizens of society. However it could be argued that in practice today the Cleveland event still carries stigma with parents believing their children are going to be taken into care. Sexual abuse statistics from the NSPCC (2012) state 20, 758 children in 2009 were subject to sexual abuse with a decline in 2010/11 to 17,727. This result could offer a suggestion that preventative work and forceful criminal justice system in the last two decades is responsible. Alternatively it could be argued there may have been no decline at all and is purely a drop in the number of cases being identified.

Interestingly Child protection: Messages from Research conducted in the early 1990’s (DoH, 1995) examined the role of the Children Act 1989. The document defied the socio-medical model of child abuse and reframed and contextualised the notion of the ‘dangerous family’. This suggested that the responsibility was to be laid on the parents of children that fall out of particular construct in order to combat poverty and crimes. Children such the murderers of Jamie Bulger in 1993 were children carrying out unthinkable, far from innocent acts. However this case offered a different construct as children with a ‘dual status’. They committed a crime as an adult yet they were still children in need of protection. Society wanted to look at their background to decide if watching horror movies or having divorced parents or poor discipline made them kill a little boy.

Given the media’s response the nature nurture debate came to the forefront with notions of being born bad, to being made bad. Fascinatingly the historical view had been to protect children, yet moral panics made society shift to demonising children, branding them as wicked and evil (Bracchi, 2010). The legislation that had previously sought to protect children had also come into conflict with the boundaries of criminal law, as it does not recognise them as children over ten years of age (Molan, 2008). It could be argued that criminal law agrees with Aries (1960) and children are mini adults, yet social workers guidance refers to children up to the age of seventeen. One could question how professionals can work together when legislations cannot agree what age a child is.

Further spotlight cases such as Victoria Climbie (2003) highlighted failings of multi-agency workers (Lamming 2003) and facilitated to shape the next change in legislation. The Every Child Matters green paper which outlined five outcomes to be achieved by all children was enshrined in law as part of The Children’s Act (2004). These were defined as, stay safe, be healthy, enjoy and achieve, achieve economic wellbeing, and make a positive contribution (Knowles, 2006) which gave professionals direction on the minimum requirements for every child, and allowed social workers to intervene to meet these needs in child protection practice. Nonetheless, the coalition government in 2010 abolished this agenda (McDermid, 2012) suggesting that families are not as important, even though it has underpinned social work practice for a number of years.

Nevertheless child deaths continued to be a growing problem, the Baby Peter case (2008) indicated that individuals are failing children and again multi-agency communication is poor in assessing risk. Another case that followed approximately a year later was the Edlington boys (2009) who tortured two young boys. Society then blamed foster placements and care systems suggesting they do not work and foster placements are as bad as the families they were removed from. Cases such as these developed blame culture, where children were perceived as being failed by the government workers; usually the social workers less often the police and the politicians (Community Care, 2012). The public outcries and criticisms of social services made social workers practice on the side of caution. This suggests the romantic concept of childhood (i.e. protection of innocence), came to the forefront and children were seen as vulnerable and in need of protection. It appears that each disaster that happens the social construct of children changes.

Indeed, researchers into twenty-first century childhood such as Sue Palmer (2006) refers to a ‘Toxic Childhood’ which is the harm society is causing to children through a competitive, consumer driven, screen-based lifestyle. The media and internet evidence how much it has made it available for children to consider adult notions and behaviours, alcohol, sexual activity, drug use and teenage violence that show that differences between adulthood and childhood are disappearing. Nevertheless it could be debated that contradictory attitudes remain commonplace with children being constructed as innocent little angels and little devils, innately capable of the most awful types of crime until the adults in society influenced them as Rousseau (1712) noted.

Despite these criticisms the families that children live continue to be judged as secretive with children growing into poor citizens due to not being protected by them. Very often poor families are classed as poor parents and certain constructions take place without the family even being assessed. To exemplify Tucks (2002) identified a connection between all forms of abuse and social deprivation, but a possible explanation is that perpetrators target vulnerable children or women to secure access to children; socially deprived neighbourhoods are characterised by relatively large numbers of lone parents. Through the pressures of their circumstances and in family crisis, parents had become caught up in a child protection system that was more attuned to assessing risk than to bringing out the best in parents struggling in adversity (DoH, 1995).

Moreover Owen and Pritchard (1993) identified the difficulties in classifying ‘at risk’ and the criterion for assessing what constitutes abuse. Indeed professionals hold a variety of opinions towards what constitutes abuse and could be argued that this alone diminishes the identification of risk to a child. Nonetheless professionals are still expected to protect children by the Children Act 1989 which does outlines ‘significant harm’, but it is very ambiguous in terms of definition (Brandon et al 1999). Munro’s report (2011) on Child Protection agrees that social work involves working with this uncertainty and not able to see what goes on in families which suggests little shift . The defensive practice may come from workers who are expected to manage this uncertainty if the issue of abuse and neglect is not clearly labelled.

Since the implementation of the Children Act 1989 the emphasis on the child’s rights has become very controversial. The idea of protecting children by giving those rights may have been problematic for adults in terms of taking them seriously which arguably could be minimal representation they have had over the years. Additionally adults may be averse to handing over power to their children, because as the early historians suggested, the adult knows what is best for their children. Franklin (2002) suggests a conflict between adult’s rights and children’s rights could offer explanations for ‘demonization’ of children. Another idea could be that giving children rights takes away a child’s ‘childhood’. This may have been viewed from the idealistic construction of childhood being a period of innocence where they consider that children should not be concerned with important decision-making and responsibility.

To further support children’s rights, the Children Act 2004 updated the legislation to include the abolishment of physical punishment (NSPCC, 2012). However, Owen and Pritchard’s (1983) idea of ‘cultural relativism’ whereby specific behaviours in some families is attributed to cultural practice, questions the concept of how significant harm can actually be measured. In cases of child abuse, black and ethnic minority children could arguably be at a higher risk, as warning signs that would have been picked up are ignored and accepted to be cultural practices and norms. For instance Rogers, Hevey and Ash (1989) state that the beating of West Indian children can be viewed as traditional use of chastisement within that culture, rather than observed as physical abuse of children. Owen and Pritchard (1983) propose this aspect to ‘racist beliefs’ and stereotyping, where culture is considered deviant rather than the actions of a caregiver.

Conversely Munro (2008) considers Effective Child Protection and points out the significance on the value of relationships between families and the worker and suggests this leads to better outcomes by understanding the families and cultures. An effective assessment and intervention in child protection draws from having good interactions and aids parents to disclose information and collaborate with authorities. It could be argued if a worker does not believe in certain cultural practices that children could become at risk when maybe they are not.

Another point to consider is the risk posed by professionals that work with children. Society has created an assumption that the rich, social workers, teachers and other professionals that work in child focused roles follow the legislation on protecting our children from significant harm. Yet through the power of this trust professionals have abused in ‘safe’ spaces for children. For example the murder of Jessica Chapman and Holly Wells by the school caretaker in 2002, identified ‘significant failings with regard to police vetting procedures’ (HMIC, 2004) and the notion of grooming and abusing positions of trust was incorporated into the Sexual Offences Act 2003.

Considering the Act was implemented in 2003 Nursery manager Vanessa George was found guilty in 2009 of abusing children in her nursery. The review found a systemic failure in communication throughout and highlighted a common theme of assumption provided a fruitful environment in which to abuse, a point that has been proficiently highlighted by the mainstream press. The child protection policies and procedures were inadequate and rarely followed (Community Care, 2009). This suggests that Vanessa prayed on the innocence of children knowing how society views her as a practitioner.

Cases such as this called for a review of vetting adults who work with children and formed a piece of legislation, the protection of freedoms Act (2012) which focuses on roles working closely with vulnerable groups. Some children related posts such as governors and school inspectors were being removed from the lists although they require having contact with children (Kelly, 2012). Additionally supervised volunteers will no longer be classed as working in ‘regulated activity’. Therefore, individuals barred from working in ‘regulated activity’ can still volunteer at your school, as long as they are supervised. It could be argued that although the government is keen to scale back the cost of vetting, it does not take into account the risk of grooming which is not negated by supervision. Furthermore, this process does not allow schools to check the barred list when recruiting volunteers which suggests it is providing a false sense of security for all.

A further report into child protection by Munro A child centred practice in 2011, established that a universal approach to child protection is preventing the main focus of the child. Munro recommended that the Government and local authorities should continually learn from what has happened in the past, however this could be difficult when cases such as Jamie Buglers that clamped the hatchet to protect the boys. One could question what lessons can be learnt from such secretive cases. Additionally, it could be argued that Munro’s child centred approach offers a potential negative impact on children and professionals. For instance, if the government removes the prescriptive practice that professionals may be using as guidance, this could create the potential to miss the signs of a child being abused based on judgement alone.

Having considered this idea, future risks assessment needs to change, a theoretical and practical model needs to be considered to allow state intervention in cases where a caregivers ability to care for a child is questioned. The British government will be pivotal to play a major role in reforming existing legislation and constructing new strong legislation to allow involvement by care services in the most high risk cases of child abuse. This request on the government is a consequence of the philosophy of risk now predominant in the UK, and is assumed that the government has the skill to anticipate and stop abuse and harm which in turn holds the government responsible when this does not happen.

In conclusion, the historical views of childhood can be seen throughout the numerous ideological discourses which determine how constructions of childhood continue to influence laws and legislation concerning the ways in which child protection is shaped. Although it is recognised that childhood warrants some degree of protective status, socioeconomic and cultural circumstances also affect young children’s behaviour and the way professionals practice. Those changed conditions also influence adult beliefs about rearing children and how protecting children should be. The emphasis on risk and assessing risk has changed over time, certainly through media, society and legislation.

As outlined there are some recurrent issues such as the recognition of significant harm, taking appropriate action, effective communication and achieving an appropriate balance between supporting families and disruptive intervention to safeguard and promote children’s welfare. Nevertheless child protection has been around for a number of years and indicates that there is a correlation between legislation, society and the construct of childhood which continually mirrors each other and will probably continue to do so.

The Conduct Of Inter Professional Practice Social Work Essay

This study aims to investigate the conduct of inter-professional practice in areas of social and health care, with specific regard to the involvement of service users in such practice. The case study prepared by the City and Hackney Local Safeguarding Children Board on Child A and Child B is taken up for analysis and review in this context. The case study is taken as read and is not elaborated for the purpose of this essay.

Health and social care in the UK is currently being significantly influenced by a growing commitment towards greater public involvement in the design, delivery and evaluation of services, greater availability and choice of services for all categories of service users, reduction of inequality, greater emphasis on provisioning of services at the local level, (including from the independent and voluntary sectors), the commissioning process, integration of social and health care, and professional roles for delivery of care on the basis of actual needs of service users (Barrett, et al, 2005, p 74).

Such reforms call for the blurring of strict boundaries between the different professionals and agencies working in health and social care (Cowley, et al, 2002, p 32). They also call for greater inter-professional and inter-agency working and for significant alterations in organisational cultures in order to enhance the power base of service users and members of the public in different aspects of social care provision (Cowley, et al, 2002, p 32).

It is now widely accepted that health and social care professionals need to be more responsive to the rapidly changing needs of service users. Such changes call for the development of health and social care practitioners to improve care for clients and service users (Day, 2006, p 23). Such improvement is required to be brought about by more emphasis on person centred care for clients and service users and the greater involvement of such people in different aspects of planning, delivery and evaluation (Day, 2006, p 23).

The increasing contemporary emphasis on user involvement in the policy and practice of social care is however coming in for increasing questioning from disenchanted service users and service user organisations (Branfield & Beresford, 2006, p 2). Service users, whilst highlighting the benefits of their involvement in the social and health care process, are raising various questions about their actual participation in social and health care and the continuance of various barriers that prevent their genuine contribution to the process (Branfield & Beresford, 2006, p 2).

The case study under question details the results of an enquiry into an episode, wherein a mentally disturbed mother killed her two children after (a) being released from institutional surroundings, and (b) being integrated with her children with the full knowledge and approval of an overseeing group of social, health, nursing and mental health professionals. The enquiry raises disturbing issues about the extent of involvement of service users in social and health care processes and in the decision making of the inter-professional group overseeing the care, treatment and rehabilitation of a mentally disturbed and potentially dangerous individual.

The essay investigates the involvement of service users in inter-professional practice in the UK, with specific regard to the case study and the enquiry report. Whilst doing so it takes cognizance of (a) identification of sources for evidence based social work practice, (b) the use of enquiry reports as sources of evidence, (c) the relevance of themes that emerge from such enquiries, and (d) the implications of evidenced based practice for the development of practice in social work. The essay is analysed vis-a-vis the Every Child Matters programme and makes use of legal, political and ethical frameworks.

Inter-professional Practice

Inter-professional practice and inter-agency collaboration aims to ensure the coming together of service providers, agencies, professionals, carers and service users in order to improve the final level of quality of planning and delivery of services (Mathias & Thompson, 2001, p 39. Whilst partnership and collaboration are often considered to be interchangeable, collaboration is the actual foundation for joint working and the basis for all successful partnerships (Mathias & Thompson, 2001, p 39).

The UK has been enacting legislation and policies for the promotion of Inter-professional and inter-agency collaboration (IPIAC) for the last five decades in order to enhance standards and reduce costs in health and social care (SCIE, 2009, p 1 and 2). The development of IPIAC was shaped by the white paper Caring for People in 1989, followed by the enactment of the NHS and Community Care Act 1990. The government has in recent years issued various policy documents for the promotion of collaboration in order to improve efficiency and effectiveness (SCIE, 2009, p 1).

Greater emphasis on IPIAC is expected to improve care because different professional groups like social workers, physicians, teachers and police officers will during the course of such working bring their individual perspectives to the collaborative process (SCIE, 2009, p 1and 2). The IPIAC process will aim to ensure the best ways in which such individual and sometimes differing perspectives can be made to come together, as also the ways whereby respective contributions of different professionals and agencies can be utilised to enhance standards of service and experiences of service users and carers (Freeth, 2001, p 38). Consideration requires to be given to collaboration between organisations, as well as professionals, in the course of IPIAC working. It is also important to consider the differences in the working practices and cultures of the various organisations that are required to work together and to take appropriate action to minimise the impact of such differences in order to make inter-professional practice effective (Freeth, 2001, p 38).

Policy makers and practitioners agree that adoption of IPIAC will result in greater service delivery despite the existence of various personal, individual and organisational barriers that can practically hinder its efficiency and effectiveness (Day, 2006, p 23). It is however also widely accepted that effective IPIAC working cannot take place in the absence of deliberate involvement of service users and clients in all stages of planning, delivery and evaluation processes (Day, 2006, p 23). The white paper Modernising Social Services, published in 1998 clearly states that people cannot be placed in neat service categories and users will inevitably suffer if partner agencies do not work together (SCIE, 2009, p 1).It is now mandatory that social work programmes, as well as nursing and midwifery, embrace the involvement of patients and service users. Contemporary government reforms are based on public involvement in different aspects of service delivery (SCIE, 2009, p 2). Person centred approaches in health and social care recognise the need for valuing the opinions and experiences of patients and service users and the adoption of person centred approaches by social work practitioners (SCIE, 2009, p 2).

Current research however reveals that service users often feel left out of the process of social care, despite the progressive implementation of IPIAC concepts and approaches (Branfield & Beresford, 2006, p 2). Service user organisations state that the knowledge of service users is by and large not taken seriously or valued by professionals and service agencies. Many service users find such attitudes from professionals and agencies to be intensely disappointing and disempowering (Branfield & Beresford, 2006, p 3). Agencies and practitioners do not appear to be interested in the information provided by service users and do not accord the respect to such knowledge that they otherwise provide to professional knowledge and expertise. Service users also feel that the cultures of social and health care organisations continue to be closed to service user knowledge and reluctant to change (Branfield & Beresford, 2006, p 3).

The study of the case review of the episode involving the deaths of child A and child B appears to reinforce the impression of service users about their continued exclusion from the working and decisions of different agencies and professionals involved in delivery of social and health care (Henderson, p 261). The Every Child Matters Programme requires social work agencies and professionals like social workers, health care specialists, teachers, nurses, doctors and mental health professionals to constantly ensure the safety, security and protection of children wherever they can. Extant legislation and policies like The Children Act 2004 and the Every Child Matters Programme clarify that it is everyoneaa‚¬a„?s job to ensure the safety of children (Henderson, p 261).

The report clarifies that various agencies were involved in the assessment and treatment of Ms. C, the wife of Mr. D and the mother of the two children, child A and child B. The report further reveals that agencies, as well as individual practitioners, failed to consider the views, opinions, and experiences of service users, even as it also contains a number of examples of sound agency and inter-agency practice. There is limited evidence of professional contact with Mr. D, the father of the children, after the contact session in October 2006, and it appears likely that professional networks assumed the agreement of Mr. D with arrangements for Ms. C. Professionals also paid inadequate attention during their provisioning of support to Ms. C, in response to her request for re-housing, and did not communicate with Mr. D to ensure that future arrangements would serve the best interests of the children. Interviews conducted with Mr. D and his parents also revealed significant differences between their expectations of the roles of social workers roles and what was implied by the records kept in the agency. Mr. Daa‚¬a„?s family members, it appears, were clearly under the impression that they had little choice in the rehabilitation process and were furthermore required to facilitate the contact of the children with their mother.

Whilst the report elaborates the role and sincerity of various agencies and professionals in assessing Ms. Caa‚¬a„?s condition and her rehabilitation in society, it specifically refers to (a) the under involvement of Mr. D in the process, (b) the lack of communication with him (Mr D) by social workers and agencies, (c) the differences in perceptions about the role of social workers between Mr. D and his family and the agency, (d) the poor communication of agencies with the parents, (e) the absence of school records of children, and (e) the scope for improvement of involvement of GPs and the police in the social care process.

Although the report makes several recommendations, the specific references to involvement of service users calls for detailed and greater involvement of parents and carers of children in planning of discharge and assessment of risk in order to ensure that actions are based on full information. One of the agencies, the East London and the City Mental Trust has been asked to involve family members and carers of children in all processes, even as the Hackney Children and Young Peopleaa‚¬a„?s Service has been directed to ensure that decisions are not taken on issues that can affect children without communicating carefully and appropriately with current carers.

Emerging Themes and Evidenced Based Practice

The revelations of the enquiry into the report reveal a number of themes in different areas of inter-professional practice, inter-agency working and the involvement of service users in planning, delivery, and evaluation of health and social care, which can be beneficially used to inform future social work practice.

The report specifically refers to (a) the lack of participation of services users in social and health care processes, and (b) the involvement of different agencies in their exclusion, thereby reinforcing the need for greater emphasis by agencies and practitioners on involvement of service users in their care plans. It also becomes obvious that much of the sentiments and ideas about involvement of service users in social care processes continues to remain in the realm of rhetoric and that it will need determined and deliberate effort by practitioners to truly bring services users into the actual planning, intervention and evaluation functions of social work practice.

Enquiry reports serve as important sources of evidence for development of future social work practice. The impact of the enquiry conducted by Lord Laming into the death of Victoria Climbie led to the revelation of evidence on gross inadequacies in the social care system for children and widespread organisational malaise (Roberts & Yeager, 2006, p 19). The publication of the report led to radical changes in governmental policy on social care for children and to the introduction of the Every Child Matters Programme and other important policies for the physical and mental welfare of children (Roberts & Yeager, 2006, p 19).

The utilisation of research evidence for guidance of practice and development of policies in the area of social services and health care is becoming increasingly important for enhancing the effectiveness of social and health care interventions, especially so because of the limited available resources with the government and the pressures to achieve positive outcomes (Johnson & Austin, 2005, p 5). Scholars however feel that much of research based evidence is not absorbed by practitioners and have identified five important requirements for research evidence to practically influence practice and policy, namely (a) concurrence on nature of evidence, (b) a strategic approach to the conception of evidence and the progression of an increasing knowledge base, (c) effective distribution of knowledge along with development of useful means for accessing knowledge, (d) initiatives for increasing use of evidence in policy and practice, and (5) a range of actions at organisational level to increase use of evidence (Johnson & Austin, 2005, p 5).

Conclusions

This study investigates the conduct of inter-professional practice in areas of social and health care, with specific regard to the involvement of service users in such practice. The case study prepared by the City and Hackney Local Safeguarding Children Board on Child A and Child B is specifically taken up contextual review.

Inter-professional practice aims to ensure the collaborative working of service providers, agencies, professionals, carers and service users in order to improve the planning and delivery of services. Policy makers and practitioners also agree that whilst adoption of inter-professional working is likely to lead to improved care, it cannot occur without the involvement of service users in all stages of the care process. Person centred approaches also recognise the importance of considering the opinions and experiences of service users in planning, intervention and evaluation of care. Contemporary research however reveals that service users feel that their knowledge is not valued by professionals and agencies.

The results of the enquiry reinforce the possibility of service users being excluded from the working of agencies and professionals and refer to a number of instances, where the opinions of the service users were not considered for taking of practice and intervention decisions. The report reveals a number of themes in different areas of inter-professional practice that can be beneficially used to inform future social work practice. The use of research evidence for guidance of practice in social work is becoming increasingly important for improving the effectiveness of social and health care interventions.

Enquiry reports serve as important sources of evidence for development of future social work practice. Scholars however feel that much of research based evidence is used by practitioners and that certain specific conditions, which have been elaborated in the last section, need to be met for the improvement and application of evidence based practice.

Word Count: 2530, apart from bibliography

The Concepts Of Partnership And Collaboration Social Work Essay

The concepts of ‘partnership’ and ‘collaboration’ have become amongst the most critical themes of ‘new’ Labour’s social policy, particularly in respect of the delivery of health and social care. (Lymbery, M, 2005) This is the reason why a reflective summary will be produced in which concepts of partnership, the philosophies and the reducing of negative outcomes for professional, client and organization will be discussed in greater depth. Proposals for minimising negative outcomes will also be covered.

CONTENT

CONCEPTS OF PARTNERSHIP

The definitions of partnership according to Collins English dictionary, 1991 is equal commitment or the state of being a partner. Partnership is also defined as a shared commitment, where all partners have a right and an obligation to participate and will be affected equally by the benefits and disadvantages arising from the partnership as defined by Carnwell, R. and Carson, A. in 2008. Partnership defining attributes are trust and confidence in accountability, respect for specialist expertise, joint working, teamwork, blurring of professional boundaries, member of partnerships share the same vested interests, appropriate governance structures, common goals, transparent lines of communication within and between partner agencies, agreement about the objectives, reciprocity and empathy. Antecedents of partnership are as follow: individual, local and national initiatives, commitment to shared vision about joint venture, willingness to sign up to creating a relationship that will support vision and also value cooperation and respect what other partners bring to the relationship. Partnership provides a number of benefits such as social exclusion will be tackled more efficiently, service provision from different organisations will be less repetitive, activities by agencies will be less diluted and the chance of agencies producing services that are counterproductive to each other will be reduced. However, there are also barriers in working in partnership for instance, complexity of relationships, representativeness of wider public, tokenism and excessive influence of the vocal groups, desire of individuals not to be involved in making decisions about their care, threat to confidentiality, role boundary conflicts, inter-professional differences of perspective and threats to professional identity. (Carnwell, R. and Carson, A. , 2008)

PHILOPSOPHIES OF WORKING IN PARTNERSHIP

In working in partnership, there are few philosophies that underpin partnership working. The philosophies are empowerment, independence, humanity, equity, trust and respect. Empowerment in the context of health and social care is a process through which people gain greater control over decision and actions that will affect their health. (World Health Organisation, 1998) The reason why empowerment is important in the partnership of health and social care context is because they are the vital foundation of developing an honest relationship between client and professional. They also have become accepted principles in social work practice and have received legislative endorsement as the foundation stones of quality relationships between users and providers of community care services as mentioned by Braye, S. and Preston-Shoot, M., in 1993. Without empowerment, a partnership working will not be effective.

Independence according to Oxford, 2010 is free from outside control; not subject to another’s authority. Independence in terms of partnership in the health and social care perspective is the ability to make decision that will affect the life of a person without the control of others, be it health professional, family member etc. Other than that, it can also be described as a situation in which a person is not under the power of others. An example for independence in partnership is between a patient and a health professional, the patient should be given the autonomy to choose the choice of treatment that he wants to undergo, not chosen by the professional.

Humanity is the quality of being humane according to Oxford, 2010.

Equity means fairness. Equity in health means that people’s needs guide the distribution of opportunities for well-being. (WHO, 1998) Equity in partnership means that every client should be treated and given the access to health services equally. The WHO global strategy of achieving Health for All is fundamentally directed towards achieving greater equity in health between and within populations and between countries. This implies that all people have an equal opportunity to develop and maintain their health, through fair and just access to resources for health. (WHO, 1998)

A commitment to partnership working can only be fostered if the partnership itself displays openness in the way it conducts its affairs, ‘open book accounting’ has to be taken to the extreme if a partnership is to be successful. The reason why trust is important in a partnership is because once distrust enters into a relationship, it is bound to fail. As mutual confidence grows at the individual level so it becomes much easier for the partnership as a whole to become more transparent in its working and thus, encourage trust between partners. (Geddes, M., 2005) Trust in the health and care setting is essential because without trust, it is difficult for a client to be open and honest to the professional.

Respect in partnership is important because in partnership, partners work together to achieve common goals and this relationship is based on mutual respect for each other’s skills and competencies and recognition of the advantage of combining these resources to achieve beneficial outcomes. Partnership in the health and social care context can be linked to the key of successful doctor-patient partnerships in which that patient will be recognised as the experts by the doctor. The doctor is, or should be, well informed about diagnostic techniques, the cause of disease, prognosis, treatment options, and preventive strategies, but only the patient knows about his or her experience of illness, social circumstances, habits and behaviour, attitudes to risk, values, and preferences. Both types of knowledge are needed to manage illness successfully, so both parties should be prepared to share information and take decisions jointly. (Bristol Royal Infirmary Inquiry, 2001)

MODELS OF CARE IN RELATION TO PARTNERSHIP PHILOSOPHIES

Models of care are made up of two models. They are the medical model and social model. In medical model, their thinking is that the disability of a person is of their own fault, their future is on the result of the diagnosis, they also tend to be labelled, their impairment becomes the focus of attention, assessment, monitoring, programmes of therapy are imposed to them, separation and alternative services are the only options, their ordinary needs are also put on hold, they are also only allowed to re-enter the ordinary world if they are normal enough otherwise it is permanent exclusion and society remains unchanged. (BFI, 2009) In this model, the independence of patient is being violated as their therapy is imposed on them, not their own choice. Their equity is also defied as they are being excluded socially.

On the other hand, in social model thinking, the disabled person is valued, strengths and needs are defined by self and others, barriers are identified and solutions will be developed, outcome based programme are designed, resources are made available to ordinary services, training for parents and professionals are also provided, relationships are nurtured, diversity are also welcomed and child is included and society evolves to accept the disable. (BFI, 2009) In this model, the client is empowered such as the NHS ‘Expert patient programme’ in which client take control of their own live without the relying on others. Another strategy that fosters empowerment is the ‘Prosumers’ in which providers (the disabled person) are also the consumers (supporting other disabled person as a support team). (Dickerson, F., 1998)

THE OUTCOMES & RECOMMENDATIONS

As mentioned in the working in partnership concept, partnership offers various advantages to different level of service user be it users, practitioners and organisations. Alas, it also has its own disadvantages which both will be looked into briefly.

In working with partnership, the advantage is that workload between practitioners will be distributed equally according to one’s own expertise. For example, the partnership between family nurses, the supervisor and social worker in safeguarding vulnerable child. If babies and young people who may have been, or are likely to be, abused or neglected. Family nurses will refer a child to social worker as a ‘child in need’, when appropriate, and will act on concerns that the child may suffer or likely to suffer significant harm. Family nurses will also receive weekly supervision and together with the supervisor work closely with social worker with safeguarding responsibilities. (HM Government, 2010) This benefit both the service user (in this case is children) and organisation that the practitioners work for as work will become more efficient. The Working Together 1999 initiative sets out how organisations and individuals should work together to safeguard and promote the welfare of children and young people in accordance with the Children Act 1989 and the Children Act 2004. (HM Government, 2010)

Partnership with other organisations both involving statutory and voluntary will benefit service users as competition will arise. This will enhance the service being offered by the organisations involved. As an example is the British Red Cross as the voluntary organisation and local department of social work as the statutory. The NHS and Community Care Act in 1990 split the role of health authorities and local authorities by changing their internal structure, so that local authority departments assess the needs of the local population and then purchase the necessary services from ‘providers’ such as the Red Cross. Community care ensures people in need of long-term care are now being able to live either in their own home, with adequate support, or in a residential home setting. (UWIC, 2010) This adequate support can be obtained from the Red Cross, such as support after being discharged from the hospital until they are fully empowered of themselves to be independent again. Support is important as seeking help from professional can help client to recover better. This will benefit both client and also organisation.

Albeit partnership offers benefits to everyone, it also has its own challenges. One of the major problems of working in partnership is confidentiality. The more people working together on a case, the chances of information to be breached will increase. Along the way, information could also get lost as well. This is because one party will think specific information is not as important as what other parties will think. To overcome this problem in protecting personal data of a client, the 1998 Data Protection Act is the key legislation which covers all aspects of information processed. Additionally, especially in health and social care, to ensure that this act is put into operation, the Caldicott principle is introduced. (Department of Health, 2010)

In general, working in partnership is a great way to tackle issues effectively. However, the idea of partnership does not usually work as what is expected ideally in reality. Partnership working can be difficult to do well, it can be costly if not properly managed and it may not deliver the desired outcomes if the aims and objectives are not clear. On the other hand, it can be reduced by having plans and strategies as a guidance that must be revised after a certain period of time by local authority. The principal purpose of guidance is to provide a framework against which to ‘test’ potential new partnerships and examine existing ones, to ensure that the Authority can be reassured that the partnership under consideration is one which will contributes positively to its agenda. (Rochford District Council, 2009)

CONCLUSION

Working in partnership in health and social care is beneficial to all service users, inter professional working and organisational that is involved although it has its own negative consequences. These negative outcomes however can be reduced by referring to guidelines and policies that needs to be updated from time to time.

The Concept Of Work Life Balance

Abstract

The concept of work-life balance has now become centre of attention for almost all companies, political institutions, research institutions, families, individuals and trade unions at both national and international level. Work life balance is an important topic in human resource management that means to combine work and life in a way, that both are achievable. Work life balance is generally related to role overload, time management, time pressure, job satisfaction, job stress, organizational commitment, life satisfaction, turnover, welfare, social security, working time, flexibility, family, fertility, (un)employment, migration, consumption, demographic changes, leisure time and so on. In this paper, work means paid work i.e. a person earns money by providing his/her services to the organization. Both work family balance and work life balance is same thing. Moreover, work life conflict and work family conflict are used interchangeably. We will discuss some relevant definitions, its importance in organization and in life of individual, antecedents and consequences of work life conflict, factors which help in creating work life balance, advantages of work life balance, cost of implementing its policies, some findings from literature, our recommendations and implications and in the end conclusion. From our literature we try to find some quantitative data about condition of work life balance in different countries but we were not able to get it. This paper is done mostly on qualitative data we get from different and renowned journal articles written by different prominent authors.

Introduction

”There’s no such thing as work-life balance. There are work-life choices, and you make them, and they have consequences”, stated by Jack Welsh, former General Electric’s CEO and all-round business guru (Khallash & Kruse, 2012, p. 682). The two most important domains of an individual’s life are work and family and their interface has become centre of attention in the past two decades for researchers in the field of human resource management world-wide. The changing social structures arising out of dual career couples, single parent families, globalization, changes in the demands and patterns of work, an increasing number of parents with children care responsibilities, increasing number of women workforce and ageing parents all have contributed to escalating research in the area of work life balance. There is a need to integrate and balance family and career requirements otherwise work life balance is in jeopardy as a person is unable to perform his roles due to tiredness from work or family responsibilities hamper concentration at work (McCarthy et al., 2010; Valk & Srinivasan, 2011). Work life conflict is opposite of work life balance, that can be either related to strain-based or time-based conflicts between work and life. There are two conflicting areas: (1) how work impacts on family life i.e. work-to-family conflict and (2) how family life impacts on work i.e. family-to-work conflict. But the net impact is same and that is Work life imbalance or conflict. Work-life balance is not primarily a women’s issue as the principles equally apply to men (Pichler, 2008; Crompton & Lyonette, 2006). This concept highly aims to encourage employees to adopt flexible working arrangements that can help them to achieve balance between their professional and private life.

History of Work-Life Balance

In 1986, the term “Work-Life Balance” was first identified, but it’s usage in everyday language was still sporadic for a certain number of years. Although, interestingly work-life programs existed in early years such as 1930, but people did not recognize them. Before the Second World War, the W.K. Kellogg Company created some flexible work hour shifts for their employees who replaced the traditional daily working hours, and the new shift resulted in increased employee efficiency and morale. In 1977, Rosabeth Moss Kanter, for the first time in his influential book, Work and Family in the United States: A Critical Review and Agenda for Research and Policy, raised the issue of Work-Life Balance and brought it to the forefront of organizations and research. This concept forces organizations to follow work-family friendly environment. Therefore, in the 1980s and 1990’s, some organizations began to offer work-life programs who aimed to promote balance work-life. The first waves of these programs were mainly to support women with children (Brough et al., 2008). Now-a-days, many work-life programs have been introduced which are less gender specific and identify other obligations as well as those of family.

Definitions of Work-Life Balance

Now-a-days, the concept of Work-Life Balance is not new; because of its importance it has been discussed extensively. It has been conceptualized as an individual’s orientation across various life roles and inter roles phenomenon. Different scholars have given different views on how they perceive the concept of WLB. Some of the important definitions are: (1) Kofodimos has defined it as ‘a satisfying, healthy and productive life that includes work, play and love, that integrates a range of life activities with attention to self and to personal and spiritual development, and that expresses a person’s unique wishes, interests, and values’ (Valk & Srinivasan, 2011, p. 40). (2) Kirchmeyer has viewed Work-Life Balance as ‘achieving satisfying experiences in all life domains, and to do so require personal resources such as energy, time, and commitment to be well distributed across domains’ (Greenhaus et al., 2003, p. 512). (3) Clark views work life balance as ‘satisfaction and good functioning at work and at home with a minimum of role conflict’ (Greenhaus et al., 2003, p. 512). (4) ‘Work life balance is the term used to describe the organizational initiatives aimed at enhancing employee experience of work and non-work domains’ (Darcy et al., 2012, p. 112). (5) ‘Work life balance is experienced when demands from the domain of work are compatible with demands from other domains, e.g. family’ (Pichler, 2008, p. 3). These definitions share number of common elements for example; all highlights the balance between work and non-work domains and equality of inputs and outcomes.

On the other hand, work life conflict is ‘a form of inter role conflict in which the demands of work and family roles are incompatible in some respect so that participation in one role is more difficult because of participation in the other role’ (Voydanoff, 2004, p. 399). In short, work life conflict is conflict between work and family responsibilities.

Significance of Work-Life Balance
Literature has shown that concept of Work-Life Balance is worth for discussion as it aims to create a balanced work-life. Work life balance is becoming an important issue as people deals with shrinking workplace and time pressure. Many studies have highlighted that work-life initiatives offer a win-win situation to both employees and employers and affect business progress and performance in many ways as improving work life balance practices increase productivity, employee well-being, reduces costs, lead to improve retention and recruitment and better motivation and morale for employees (Maxwell, 2005). Various theories have revealed that work life balance policies try to minimize stress and add to a healthier and safer work environment. Work life balance has been associated with greater employee commitment, job satisfaction and organizational citizenship behavior and its policies are beneficial for individuals, their families, physical health, mental health, relationships, creativity, organizations, and society (Brough et al., 2008 & Grzywacz & Carlson, 2007). Employees expect their employers to recognize that in addition to job they also have a life that includes their family, friends and social gathering. Studies have shown that a workforce that is out of balance faces stress and dissatisfaction which reduces family and work engagement. Work life balance issues are one of the main reasons which forces workers to quit their jobs. Therefore, work life balance is an important and increasingly hot topic because it’s about improving people’s quality of life and aims to widen access to career opportunities and paid employment. Firm size is also the next best predictor of the presence of work life balance policies; because its size affects the extent and type of work life balance policies a firm can offer. Large companies are more likely to offer longer and paid parental leave and flexible working hours (Beauregard & Henry, 2009; Kucharova, 2009). In short, firms have recognized that creating a balanced work and family life of employees is the only solution of all problems. Now, senior management has become more proactive about their employees health and they are introducing and implementing work life strategies.
Measurement

There is no as such one measurement tool for work life balance in literature. But most widely used tool is questionnaire and surveys. Most companies do questionnaires and survey to their employees to find out how balanced is their work and life is. One such questionnaire is discussed here. Employee has to select one option and each option is assigned different point. Options were based on a 5-point rating scale that ranged from never to always. Questions are: I have come home from work too tired to do the chores which need to be done? It has been difficult for me to fulfill my family responsibility because of the amount of time I spend on my job? I have arrived at work too tired to function well because of the household work I had done? I have found it difficult to concentrate at work because of my family responsibilities? Keep worrying about work problems when you are not working? Feel too tired after work to enjoy the things you would like to do at home? Find that your job prevents you from giving the time you want to your partner or family? Find that your partner or family gets fed up with the pressure of your job? If employee faces these problems quite often it means he/she is facing work life conflict (Pichler, 2008). Higher scores indicate imbalance rather than balance of work and life. (Other surveys and questionnaires are mentioned in appendix).

Antecedents Which Cause Imbalance Work-Life

In many researches both men and women has reported that they face difficulties in keeping a balance between family and work life, therefore, their lives suffer because of this imbalance. One of the main reasons for this difficulty is lack of support and help from their better half or spouse. In addition to this, work life (im)balance highly depends upon on job role, project-based job and nature of industry. For example, project-based work with unpredictable work pressure and requirement to deliver project consistently with predetermined time, often requires extensive travel disturb family relations. Additional working hours and working outside normal hours at expense of home and family time with high work intensity and pressure may result in bad health, stress, anxiety, fatigue and adverse/unpleasant psycho-physiological consequences that can have dreadful affect on quality of family and work life. Some researches has indicated that despite of an overall decline in weekly working hours across Europe over the last decade, the increased stress level, insecurities and competition at work-place are considered to be additional factors which are relevant in creating disruption of balance in life (Valk & Srinivasan, 2011; Pichler, 2008). Literature has also highlighted that fact that highest level of stress occurs when job demands are high whereas work life balance practices and policies are low. There are also some barriers which restrict organizations to implement work life balance policies that are job requirements, commitment and loyalty, cultural values, and change (Chiang et al., 2010). According to Voydanoff (2004), work demands expected to be highly associated with work-to-family conflicts which are of two types i.e. time based and strain based. Long paid working hours restrict an individual’s time that can be spent with friends and family. This lack of time may create difficulties for employees in maintaining family relationship and performing family orientated task or duties. Sometimes, strain-based demands (job insecurity or concern over losing a job) threaten the economic well-being that is necessary to quality of life and stability. The stress related with job insecurity decreases interpersonal availability and restricts effective participation in family life. Sometimes, family responsibilities also restricts person to perform his/her work duties effectively but researches have been more focused on work to family conflict rather than family to work conflict.

Consequences

Conflict between family and work has real and worth discussing consequences which extensively affects quality of life and career success for both women and men. Stressfulness, lower productivity, low employee morale, decreased job satisfaction, absenteeism and sickness are some common consequences which are caused by work life conflict. The consequences for women may comprise serious career choices and constraints, limited career advancement opportunity and success in their work role and need to choose between an active satisfying career or marriage and children. Most of the men face tradeoff between career and personal values when they tries to find out ways to make dual career families work that often requires them to hold family roles that are far different and open. Other serious consequences of imbalance work-life are alcohol-drug abuse, negative physical and mental health effects, poorer outcomes for dependants and other household members, a lesser work contribution, a diminution of social citizenship and community participation, depression, financial and marital problems, distrust, tardiness, cheating and violence in workplace, task avoidance, embezzlement, organizational sabotage, compulsive eating disorder and burnout (Voydanoff, 2004; Pocock, 2005). Because of these serious consequences organization faces with the prospect of losing talented men and women who because of imbalance between work and life become unable to cope with dual family and work demands. That is why; organizations reconsider personnel policies and expectations.

Factors Which Help in Creating Work Life Balance

The role of social/family support and supervisor/co-worker support has consistently emerged in literature as an important factor that influences work family balance in a positive manner. Social support includes support from an employee’s parents, siblings, spouse or partner, children, friends and extended family. Of particular importance is support from the spouse who contributes in a variety of areas including moral, domestic and childcare support, earnings and personal financial management, home and family responsibilities, career management and interpersonal support. Family support also includes the exchange of support among relatives. The personal social support can be further conceptualized as emotional and instrumental support, thus suggesting that it positively influences the individual’s functioning at work. The role of workplace support, i.e., the support received from supervisors and co-workers is another critical element of work family balance. Organizational and supervisor understanding of family duties are positively related to satisfaction with the balance between work and family life. Workplace support via an organizational approach involves the implementation of family friendly policies, which are associated with integrating work and family responsibilities and achieving a healthy work and family balance. Organizations offer a wide range of work family benefits and programs to their employees (these are discussed in appendix). Through research it is found that flexible work arrangements allow individuals to maintain a balanced life. There is also importance of supportive supervisors, peers and colleagues in managing their work family balance. Literature recognizes that all of the above mentioned variables have a greater impact on women. An emerging category appeared to achieve work life balance that is self-management or reinvention: reconsidering not only the kind of work one wants to do but also the kind of person one wants to be and the sacrifices one is prepared to make to grow into that new self (Valk & Srinivasan, 2011; Wayne et al., 2007; Voydanoff, 2004). Communication about work life programs to employees and providing proper resources and rewards to them also contribute towards work life balance.

Advantages of Balanced Work and Life

Researchers are now focusing on how family and work can benefit each other and this concept is known as work life facilitation. This facilitation may take place when gain from one domain can be transferred to and improving the functioning in the other domain. Work life balance can serve as a guide for organizations to address family work balance issues by redesigning the HR practices and policies for facilitating family work balance. This will help further help in enabling workers to be more committed to the organization, perform better work, and contribute to growth of economy and positive impact for society as whole (Valk & Srinivasan, 2011). Work-Life programs promotes improve productivity and employee commitment, lower rate of turnover, thus result in fewer employee relation challenges and reduced likelihood of unethical business practices. Moreover, implementation of work life balance policies can result in less loss of knowledge workers to competitors, reduced staff turnover, lower training and recruitment costs, reduced absenteeism, improved quality of workers, reduction in work stress, reduced use of sick leave, high self-esteem, confidence and loyalty, better performance and high morale and satisfaction. Some vital benefits that employer gains from work life balance includes employees feel valuable and work harder, maximized available labor, more loyal and motivated workforce, less stressful workplace, high employee involvement, organizational effectiveness and positive employee attitude and behavior (Beauregard & Henry, 2009). Work life promotes happiness and better relations among employees and employers.

Costs of Implementing Work Life Balance Policies

The cost of implementing work life balance policies is another vital issue which organizations take into account. These costs include direct cost e.g. parental leave payments, childcare subsidies, cost of extra space associated with increased facilities like breastfeeding rooms or childcare facilities, providing equipment to telecommuters and indirect costs such as temporarily filing absentee’s post and reduction in productivity from temporary disruptions (Darcy et al., 2012; Brough et al., 2008). It has also highlighted that manager’s role plays a critical role in policy development and implementation. Poor managers/supervisors skills and behaviors in work life balance practice can lead to increase costs (Maxwell, 2005). According to Roberts (2008) a reduction in worked hours is perhaps the most obvious route for employees to improve their work life balance despite the connected costs in terms of income, career and status.

Managerial Implications/Recommendations

Based on feedback from family and co-worker a person can evaluate whether he/she fulfilling both family and work responsibilities (Grzywacz & Carlson, 2007). Work life balance support and practices promotes a mean by which workers may alter their work hours and condition in a way which can reduce stress. When employees enjoy high degree of freedom and flexibility, sense of job control will increase, thus alleviating job stress (Chiang et al., 2010). Work life balance practices can have positive impact on employees and competition at firm level. These are some suggestions to promote work-life policies and program: (1) Use questionnaires to find out what workers feel about work life balance. (2) Review HR strategy and see if they support company’s mission. (3) Develop work-life reward programs by using non-cash incentives associated with business objective. (4) Align HR strategy (e.g. employer of choice) with work-life initiatives (McCarthy et al., 2010). Work-life initiatives also create positive employer branding, promote organizational citizenship; endorse being an employer of choice and support diversity programs. To start work-life programs, managers should consider these key areas: employee retention, absenteeism, employee time save, increase productivity and motivation and decrease stress related illness and health care costs. However, the entire work-life programs cannot be told firmly by only quantitative measurements. HR professionals must consider four significant questions: (1) do supervisors and managers aware of the impact work life balance and its policies has on their employees, (2) does a firm culture and environment truly support work-life benefits, (3) does the company’s management philosophy sincerely promotes work-life benefits, (4) are workers aware of and do they recognize company’s work-life policies and programs. If a company is already in practice of offering work-life benefits, then the next step for it would be to re-communicate and repackage them so employees can see how such benefits may find them ways to reduce or manage work-family conflict. Moreover, creating a HR strategy that clearly comply with company’s mission will exhibit that how committed the company is to its employees needs. Organizations may need to adopt more modified work life balance programs, initiatives and have the courage to go beyond from a one size fits all approach (Darcy et al., 2012; McCarthy et al., 2010). In other words, Companies may need to re-think work life balance more specifically and need to pay more attention on it. Work life balance programs are not reduced hours, flexible delivery, but it is about assisting people to match their behavior to their values (Reiter, 2007). According to Grawitch et al., (2010) it’s not about balance, it’s about resource allocation (in appendix, it is discussed in more detail). Companies should tailor its HR and work life balance policies according to the need of the employees and should implement it effectively to get desired results.

Discussion & Findings

From the literature we found that younger employees and employees in professional and managerial positions account higher levels of work life conflict. Singles are generally more balanced than people whose partner is in paid work. Long working hours, high levels of job insecurity, a lack of power in deciding when to start or finish work and demanding jobs result in higher imbalance in work and life. Women with children also report high level of work life conflict (Pichler, 2008). But it was revealed by Emslie & Hunt (2009) that there is no clear relationship between work life balance and gender. It is definitely clear that women is considered to do the home related work, on other hand men is also supposed to fulfill family responsibilities. There is also no clear relationship between work life conflict and age of employee’s children, but there is some evidence about those employees whose children are below three faces more work life imbalance. A ‘one size fits all’ approach used for the development of work life balance programs is costly and ineffective to meet the needs of different type of employees. Job involvement was negatively related to work life balance whereas, perceived managerial support was positively related to work life balance (Darcy et al., 2012). It was found by Kucharova (2009) that there is no clear relationship between work life balance and economic condition of the different countries. It was found that sometimes flexible working and working from home increase work life conflict and part time work and job sharing also sometimes increase work pressure. There was no clear relationship found between flexible working arrangements and working conditions such as pay, promotion opportunities and employee commitment (Russell et al., 2009; Moore, 2006). Through study of Reiter (2007) it was clear that organizational development field is struggling with the apparent lack of success of work life balance programs in many organizations and this is caused by lack of investment by companies and government in work life balance initiatives. Furthermore, to gain real value from investment in work life balance, organizations need to recognize it as a complex issue and apply much more holistic solutions than has usually been the case.

Conclusion

In conclusion, we like to say that people who combine all aspects of their life in a balanced manner should therefore be the most satisfied and happiest one. In short, work life balance is part of the general well-being. The higher work-life imbalance, the lower are life satisfaction, happiness, subjective health and emotional well-being. Work life balance programs have the potential to extensively reduce absenteeism, improve employee morale and keep hold of organizational knowledge, particularly during hard economic times. In such a marketplace where there is increasing globalization and companies aspire to reduce costs, it depends upon human resource expert to comprehend the serious issues of work life balance and become of winner work life programs. It will cost some money, but in the long run, the company will benefit from this. If properly introduced and implemented then work life balance programs can be win-win situation for employee, family and organization. Flexible working arrangements are important but it should be catered according to employees’ needs, resources, time and demands to get more improved results. Work life balance is associated with quality of life and is not only a moral issue – it is productivity and economic issue, a workplace issue and a social issue, and needs to be addressed as such.

We can also measure by using some other questions and that are, how successful do you feel in balancing your paid work and family life? Are you satisfied or dissatisfied with the balance between your job or main activity and family and home life? I am satisfied with the balance I have achieved between my work and life? I am able to balance the demands of my work and the demands of my family? I experience a high level of work-family balance? I am satisfied with the balance I have achieved between my work life and my family life? How successful do you feel in balancing your paid work and family life? Are you satisfied or dissatisfied with the balance between your job or main activity and family and home life? Responses were based on a 5-point rating scale that ranged from ‘strongly disagree’ to ‘strongly agree.’ (Allen & Kiburz, 2011; Kucharova, 2009; Reiter, 2007).

Factors Which Help in Creating Work Life Balance

Organizations offer a wide range of work family benefits and programs to their employees such as job sharing, staggered hours, compressed working hours, telecommuting, job protected parental leave, part-time return to work options, shift swapping, flextime, resource and referral services, unpaid family leave, dependent care assistance, shorter standard work weeks, improvement in job conditions, breaks from work, work for home, on-site childcare, support groups for working parents, sports facilities, day-care facilities, laundry facilities, and canteen facilities (Valk & Srinivasan, 2011; Wayne et al., 2007; Voydanoff, 2004).

It’s not about Balance, It’s about Resource Allocation

Literature has re-conceptualizes the frame work of WLB. Previous researches have given more emphasized on the ways in which work and non-work life affect each other, but now new studies has introduced the concept of Personal Resource Allocation (PRA) framework which considers that all life demands forces an individual to make choices about where, when, how to allocate personal resources across the life domains. This Framework has four main central components which include personal resources, demands, resources allocation strategies and the individual outcomes. It suggests that effective work-life balance is an effective personal resource allocation across all life pursuits. It allows researchers to move beyond the old assumption of WLB, in which work life is considered bad and family life considered as good, to person-environment interactions that brings positive individual outcomes. According to PRA framework, individuals bring their personal resources to their daily lives, and because they come across repeated demands (anything that competes for personal resources) on their resources so, these demand forces them to make choices where to allocate these resources. Once the resources are allocated, then individuals are left with fewer resources to meet additional demands (Figure1, in appendix shows the PRA framework). Therefore, positive outcomes can only be achieved if (a) perceives that they have necessary resources to respond to their demands of life, (b) when they believe that they have adequate control to allocate their resource according their preferences, (c) when they feel satisfied with the way they have managed their resources (Grawitch et al., 2010). This Framework has presented the rethinking concept of WLB interface by de-emphasizing the negative role that work plays in life and emphasizing a resource allocation strategy. This theory incorporates person-environment interactions that bring positive outcomes, instead of, simply those that decrease or increase outcomes.

The Concept Of Social Exclusion Social Work Essay

This essay will discuss the origins of social exclusion, explain its meaning and the impact that it can have on groups and individuals in society. It will also describe the significance of social exclusion on people who may experience mental health problems; how government reform has been focusing on raising awareness and also why poverty is very much attached to people who experience social exclusion. It will discuss the greater divide that is being created between the rich and Poor and will also highlight the three discourses and the serious implications and consequences that people who experience these have to live with on a daily basis. It will talk about community care and how the system in which the NHS operates frequently seems to pay little attention to people with disabilities or mental health disorders and how the media should have a large part to play in emphasising the negative attention given to mental health issues.

(Pearson, 2010) Believed that social exclusion often had different meanings to various people and was a controversial subject which usually provoked extensive debate and widespread discussion. There were two different meanings to social exclusion. The first referred to was when an individual isolated and detached themselves from society, the second, how society treated people differently and made decisions that affected the lives of individuals, creating feelings of, powerlessness, injustice and inequality.

Social Exclusion first originated in France during the 1970s. It arose from groups in society being subjected to rejection or being marginalised and cut off from society. It meant that people, who were disabled, in receipt of benefits or those who may have been asylum seekers, frequently lacked any rights or access to any organisations that could represent or support their needs. The Labour government (December 1997) first introduced the (SETF) The Social Exclusion Task force when they realised that there was a significant need to focus on families which were identified as being either excluded, dysfunctional or both.

According to (Jack, 2000) In 1998 a report led by the social exclusion unit revealed that residents who lived in deprived and run down areas often disliked their estates due to the lack of amenities, crime, vandalism, and the fear of violence and drug dealers. (Sheppard, 2006) stated that People who lived in poverty and hardship were socially excluded which caused concern for social workers. However people who struggled to fit in or suffered dispossession were not the only ones excluded from society as other groups within society were marginalised as well.

During 1999 the Labour government set up the National Service Framework (NSF) for mental health in order to improve services for people who suffered with mental health problems. The Seven standards service policy was implemented to promote wellbeing and to eliminate social exclusion. In addition the service wanted to deliver intervention to reduce hospital admissions whilst also being cost effective.

Mental Health has been viewed poorly in the terms of acknowledgement and given less priority and little recognition in relation to policy makers and the general public because of the lack understanding, ignorance and fear. Mental health was deemed as the “Cinderella” service of The National Health Service. This is why the government made the decision to develop the (NSF) (Wilson, et al., 2008)

(Lanyard, 2005) stated that NHS resources were limited. Service users frequently complained of the lack of services, only 8% had ever seen a Psychiatrist and 3% a Psychologist, which was also combined with a long waiting list. People who were depressed often tended to spend little time with their GP and when they did have the courage to see them were usually only offered anti-depressants as a solution. However in comparison a person with other medical needs such as heart problems or cancer sufferers were automatically referred to a specialist.

According to research, the numbers of people now experiencing mental health disorders had grown dramatically in recent years and included people who came from a range of backgrounds and classes.

Christian’s (Pantazis, et al., 2006) pg. 285/286 believed that Policies from central government had identified issues surrounding mental health and taken into consideration the difficulties and adversity in relation to individuals who experienced mental health issues, and on that basis how mental health could suffer and deteriorate as a result of social exclusion. The government had attempted to eradicate exclusion. There was substantial evidence to believe that social exclusion and poverty were characteristics that contributed to mental health problems and it also became abundantly clear that health and poverty were very much related and were difficult and challenging issues to combat. (Gough, et al., 2006, p. 3) Stated that variations of household income and poor health and education did impact on individuals causing communities to breakdown.

(Kirby, et al., 2000) Stated that one of the criticisms of the welfare state was intuitionalism of people who suffered from mental health issues; therefore a framework of community care was developed resulting in care being provided within the home and community setting or separate institutions. The main problems with community care was that there was often little funding and community support, which subsequently resulted in increased suicide rates and homelessness therefore this raised concerns regarding the overall effectiveness of community care.

(Minister, 2004) stated that Research had shown that discrimination and attitudes towards people who suffered from mental health problems still remained poor and inappropriate. Most employers would not employ someone with a mental health problem. People in the community struggled to access resources and in addition were excluded from the law in relation to jury service. (Thornicroft, 2006) stated that over the last 50 years employment statistics showed that people who suffered from mental health problems had declined within the workforce. Employers tended to discriminate against individuals with long term mental health problems especially people who had Schizophrenia. Therefore finding work could be difficult for people who experienced mental health problems.

(Golightley, 2011) Felt that there was little research in the area of groups of people who had profound needs or disabilities, including the deaf, those with special needs or learning disabilities or even those with mental health issues. Mental health services often adopted the preconception that most people who used the service could hear and were White British. It was fundamentally important for professionals not to pigeonhole people and to understand why there may have been changes in behaviour. It was important to remember that challenging behaviour could be linked to the mental health of the individual and not necessarily be due to the disability that they were suffering from.

Young people who were from asylum seeker families and refugees who had suffered trauma and experienced racism felt socially excluded from society. Experience informed us that stress brought on mental disorders; however there was no existing proof that this was the case. Families and children who experienced emotional abuse may have felt isolated resulting in mental health problems.

(Watkins, 2009) Stated that attempts had been made to try and change people’s perception towards mental illness; unfortunately with little effect. Poor views still remained strong towards mental illness with the opinion that people who were mentally ill behaved irrationally and displayed aggressive behaviour. The media was a very negative force and exacerbated stereotypical views. (Cutcliffe, 2001) Also believed the media increased poor representation of mental illness and portrayed people suffering with mental illness as violent and dangerous, therefore promoting stigma and further ostracism from the public. The tabloids helped develop hysteria and could be a very powerful resource that influenced poor perception of mental illness and ignited outrageous high levels of public ignorance. (Anderson, 2003) Stated that views are similar, in that films have been produced and have often used destructive language. For example “Psycho” and the “One Flew over the Cuckoo’s Nest” are both films that have had an impact and lasting effect on individuals and influenced and formed people’s perception of what mental illness was seen to be.

Loneliness and feelings of despair encompassed the lives of the individuals with mental health disorders, even when there was contact with family or friends, the feelings of isolation could still remain. Deeper depression and low self-esteem tended to increase due to a lack of activity and structure within their lives. In the long term this could result in the individual developing feelings of self-worthlessness and forming a poor view of themselves with a feeling that they were not contributing anything to society. This could eventually result in the individual removing themselves from any form of social contact or interaction. (Granerud & Severinsson, 2006)

(Levitas, 2005) discussed the three discourses in relation to social exclusion. In British Politics the main objective was to reveal the three versions of account to social exclusion. RED the redistributionist discourse is primarily related to poverty and lack of materials and access to resources and inequality. The lack of provisions appeared to be the underlying cause, some people would say that through redistribution of wealth and taxation poverty would be eliminated.

(MUD) The Moral Underclass Discourse applied to attitudes towards moral obligations in relation to neighbourhoods and communities and the belief that people who resided in poor neighbourhoods and who were in receipt of low incomes were more likely to experience criminal behaviours or be unemployed. It was very much aimed at gender such as fathers who failed to pay child support and young males who chose crime as part of life or single unmarried mothers. A society that held these values could often believe this behaviour was acceptable.

(Hills, et al., 2002) Stated that both Upper and lower classes were similar in many ways, and had more in common than it may have been thought. People who experienced deprivation and resided in poor “ghetto” areas were more likely to have had little police protection. However, in contrast the wealthy of gated communities would usually have their own security. In addition the poor tended not to vote, whereas the wealthy did not need to as they usually had connections to political parties by funding organisations.

(SID) Social Integration Discourse was emphasised on the labour market and influenced by the Labour Government, it featured some of the RED but felt exclusion came from the labour market.

(Berns, 2007) stated that People who suffered mental disorders experienced poverty and economic pressure which impacted on their self-esteem. Consequently they could struggle to either sustain jobs, or take up training and education because of feelings of hopelessness, therefore making it impossible to alleviate poverty and improve life chances.

Through evidence and research my conclusion is that there is much more to be done for people who experience mental health problems. I have discovered that people’s attitudes, ignorance and biased views towards mental health are formed by opinion rather than understanding. Throughout this essay I have confirmed that social exclusion exists within services and society. The NHS budget on mental health is limited and substantially small in comparison to other medical conditions and as a consequence many medical staff and professionals still carry the preconception that medication is the only answer to the problem. There is little intervention in relation to therapy, counselling or alternative approaches which in turn could be more productive and rewarding. With small amounts of money spent on resources and little effort being put into care and rehabilitation, there is less chance to enhance the lives of the most socially excluded. Equally people with mental health often suffer within the workplace and can experience further prejudice and discrimination, coupled with feelings of guilt and hopelessness for not fully participating in the work force. Sufferers of mental health can also often feel rejected by society and feel ostracised for having what they feel is a mind that is broken. However in comparison to this, physical conditions are frequently met with sympathy, warmth and understanding. The media can be responsible for reinforcing negative public views and in promoting stigma and fear towards mental illness. Leitvats discussed the three discourses and looked at the holistic features that impacted on the socially excluded. I feel all three categories relate to people who are suffering with mental health problems. The government needs to do more to eradicate discrimination and aim to highlight positive attention and awareness to change people’s perception. (Commission, 2012) Stated that to encourage a quality of life and wellbeing and opportunities for people with mental disorders there needs to be radical changes in order to prosper and gain employment and to feel part of the community. To feel included would be the ultimate freedom but what a massive task it will be in order for this to be fulfilled. There is hope however, with new and innovative campaigns being introduced such as “The Time to Change” campaign, which is funded by the (DOH) and which is being supported by many celebrities, such as Gary Lineker and Stephen Fry. This is a positive step forward as many celebrities are now opening up and being prepared to speak out about their own experiences with mental health problems. In the long term this can only benefit society in raising awareness and changing attitudes towards the stigma that mental health carries.

Word Count ,2193.

The Concept Of Risk And Public Protection Social Work Essay

All activities and behaviours that people have can have different positive or negative impacts on their lives, partially because of potential risks which are easy to predict or manage. According to Leitch (2009) the word risk does not have any physical existence; rather it exists only within the mind, like many other abstract words such as idea, concept, attitude, emotion, and culture.

This essay will firstly discuss the concept of risk and public protection, and how it has developed, with particular attention on the meaning of risk assessment and risk management. Secondly, it will focus on government inquiry and its effects on legislation and policies, as well as the benefits and failures of inter-agencies and inter-disciplinary policies with particular reference to risk and public protection.

The concept of risk can be defined simply as the probability of suffering some damage or injury, catching a disease or in some circumstances even dying. At a more complicated level, it can be defined as the chance or probability of an undesirable event happening with an undesirable result (Duffey & Saull, 2005).

The term risk, like many other concepts, can be used in different ways. The Oxford English Dictionary defines the term risk as, “hazard, danger; exposure to mischance or peril” (Alaszewski et al., 1998 p3).

Risk could be the probability of losing a valued resource. For instance, the risk of investing money could be losing that money; the risk of going rock-climbing might be getting injured or dying. On the other hand, some people take that risk in order to gain positive outcomes such as profit from investing that money and a feeling of adventure or thrill at going rock-climbing (Neill, 2003).

Duffey and Saull (2005) explain that risk is the chance or likelihood of a disaster occurring, and its potential cost, during a specific period of time or under specific circumstances. Giddens (1994) argued that the nature of risk has resulted in a crisis in the welfare systems of contemporary society. However, he had suggested that using it can lead to a rethinking of welfare.

Duffey & Saull (2005) argue that risks regarding health are defined in terms of the probability that an individual will suffer from disease or injury within a given time period. In fact, there are various sources of risk. For instance, some risks could be environmental, such as those caused by natural disasters, poverty and war. Furthermore, community, family, school, and friends are all causes of environmental risk, while some risks are due to personal lifestyle, such as smoking, lack of exercise, un-balanced diet and so forth.

According to Alaszeweski et al. (1998) in the seventeenth century the word ‘risk’ seems to have appeared in the English language derived from the French risque, that had in turn come from the Italian ‘risco’ which means to run into danger. When the word risk came into the English language, it indicated both chance and consequences.

Most people classify the components of risk as follows; occurrence of something bad, the chance of such an occurrence, and the consequences of occurrence. These components could be used to evaluate risk (Merna &Faisal. 2005).

Martin (2002) identifies different sources of risk. For instance,

Physical- damage to individuals, equipment, and buildings, as a result of accidents or natural disasters.

Labour- people unable to do their job because of health problems, career changes, or work pressure.

Political/ social: policy change, protests from community, patients, or service users.

As it is difficult to admit a mistake, whether personal or professional, most people tend to shift the blame and allocate responsibility to others such as the state, agencies, and officials when things go wrong. Therefore, the concept of blame can be defined as follows; “blame is the process of allocating responsibility and punishments when accidents occur” (Alaszewski et al, 1998 p13).

According to the report of a Thematic Inspection, (1995, p12) a risk assessment can be defined as, “an assessment carried out to establish whether the subject is likely to cause serious physical or psychological harm to others”. When the term risk is used, it is generally not thought of as having positive consequences, as most people believe that if there is a risk there is less chance of protection, (Kemshall, 2002). Negative risk is represented by possible events that could harm a plan and which should be avoided. On the other hand, positive risk refers to risks that we initiate ourselves because we see a potential chance of success, along with probable failure.

There are five steps to risk assessments, which are as follows;

Classifying the risk.

Stating who could be harmed and in what way.

Assessing the risks.

Reporting findings and implementing them.

Updating evaluations if necessary (Health & Safety Executive, no date).

Alaszewski et al. (1998) think that risk management is the complete process of identifying, measuring and minimizing the chance of uncertain events affecting resources. Effective assessment and management of risks is a major professional practice in human service professions. It is the main part of any organisation’s strategic management; it is the process of addressing the risks so as to be able to work with the goal of achieving sustained benefits. Effective ‘risk management’ should be able to identify and treat these risks so as to increase the probability of success, and reduce the potential for failure. ‘Risk management’ has to be a continuous and developing process which runs throughout the organisation’s strategy and its implementation.

According to Thematic Inspection by HM Inspectorate of Probation (1995) any effective risk management plan should begin with identifying the potential risks in all its manifestations. Once risk is identified, it must be assessed as to its likelihood of occurence and the extent of any possible damage. After that, all risks should be prioritized so that each can receive the appropriate time and resources. In order to achieve a meaningful and efficient assessment, it must be done thoroughly and accurately and in a timely manner.

Public protection can be defined as the desired result of effective risk assessments and successful risk management (Report of a Thematic inspection, 1995). Due to a lack of safety strategies in organisations and drawbacks in some state policies, the idea of public protection was developed mainly by the public (Becks, 1992). It meant that governments and organisations should play a greater role in ensuring the protection of citizens by evaluating and managing risks.

Currently, there are many agencies that attempt to produce policies and practices in order to address the issue of risk and public protection for vulnerable people like the elderly, children, people with mental health problems and people with learning disabilities. However, there is the problem of how to implement these policies as there is little practical guidance and training (Kemshall & Pritchard, 1996).

In fact, there are many kinds of risk, including the risk of specific diseases, accidents, assault, drug abuse, child abuse, adult abuse, heart disease, cancers, disasters, and poverty. As child abuse is a highly controversial issue and a contested area in contemporary society, this essay will now focus on conceptions of child abuse with reference to a government report on the subject and its impacts on legislation and policy.

Child abuse or neglect may happen intentionally or as a result of negligence towards a child by an adult. According to the report ‘Childhood Matters’, child abuse contains several things which can be harmful to children or which can damage their ability to have a healthy development either directly or indirectly (Hobart & Frankel, 2005).

Despite the international consensus regarding children, that they should be treated with respect and must be protected from any kind of abusive exploitation, there is still a lack of clarity about what exactly constitutes abuse, (Cloke & Davies, 1995).

There are four kinds or categories of child abuse: physical abuse, sexual abuse, emotional abuse and neglect, which are explained below;

Physical abuse is the type which has been most studied. It is defined as: “any non-accidental physical injury to the child” (Child Welfare Information Gateway, 2009 p1). It is a feeling of pain or injury to the body or even a feeling of intimidation (Suryanarayana et al, 2010). Physical abuse’ may involve hitting, shaking, throwing, poisoning, burning, scalding, drowning, suffocating, or otherwise causing physical harm to a child’ (Polney, 2001 p129).

The explanation of sexual abuse is forcing children or adolescents to take part in sexual activities, regardless of their awareness (ibid). Using pornographic material such as pictures or videos of children or encouraging children to behave in sexually inappropriate ways are regarded as non-contact forms of sexual abuse, (Hobart & Frankel, 2005).

Emotional abuse is considered as ‘the most elusive and damaging form of abuse in childhood’ (Terreros, 2006 p1). Psychological or emotional abuse includes a child or young person being continually frightened, rejected or berated. There are a number of adverse effects of this type of child abuse. For instance, a child who is brought up in a home where there is no love or warmth will find it difficult to respond to other people’s emotional needs, (Hobart & Frankel, 2005).

Neglect is when a child’s basic physical and psychological needs are not met. Types of neglect include failure to provide adequate food, shelter, clothing or hygiene. In addition to health care neglect, there is also educational neglect and other physical, emotional, and environmental types of neglect, (Polney, 2001).

Over the last three decades a number of children tragically died as a result of abuse and resulted in the emergence of a number legislations and many reforms in agencies and policies. For instance, the death of Victoria Climbie was one of the most major news stories in the UK and all over the world, and has led to the revision of newer policies to protect children from any aspects of abuse. According to a public inquiry there were at least twelve chances for either social services or the police to save Victoria’s life, (Hobart & Frankel, 2005).

Adjo Victoria Climbie was born near Abidjan on the Ivory Coast in West Africa, and died in the intensive care unit of St Mary’s Hospital in London in February 2000 after suffering months of multiple injuries as a result of abuse and neglect from her aunt, Marie Therese Kouao and the aunt’s partner, Carl Manning. Both of them are now serving life sentences in prison (Laming, 2003). According to her parents, Victoria was the fifth of seven children, and she had a good life with them. She was also good at school. The tragic story of Victoria started when her aunt Marie took her from her parents to travel to France, where she had been living for some time, in order to give her a better life and good education. However, they only stayed there for about five months. Victoria began to appear unwell at school and the school was concerned as to whether this was the result of child abuse. Kouao told the school that she wanted to remove Victoria from the school and travel to London in order to get her the necessary treatment. They travelled to London in April 1999, (The Victoria Climbie Inquiry Report, 2003).

The year 1999 was a year of suffering for Victoria, especially once she moved in with Manning, her aunt’s partner. Before that Victoria had spent much of her time with a childminder, Priscilla Cameron, while her aunt was at work. Mrs Cameron noticed the way in which Kouao treated Victoria. When Kouao met Manning she and Victoria moved into his flat, and it was at this time the abuse of Victoria started. Mrs Cameron noticed that the bruises and marks on Victoria’s body and face become worse during the period she was living with Manning. On 13 July, 1999, Victoria was kept overnight in Mrs Cameron’s house because Manning did not want her living with them. The next day Mrs Cameron’s daughter took Victoria to the Central Middlesex Hospital, as she suspected the injuries were not accidental. After the examination the doctor performed, he referred her to the paediatric registrar, and although Victoria was admitted to the hospital and Brent social services and the police were informed, none of these agencies intervened to protect her (Laming, 2003). During his trial, Manning said that Kouao would hit Victoria every day using different items such as a coat hanger, a shoe, a cooking spoon and even a hammer. In addition to this, Manning admitted that he would hit Victoria with a bicycle chain. According to the Victoria Climbie Inquiry Report, (2003) Victoria was treated like an animal, barely fed and forced to sleep in the bath in an unheated bathroom. As a result, her death was due to all kinds of abuse, (physical, emotional abuse and furthermore neglect).

The outcry about Victoria’s death led to the Laming Report, which was published in 2003 by the government to investigate the involvement of the various agencies in the case and to make recommendations for change in order to avoid such a death in the future. Moreover, this case led to the reshaping of services for children and the reform of child protection agencies in England and Wales, (Hobart & Frankel, 2005).

The Laming report discovered the circumstances surrounding Victoria’s death, and it indicated the failure of the social, health and police services in safeguarding her. Furthermore, it attempted to address the concept that some of the professionals in Victoria’s case might have been obstructed by accusations of racism if they had followed a particular action. Thus, the Laming Report suggested that, ‘child safety comes first,’ meaning child protection is the entitlement of every child regardless of his or her cultural heritage or background (Garrett, 2009).

There are other cases of children who died as a result of cruel abuse, such as Marria Colwell in 1973, Susan Auckland in 1974, Tyra Henry in 1984, Chelsea Brown in 1999 and many other cases whether known or unknown. While the circumstances of each case might be different there are points of similarity, especially when the following features which occur more than once are taken into account;

There is no communication between people and agencies.

Inexperienced social workers who lack necessary skills.

Lack of resources to meet demands (The Victoria Climbie Inquiry Report, 2003).

Every Child Matters was published in September 2003 and issued some recommendations to be implemented in 2004. These included;

The job of the Children’s Commissioner is to raise awareness of the interests of children and adolescents.

The duty of local authorities is encouraging cooperation between agencies.

Legislation for the setting up of databases so that children’s basic information will be there to help professionals in providing support to young people.

A director of children’s services and a lead member will be appointed by local authorities in order to be responsible for education and social services with regards to children

The production of a single children and young people’s plan would be demanded of local authorities, (Hobart & Frankel, 2005).

The focus of the Children Act 2004 was on encouraging partnership and collaboration between health, welfare and criminal justice agencies, as well as raising their awareness of responsibility (Stafford et al, 2010).

According to Foley et al (2002) the child protection system in the UK for dealing with child abuse and neglect has not been effective enough at dealing with the problems of a large majority of families and their children. The development of such a system can be traced back to a number of high profile child abuse cases and has been dominated by a preoccupation with surveillance and investigation. The major concern of such a system was with only a small number of the total incidences of neglect and abuse; a total which is expected to rise every year. Such a system was also not successful in providing the necessary services which are essential for meeting the needs of most of the families and the children who were investigated.

However, over many years the fundamental aim of policies has become to push different agencies and professionals to work together where there are concerns about child protection, or safeguarding and promoting the well-being of children. This was promoted and strengthened in 2006, by the establishment of Local Safeguarding Children’s Boards (LSCBs) for improving safeguarding practices, polices, training and quality control in every local authority area. They identify accountability and compile information for Serious Case Reviews, where a child has died unexpectedly or been seriously injured and abuse is obvious or suspected to be a factor (Stafford, 2010).

Interagency means two or more agencies working together in an official way in order to achieve an aim or several aims (Fitzegarld et al, 2008). Hence, each agency supports another by giving information, experience and other provisions when they are needed. It can be said that they act as a public body towards definite purposes.

Currently, many agencies such as the police, social services, health services, and other relevant agencies attempt to produce policy documents in order to address the issue of risk, but there is little training or practical guidance with which to apply these policies (Kemshall & Pritchard, 1996).

Inter-agency co-operation, whether for community care or for child protection, is often directed by central government. However in practice this often causes difficulties and so these organisations tend to keep their own independence rather than attempt to co-operate. Hence, agencies are unlikely to change certain roles unless they are persuaded that it is their duty (The Scottish as Government, 2003).

Over the last three decades, the deaths of children in the UK have caused changes to both policy and practice, especially after Victoria Climbie’s death. This case highlighted a failure by child protection services and indicated a lack of effective communication between health professionals and social workers. “The extent of the failure to protect Victoria was lamentable. Tragically, it required nothing more than basic good practice being put into operation. This never happened” (Lord Laming, 2003).

Due to so many children dying because of different types of abuse, it has led many agencies to improve child protection systems. However, because of the shortage of resources and staff, especially in social services’ child protection division, there are still concerns that these improvements and changes will not be enough to protect children. Therefore, it is important to increase the quality of child protection in order to raise social awareness (Kendrick, 2004).

The main weakness regarding protecting a child was often a lack of proper evaluation of the child’s needs and demands. Individual errors, poor investigations and poor communication between agencies are also important factors (Kendrick, 2004).

In fact, before the outcry caused by Victoria’s case, there were many attempts from different agencies to save children’s lives. For instance, in 1986 child line was established by the NSPCC as a confidential help line which children can call when they are unable to get help elsewhere, and in 1999 the UK government published Working Together to Safeguard Children, which focused on setting a national framework for child protection for anyone who wanted to work with children and families. In addition to this, it encouraged the need for protection to be recognised, and for people to take into account the strengths and weaknesses of a family and look more widely at children and families’ needs (Hobart & Frankel, 2005).

As doctors are in an ideal position and are often the first to see and treat serious injuries and trauma they can report abuse allegations to Child Protection Service (CPS) social workers who have a responsibility to protect children. This is especially true considering that victims and offenders will not self-report to the CPS and thus the responsibility for reporting it must fall to others (Vulliamy et al, 2000).

Polney (2001) highlights the crucial role in protecting a child from harm that must be played by health visitors, because they are well placed to assess whether a family’s circumstances may lead to abuse or neglect, and to appreciate whether children are safe or not. As communication and co-operative working is the key, their work must be done in partnership with other agencies and colleagues in order to meet families’ and children’s needs and to safeguard children from harm.

The starting point in providing an integrated service for children and young people was when the UK government published the Every Child Matters (ECM) Green Paper (2003) after the death of Victoria Climbie, and the Children Act 2004 that led to a number of changes in children’s services (Dunhill et al, 2009)

The importance of inter-agency cooperation in the development of children’s services was emphasised by the labour policy. For instance, the National Service Framework for children, young people and maternity services reflects a strategy that demands all agencies work in a way which complement each other in order to address some issues like social exclusion and the children’s fund (ibid).

However, the priority of the new labour policy was to intervene in children’s lives at an earlier stage to avoid and prevent problems that may occur in the future, such as anti-social behaviour, unemployment and crime, before they become chronic problems. Therefore its concern with child abuse was only partial (Stafford et al, 2010).

According to Frost (2005) the way to avoid interference and conflict between inter-agencies is that inter-agency working must be based on formal structures. Moreover, clarity must be one of the aims and objectives of the team members.

There are many elements that are a key to the successful work of a multi-agency, including clear leadership and a clear focus, with common purposes and common knowledge between professionals. This process demands commitment by professionals to regular meetings and to allocating time to learn basic and necessary communication skills (Dunhill et al, 2009).

According to Fitzgerald & Kay (2008) interdisciplinary teams are those who are from various disciplines and backgrounds with different qualifications, experiences and training that play a significant role in making decisions and minimizing risks.

The framework for interdisciplinary training introduced by the Green Paper as a part of its proposals on ‘workforce reform’ had the following key elements:

“Understanding the developmental nature of childhood

Parents and family life

Managing transitions

Understanding child protection

Understanding risk and protective factors

Listening to and involving children and young people” (Williams, 2004 p422).

Parents and carers, early intervention, local and national integration, and workforce are the main four areas of action covered by the Green Paper (ibid).

‘Working Together’ indicates that inter-agency policy is an initiative to address the needs and demands of the most vulnerable individuals in society. The assumption is that improving co-ordination and co-operation between agencies will lead to better consequences in terms of child welfare. However, the inter-agency cultures and structures must be taken into account (Morrison, 2000).

Paragraph 5.54 of Working Together declares that a strategy discussion between the local authority, children’s social care and other services such as school, health and the police should be present whenever there is a suspicion of a child suffering significant harm. The aim of the strategy discussion is to share information, to plan how the enquiries will be carried out and by whom, to agree what action is needed to protect a child, and also to decide whether any legal action is needed (Beckett, 2007).

However, inter-agency and inter-professional communication face some inherent difficulties in some common areas which are as follows:

}Status differences and different areas of expertise;

Negative stereotypes of other agencies or other professionals;

Focussing on different aspects of the problem~ (ibid, P: 29).

According to Lawrence (2004) active dialogue is needed to be kept between managers and practitioners in order to resolve some problems when they arise. Also, it is vital to interact satisfactorily in the lives of children and their families.

Local authorities, differently to other agencies, have statutory commitments and have their own specific aims. However, in working together to protect children, they need to appreciate that they are not only trying to achieve their own purpose, but they are also making a significant contribution in advising and assisting to protect children (Department of Health, 1991).

Social services departments, health workers, medical practitioners, the police, schools, and voluntary sector and others working in a partnership is, in addition to being a way to monitor and review child protection policies, is also a basic strategy for child protection (ibid).

In conclusion, it can be said that risk is a word that means a probability of suffering harm or damage during life, or even of dying under specific circumstances. There are many sources or factors of risk which threaten individual’s lives, in particular the lives of children. These factors include homelessness, financial pressure, living in a disadvantaged community, parental unemployment, environmental factors and many others which impact on people’s behaviour and their treatments of their children. It is undeniable that children rely on their parents or others who care for them to meet their needs, and it is unfortunately also undeniable that sometimes children are abused or even killed by these same people. This has made the relevant authorities develop many policies and strategies to ensure children live in safety and to protect them from maltreatment, as well as to encourage inter-agencies to work together to promote children’s welfare. According to Blair (2003) our children are everything to us: our hopes, our ambitions, and our future.

The Concept Of Identity In Society

The concept of identity is described in numerous different ways such as the I, Me, personality, self and essence. These offer a starting point for us to attempt to understand and explain who and what we are internally and within the external world .There are various theories that have been developed to help us make sense of what contributes to our identity. These theories examine the factors that can build, shape and change our identity, covering aspects such as the structure of society, our interactions with others and past experiences.

Identity could be defined as being directly relevant to associated characteristics of an individual’s character or of a group. Identity can be viewed as a both passive and active form, it can be used to help others define us which is usually not controllable by that individual it can also be relevant to how we as individuals view ourselves.(Macionis and plummer,2008). There are various forms of the self and identity the three main groups most individuals are able to place themselves within .These are the collective self, the individual self and the relational self. The concept of identity in modern western society has shifted as a result of changes in ideology and society. These changes have included industrialisation where subjects act as workers who move around for work and have a identity that is flexible and not rigid within social structure and enlightenment where subjects are able to change their identities and create new choices and choosing new value systems (Michael.A, 2008)

The relationship of identity in the structural sense and the actual power an individual has over their identity has been critically analysed by theorists such as Goffman (1999) and Garfinkel (1984) have placed emphasis on the way individuals can develop and mould identity using language.Mead describes a similar form of interaction where personality, interaction and social structure provide a framework that can then be used for an understanding of identity (Choudry,2010,p11). To examine the various theories that contributes to the study of identity in regards to investigating societies understanding of older people. This will be looked at using the following structure, firstly looking at ways in which ‘age’ forms an identity will be considered. Secondly, the influence of theorists on attempting to understand the process by which this identity is created will be examined. Third, the concept of stigma and its repercussions will be discussed. Finally, the role and identity both personal and professional of the Social Worker as an agent between structural aspects and the impact of this role on the service user.

How old an individual is and how this influences identity varies and can be interpreted differently from different personal perspectives and cultures. From an objective sense age is simply the culmination of a process that is begun at birth and one that is given certain social indicators (Taylor and field, 2007, p.113). Older people or old age in many societies worldwide is not clearly defined but usually a term used when referring to someone a few years older than the individual being referred to (Miller,2008). Various cultural views can produce pressure on who is considered young or as an older person within society. This can vary according to cultural context (Stephens and Leach, 1998,p.475).

The implications of being identified as an older person can cause tension between the potential conflict of the individuals view of their identity and the structural view . In traditional society, the identity of the elderly is often a prescribed element, that presupposes norms of clothing and behaviour (Taylor and field, 2007).Other members that belong to that particular traditional society are projected with ideals of how to behave in a manner suited to people of an older age a manner that would change for another person of similar age (Stepehns and Leach, 1998, p. 476) . These assumptions have the ability to reduce the amount of power a older person has as they are defined and categorised based on visible characteristics rather than as a whole person (Miller,2008). Therefore social workers interpretation of an older person should fully consider the relationship between identity ,older people and structural factors.An older person may not view themselves as simply fitting in to a particular category such as ‘older person’ even if society is able to do so.

There are many different sociological theories that can assist in understanding contemporary societies attitude to identity when referring to older people (Giddens,2000 ,p.521).Within social work acknowledging and utilising the right of self determinism is an important part of the framework created when providing support and assistance to older people(Miller, 008 , P4). When identifying a person in need the role of the social worker could include providing a range of suitable options to choose from. However the social worker would provide the older person with the tools to make an independent decision. This can be explained by the adherence to identification in terms of the agency exerted by the older person (Franzese,2009,p.71).It is important that the social worker refrains from categorising the elderly originating from the perspective of an ‘older person’ but viewing as an independent individual in need (Franeze,2009).To assume without proof about the lack of ability of an older person must be avoided. This can create a tendency to make judgements and disempowered the service user, leading to lack of understanding in regards to the care and support required. Especially in regards the older person’s ability to make independent informed choices based on a understanding of their life and being the ‘expert within their own situations’. Although there are types of illnesses such as mental health issues that tend to occur more in the elderly than in the younger generation the social worker needs to assume the service user is capable -so regardless of how the service user is generally presenting him o herself unless presented with proof that suggests otherwise. Using this method in social work and emphasising the person centred approach can be explained through understanding the right to self determinism and empowerment (Kim, 1991). To practice effectively the social work must actively avoid becoming complacent with the attitudes towards older people projected through dominate discourse in contemporary society. This discourse projects identity on to individuals using age as way of categorising the social work need to provide the individual with the right to self-determination.

This is a difficult perspective to maintain when the structure of society promotes and accepts the idea of defining individuals in regards to age (Giddens,2000).This is also difficult to maintain when surrounded with many resources that are provided to those in need by social services that are allocated based on age and therefore creating restrictions if an individual does not fall into that age bracket. Therefore suggesting it is difficult to completely avoid catergosring older people as this is the system used in the society they exist in. This can be examined by looking at psychosocial identity, although Giddens suggests that we are reflexive agents we may have a smaller agency than what is suggested (Newman and Newman,2008).This suggests the rationale model of decision making for an individual is limited in its uses ; the choices we make are usually created for us to some extent as they are usually made when need or desire ansd the actually outcome only clear after the choice has been made.(Newman and Newman, 2008). Consequently an older person may experience the limitation of making a rational choice in regards to their identity as these choices may be made from a particular need. The older persons rational choices maybe affected by anxieties and fears surrounding their identity. As a result the role of the agent is quite limited in regards to the way interaction occurs between agent and structure. Therefore the individual has less choice than what may be assumed.

Another important element for understanding identity in relation to contemporary social work is the subject of stigmatism. Stigma can be explained as a loss of individual social identity and status that occurs when an individual is simply looked upon as a member of a group with shared characteristics (Giles et al., 1990).The concept of being an older person could be looked upon as a creation of society rather than something that has naturally developed through positive association. This is relevant to older people as stigma can produce problems as it relates a number of conditioned to older people, stereotyping them (Giddens, 2000).Bringing in ethical practice a better way to avoid projecting identity on to an older person it would be more effective to avoid placing stigma upon the older person.With messages provided by the media in various forms such as television advertisements that depict older people as suffering from illness and being in need. When only provided with these images of older people not stigmatising within social work would appear to be problematic. Structural aspects such as bureaucratism and globalisation make community self determinism and professional independence very difficult if not impossible (Bowles et al,2006).There is an conception that older people after being classified as ‘older’ change from being active to passive members of society with limited involvement and are limited in their self-determinism. Goffman proposed a definition of stigma that emphasisies the differences between the virtual self in social identity and the actual social identity.(Goffman, 1969)

Tension that has been identified by Sociological theory therefore is concerned largely with the interaction between the agency of an individual against the stigma that may be imposed upon the concept of the elderly, and their own right to self-identity (Newman and Newman, 2008, p.388). To an extent, as is represented by the psycho-social theoretical standpoint, it is difficult to argue from the perspective of interactionism the ways in which the individual has a significant agency in order to combat this perspective (Macionis and Plummer, 2008, p.76). Garfunkel (1967) argues that language is used as an active means by which individuals shape the identity around them. Rather than accepting a social identity that is imposed by the social structure in which they find themselves, individuals are active participants in the creation of such categories (Stephens and Leach, 1998, p.24). Of course, given that much of the social stigma associated with ageing stems from the ways in which the elderly are portrayed as mentally unstable, passive victims with mobility issues, all of which can be supported with a certain degree of statistical evidence, the ways in which individuals can rail against the stigma is problematic (Newman and Newman, 2008, p.289). However, the stigma is better understood as a blanket type definition applied to all individuals within a certain category ignoring the extent to which they fall into such categories. Identity theories, particularly from an interactionist perspective, are quite limited in their approach to describing how each individual holds their ability to actively define themselves in opposition to such stigma.

The use of identity theories are not only significant for the ways in which Social Workers treat the elderly but can be seen as useful understanding the means by which the individual appreciates their own impact upon the context (Giddens, 2000, p.522). In particular, an understanding of the interaction between agency and structure can help the individual reflect on the extent to which certain roles are almost predefined by the context in which they find themselves (Haslam, 2003, p.99). First, the Social Worker’s role can be interpreted in the way in which they can be seen as part of the social structure. The fact that the provision of services can be interpreted in a negative fashion as the imposition of structure allows the individual to assess their own role and position within this context. Furthermore, the individual must appreciate their own potential for agency within the structure in the attempts provided for the avoidance of oppressive practice (Newman and Newman, 2008, p.388). An important element of this process is in the use of reflective practice which allows the Social Worker to assess their own individual approaches and their emotions to the servo e provision. The extent to which they view the elderly with a stigma, or make assumptions regarding their ability to provide their own active approach to their own identity can be self-assessed. In many cases, it is possible for the Social Worker to adopt the Goffman idea of a distanced role, where they play a role in the service provision that fits various notions of the ideal way that such services can be provided without stigma (Goffman, 1963, p.54). This will involve occluding their true feelings or impressions of an individual, and the reflective practice allows them to assess and understand their approach to the subject (Goffman, 1999, p.16). The notion of the importance of agency within this context is therefore a key way in which Sociological Theories have affected Social Work practice.

A range of effects have a significant effect on the way in which individuals are influenced in their identity (Giddens, 2000, p.522). In many such cases it is almost impossible for the elderly to exert their own level of agency in order to resist the categorisation and the accompanying stigma that often applies. In many cases, this can occur as the result of active influences on the part of the individual themselves, even if it is a distanced social role as suggested by Goffman (1999). The important influence of such theories upon the understanding of identity, however, fall into the area where the Social Worker can be seen as part of an active element of the structuration process (Zastrow, 2009, p.59). This is a difficult role to avoid on account of the fact that despite the ways in which agency is emphasised for the individual for whom care is provided, the provision of services is often defined by age rather than simply by need. From the perspective that to avoid stigma as a whole, it could be expected that the various requirements of the elderly may come under different remits, such as mobility issues coming under the disabled remit; and in many cases this does continue (Zastrow, 2009, p.61). However, the fact that certain benefits are available to the elderly on the basis of age alone means that the Social Worker remains an agent, albeit an active one, of the notion that age defines a social identity. This social identity therefore means that there is a subgroup of services that would be provided, and this perhaps undermines the active attempts to avoid imposing stigma on the concept of the the elderly and allow the individuals to impose their own agency.

The most useful forms of identity theory would appear to ultimately stem from Lemert and Mead, that emphasise the position of an interaction between structure and agency (Franzese, 2009, p.71). As has been described in the previous discussion, elements that emphasise the process of either agency or the role of structure tend to miss the point of the way in which elderly people interact with the definitions that are applied to an identity. For the Social Worker there are numerous advantages that can be gained from an understanding of such theoretical contributions and the influence of different theories can help understand the requirement to avoid stigma and the emphasis that is made in Social Work to the process of individualisation, despite the inherent contradictions that can exist in the way in which services are provided. Social Work is essentially a part of society and represents and reflects the processes within it; as such, Sociological theories will always be of use in explaining and describing the ways in which different processes form a part of practice (Franzese, 2009, p.71).

The Concept Of Evidence Based Practice Social Work Essay

Introduction

This essay aims to identify and critically appraise evidence of whether ‘social intervention’ improve outcome for depression in British Pakistani women. I will analyse whether ‘social intervention’ can lead to improve mental wellbeing, empowerment and individual growth. I will analyse the value emphasis of therapeutic social support in mental health. The context of social work practice in mental health is complex, therefore social work intervention has to have an ethical and value based framework. I will assess the theoretical basis for standardise practice. The statutory changes in Britain to consider the fundamental values position incorporated in recent policies and legislation will be examined.

Define the concept of evidence based practice

Evidence based practice (EBP) according to Sackett (1997) citied in Gray et al (2009: 119) connotes a process of improving professional judgement through the “conscientious and judicious” integration and synthesis of well-researched empirical evidence to evaluate the efficacy and effectiveness of intervention in enhancing service users’ outcomes and how this can be integrated into practice context to improve service delivery and professional accountability (Department of Health Service and Public Safety, 2012) (Gray, Plath, & Webb, 2009) (Sheppard, 2004) (Corby, 2006). It “gives a framework for analysing the situation and generating a number of possible options” (Thompson N., 2000, p. 35). (Mathews & Crawford, 2011) suggested that practitioners must think critically and reflect on research evidence for credibility, completeness and transferability to inform professional judgement as this an implication for policy makers, professionals, communities and service users.

The impetus for EBP within social work is underpinned on the centrality on service users’ best interest to guide practice that is culturally sensitive and of significance to service users within the dynamic context of practice, legislation and social policy (Bolton, 2002). EBP therefore necessitates social workers’ reflexivity of how values, “theoretical assumptions”, policies, past experiences and the context in which practice takes place combine with service users perspective, preferences, and culture to guide and inform practice (Munro, 2002:10). This is to account for the multifaceted personal, cultural and social dimensions of service users (Webber & Nathan, 2010)

Select an aspect of social work

What interest me in this topic is the gap which exist in providing culturally sensitive support to black and ethnic minority group with depression. The evidence available suggest that individual with mental health distress including depression are “the most marginalised and excluded groups in society” (Stepney & Ford, 2001). Additionally, the prevalence of depression in black and minority ethnic (BME) and in particular women from Pakistani background in Britain, underlines the importance of supporting statutory and voluntary initiatives directed towards meeting their needs (Husain, Creed, & Tomenson, 1997) (Gater, et al., 2009). (Miranda, et al., 2003) noted the gap in evidence based for ‘social intervention’.

Drawing on their practice experiences and appropriate evidence

Within the context of community voluntary mental health services, their diverse types of evidence that informs practice and policy and social workers have an ethical obligation in the choice of theories and model of working.

In my practice, a systems approach is emphasised in understanding the interplay and multiplicity of service users’ context. Psychodynamic approach is concerned with how perceptions of needs, stigma and stereotypical assumptions motivate human behaviour including help seeking, disclosure of sensitive information. Past experiences are seen as central in the problems individual experience and used in understanding the dynamics of the helping relationship.

Social learning theory suggests behaviours are influenced by service users’ socio-cultural context. For example help seeking behaviour is influenced and reinforced by stigma and service delivery

Therefore cognitive- behavioural therapy is emphasised by understanding the role perceptions in help seeking. Therefore through interaction, modelling service users’ perception is influenced.

Conflict theory is invaluable in understanding cultural conflicts, stigma and oppression, power imbalance.

As noted in Saleeby (1996) the strength perspective is intrinsic to social work values of service users’ involvement, and respecting individual as having strengths

The feminist perspective takes into account the role of gender and the historical lack of power experienced by women. Collaborative relationship is emphasised between the social worker and service user through equality and empowerment.

Through empirical observation using randomised controlled trial, Gater, et al (2010) investigated the effective of ‘Social intervention’ for British Pakistani women with depression. It sought to explain the ’cause and effect’, to predict and control reality, and to create unambiguous objective ‘truth’ that can be proven or disproved to inform the effectiveness of intervention and policies implementation.

Qualitative data used to understand individuals “social reality” within their socio- cultural context which questions cultural assumptions, discrimination and oppression and the implication and significance in implementation. This can be used to conceptualise service users’ perspective regarding intervention and polices implications, their needs and perceptions about current polices and interventions.

The problem solving model focuses on understanding service users in their context and working in partnership.

In a cross sectional study, prevalence of depression amongst women of Pakistani origin was twice as high compare to white European women (Gater, et al., 2009).

(Campbell & McLean, 2002) suggested that social capital resources is embedded in within social networks and improve recovery. An alternative explanatory framework for the prevalence of depression in Pakistani women in mental health statistics has been the social constructive perspective. This perspective encompasses help seeking behaviour.

There are some evidenced based interventions that have been proven to help people recovery from depression. The randomized control trial study by (Harris, Brown, & Robinson, Befriending as an intervention for chronic depression among women in an inner city: Randomised control trail, 1999) found that befriending schemes are beneficial in improving recovery.

This is to counter the criticisms of ‘institutional racism’ and cultural assumptions in the delivery of mental health services to black and ethnic minority groups (Gould, 2010). Phillip Rack (1982) cited in (Gould, 2010): 40 proposed a “Culturally attuned approach that used insight”

This intervention is central to social work values of respecting and valuing uniqueness and diversity and recognising and building strengths. Social intervention involves aspects of partnership and include and emphasis on the impact of environmental pressures on individuals and therefore can be invaluable in anti-discriminatory work with service users in “offering empowerment and dealing with structural oppression” (Ahmad B. , 1990, p. 51). He also noted the importance of importance of qualitative research in exploring these issues (Ahmad W. , 1995). This social intervention included specific target groups. It uses an approach that included education and/or direct contact with people who are depressed.

Social intervention provides social workers with a “structural appreciation of the nature of social problems” (Gould, 2010, p. 60)

(Harris, 2010) social support and depression

Reconnection of hope through therapeutic encounter

Psychosocial and cognitive therapies have now been included in clinical practice guidelines. However, there remain considerable problems with black and ethnic minority accessing these services.

Research has shown a consistent relationship between mental illness and indicators of social disadvantages (Fryers, Melzer, & Jenkins, 2003). Thus, development of strategies to support help seeking and treatment is needed.

(Mathews & Crawford, 2011)

(Orme & Shemmings, 2010)

(Smith, 2004)

(Gask, Aseem, Waquas, & Waheed, 2011) qualitative thematic analysis (social isolation) family conflict, social cultural factors, psychosocial factors

Identify what can be learned from the evidence

In Gater,et al (2010) Social intervention for British Pakistani women with depression: randomised controlled trial, Participants’ social functioning and depression were signi¬?cantly improved. Given the prevalence of depression (Gater, et al., 2009) in this group and the under-representation amongst people able to access supportive services, this presents an important development.

In relation to improving participants’ engagement qualitative studies have found the debilitating effect of stigma as a signi¬?cant barrier for accessing support (Livingston & Boyd, 2010) (Mak, Poon, Pun, & Cheung, 2007). Stigma is understood as the interplay of individuals’ social identity and socio-cultural dynamics in which individuals with mental health are discriminated against and socially excluded due to stereotypical assumption (Lam, 2008). This ¬?nding is consistent with the evidence regarding social support interventions in (Harris, A stress-vunerability model of mental health disorder: implications for practice, 2010). However, there is a gap of how stigma associated with mental illness can be reduced.

The study was of high research quality, which indicates a reduced risk of biasness and confounding. A major limitation of this study is heterogeneity amongst the sample, that only 123 participants and increase in social functioning is limited to only 3 months. Therefore, the medium to long-term effects of social intervention within this group remain largely unknown. Another research gap is the absence of a dynamic medication adherence related studies aimed at this group, which have been identi¬?ed as important for achieving adherence and better outcome for depression (Miranda, et al., 2003).

Addressing the resistance from family members around issue of confidentiality and stigma amongst this population may be best accomplished through culturally appropriate communication strategies that facilities warm and empathy and social capital. In contrast, the research suggests that social intervention although it improves depression in the short run will not achieve meaningful improvements in the long run without antidepressant.

(Department of Health, 2007) emphasises partnership working, respect for diversity, strengths and aspirations and service users centred. Its focus on effectiveness, accountability and personal development are congruent with the principles of evidence based practice.

(Slade, 2009) noted that personal recovery is a challenging and contested concept within the domain of empirical evidence. The multi facet level of mental illness is evident in the definition of mental health, the impact of treatment and the social consequences. However, (Resnick, Fontana, Lehman, & RA, 2005) highlighted that “empowerment, hope and optimism, knowledge and life satisfaction” outcome that are central to the recovery model allows the prevalence of recovery to be investigated empirically. (Gould, 2010)

As stated in (Gater, et al., 2009), an epidemiology of depression that accounts for social support and social difficulties is critical. Social context of depression

Nonetheless, depression is associated with important negative consequences, such as social exclusion, low self-esteem.

Social exclusion according to (Hills, LeGrand, & Piachaud, 2004)should be conceptualise in the context of the personal, cultural and structural dimension and highlighted lack of social interaction as a form of social exclusion.

Attuned to cultural beliefs and norms

Social and inclusive practice have been developed and reinforced by the Capabilities for Inclusive Practice (Department of Health , 2007) report: working in partnership, respecting diversity.

Assessment requires service users’ participation and access to information to make informed choice. This model of assessment has to be cultural sensitive and proactive in nature.

Psychosocial assessment

Although social support is frequently referred to as beneficial in relation to depression, there has been little attempt to specify what this means and to evaluate the effectiveness of interventions to reduce isolation.

(Tew, 2004) Partnership working is crucial in adopting a social model of intervention. Culturally sensitive practice.

(Gater, Waheed, Husain, Tomenson, Aseem, & Creed, 2010)

(Webber W. , 2011)

Research indicates that (Oakley, Strange, Toroyan, Wiggins, Roberts, & Stephenson, 2003)

Mental health is practice within a context of multi-disciplinary collaboration to integrate the bio-psychosocial model of practice. The implementation of EBP within this context has to account for the theoretical assumptions that underpin this area of practice. This involves training and supervision. Research by (Huxley, et al., 2005) indicated stress of workers as accounting for their lack of implementing EBP.

— noted that another reason for EBP not been implemented is due to stereotypical assumptions that black and ethnic minorities prefer informal support than support from professional.

One barrier to effective assessment and intervention for depression epidemiology

Another barrier is the reluctance of ethnic minority group to share their emotional symptoms due to family pressure and perceive stigma. To overcome these barriers, —social intervention that accounts for social capital is crucial.

EBP therefore requires practice that is needs not resources leads if services are to be provided that are of sound professional judgement.

Perceptions about depression and stigma have been empirically supported in experimental, cross-sectional and longitudinal studies to worsen depression and affect interpersonal outcome and social support (Thomsen, 2006).

Analysis and reflective process of data collection, the transparencies about the relational nature of the research, and the ways which service users perspective are constructed through a respectful partnership and reflexivity of how our values, theoretical assumptions, policies, past experiences and the context in which practice takes place.

Trust and openness in research relationship a reciprocal process

“right- based” analytical approach (Department of Health, 2008) ethical and critical engage that with respectful uncertainties that reflect on the process of engagement and analysis

Mutual and sincere collaboration, over time

“respectful uncertainties”

Using multiple data sources to account for publication biasness and multiple perspectives and ways of knowing

Acknowledgement of complexities of realities

Use of reflexivity – focus on contexts of and relationships between researcher and researched as shaping the creation of knowledge. Ethical consideration in knowledge

(Gask, Aseem, Waquas, & Waheed, 2011) understanding how symptoms are expressed and perceive. Understanding emotional expressiveness within cultural context.

Conclusion

In conclusion, social intervention has highlighted strategies that have demonstrated some success for improving help seeking.

Given the complexities and multi facet dimension of individual experiences and the context in which needs occurs, it is imperative that the uniqueness of individual is taken into account within the paradigm of culturally competent practice (Dalrymple and Burke, 2006). In addition, Social Work practice draws on theoretical knowledge from social sciences, which are usually Eurocentric, it is essential, that Social Work practice integrate knowledge from best evidence for it to meet it ethical obligation to counter oppressive and discriminatory practice (Thompson N. , 2003) (Webber W. , 2011).

(Thompson N. 2003)

The Concept Of Collaborative Working Social Work Essay

“Collaboration is a interprofessional process of communication and decision making that enables shared knowledge and skills in health care providers to synergistically influence the ways service user/patient care and the broader community health services are provided” (Way et al, 2002). The development of collaborative working will necessarily entail close interprofessional working” (Wilson et al., 2008). According to Wilson et al, (2008) and Hughes, Hemmingway & Smith, (2005) interprofessional and collaborative working describes considering the service user in a holistic way, and the benefits to the service user that different organisations, such as Social Workers (SW), Occupational Therapists (OT) and District Nurse (DN) and other health professionals can bring working together can achieve. These definitions describe collaborative working as the act of people working together toward common goals. Integrated working involves putting the service user at the centre of decision making to meet their needs and improve their lives (Dept of Health, 2009).

This paper will focus first see why health care students learn about working together then reviewing government policy and how this can be applied in a Social Care context, then on influencing factors on the outcomes of collaborative working references within the professional literature, and finally, reviewing evidence on collaborative practice in health and social care.

Learning to work collaboratively with other professionals and agencies is a clear expectation of social worker in the ‘prescribed curriculum’ for the new Social Work Degree (DoH 2002). The reasons are plain:

a-? Service users want social workers who can collaborate effectively with others to obtain and

provide services (Audit Commission 2002)

a-? Collaboration is central in implementing strategies for effective care and protection of

children and of vulnerable adultsas underlined, respectively, by the recent report of the

Victoria Climbie Inquiry (Laming 2003) and the earlier ‘No Secrets’ policies (DoH 2000)

a-? Effective collaboration between staff at the ‘front-line’ is also a crucial ingredient in delivering the Government’s broader goals of partnership between services (Whittington 2003).

Experience is growing of what is involved in learning for collaborative practice. This experience promises valuable information for Social Work Degree providers and others developing learning opportunities but has not been systematically researched in UK social work programmes for a decade (Whittington 1992; Whittington et al 1994). The providers of Diploma in Social Work programmes (DipSW) represented an untapped source of directly transferable experience in this area of learning and were therefore chosen as the focus of the study.

Making collaborative practice a reality in institutions requires an understanding of the essential elements, persistent and continuing efforts, and rigorous evaluation of outcomes. Satisfaction, quality, and cost effectiveness are essential factors on two dimensions: outcomes for patient care providers; and outcomes for patients. Ultimately, collaborative practice can be recognized by demonstrated effective communication patterns, achievement of enhanced patient care outcomes, and efficient and effective support services in place. If these criteria are not met, collaborative practice is a myth and not a reality in your institution. Simms LM, Dalston JW, Roberts PW. Collaborative practice: myth or reality? Hosp Health Serv Adm. 1984 Nov-Dec;29(6):36-48. PubMed PMID: 10268659. http://www.ncbi.nlm.nih.gov/pubmed

Health care students are thought about collaboration so that they can see the unique contribution that each professional can bring to the provision of care in a truly holistic way. Learning about working together can help prevent the development of negative stereotypes, which can inhabit interprofessional collaboration. (Tunstall-Pedoe et al 2003) Health care students can link theory they have leant with practice and bring added value of successful collaborative practice. (www.facuity.londondeanery.ac.uk) Learning collaborative practice with other professionals is the core expectation in social work education both qualifying and post grad.

Effective collaboration and interaction can directly influence a SU treatment, in a positive way, and the opposite can be said about ineffective collaboration that can have severe ramifications, which has been cited in numerous public inquiries. Professionals should also share information about SU’s to keep themselves and their colleagues safe from harm.

Working together to safeguard children states that training on safeguarding children and young people should be embedded within a wider framework of commitment to inter and multi-agency working at strategic and operational levels underpinned by shared goals, planning processes and values. The Children Act 1989 recognised that the identification and investigation of child abuse, together with the protection and support of victims and their families, requires multi-agency collaboration. Caring for People (DH, 1989) stated that successful collaboration required a clear, mutual understanding by every agency of each others’ responsibilities and powers, in order to make plain how and with whom collaboration should be secured. It is evident from the above that Government has been actively promoting collaborative working, and this is reflected in professional literature. Hence, the policy climate and legislative backdrop were established to facilitate inter-agency and intra-agency collaboration. The stated aim has been to create high quality, needs-led, co-ordinated services that maximised choice for the service user (Payne, 1995). Political pressure in recent years has focused attention on interprofessional collaboration in SW (Pollard, Sellman & Senior, 2005) and when viewed as a “good thing”, it is worthwhile to critically examine its benefits and drawbacks just what is so good about it. (Leathard, 2003). Interprofessional collaboration benefits the service user by the use of complementary skills, shared knowledge, resources and possibility better job satisfaction. Soon after the new Labour government in 1997 gave a powerful new impetus to the concept of collaboration and partnership between health professionals and services, they recognised this and there was a plethora of social policy initiatives official on collaborative working published. A clear indication of this can be found in NHS Plan (DH, 2000), Modernising the Social Services (DH, 1998a). Policies concentrated on agency structures and better joint working. This was nothing new, since the 1970s there has been a growing emphasis on multiagency working. 1974 saw the first big press involvement in the death of a child (Maria Coldwell) and they questioned why professionals were not able to protect children who they had identified as most at risk. The pendulum of threat to children then swung too much the other way and the thresholds for interventions were significantly lowered, which culminated with the Cleveland Inquiry of 1988 when children were removed from their families when there was little concrete evidence of harm (Butler-Sloss, 1988), with too much emphasis put on the medical opinion. An equilibrium was needed for a collaborative work ethic to share knowledge and skills and Munro (2010) states that other service agencies cannot and should not replace SWs, but there is a requirement for agencies to engage professionally about children, young people and families on their caseloads. The Children Act 2004 (Dept of Health, 2004) and associated government guidance, introduced following the Public Inquiry into the death of Victoria Climbie in 2000, including Every Child Matters (Dept of Health, 2003), were written to stress the importance of interprofessional and multiagency working and to help improve it. The failure to collaborate effectively was highlighted as one of many missed opportunities by the inquiry into the tragic death of Victoria Climbie (Laming, 2003) and Baby Peter (Munro, 2009). There is an assumption that shared information is information understood problems with information sharing and effective commination are cited again and again in public enquiry reports Rose and Barnes 2008; Brandon et al, 2008). These problems can simply be about very practical issues, such as delays in information shearing, lost messages, names and addresses that are incorrectly recorded (Laming 2003 cited in Ten pitfalls and how to avoid them 2010)

An explicit aim was to motivate the contribution of multiagency working. By 1997 Labour had been re elected and rolled out a number of studies into collaboration. These studies revealed the many complexities and obstacles to collaborative working (Weinstein, 2003). The main drivers of the government’s health and social care policies were partnership, collaboration and multi-disciplinary working. One of the areas covered by Working Together to Safeguard Children 2010 (Dept of Health, 2010) stated that organisations and agencies should work together to recognise and manage any individual who presents a risk of harm to children. The Children Act 1989 (Dept of Health, 1989) requires multi-agency collaboration to help indentify and investigate any cases of child abuse, and the protection and support of victims and their families. It should be remembered that everyone brings their piece of expertise/ knowledge to help build the jigsaw (Working Together 2010) and to assess the service user in a holistic way. Although the merits of collaboration have rarely been disputed, the risk of conflict between the professional groups remains.

Some of the barriers to collaboration are different resource allocation systems, different accountability structures, professional tribalism, pace of change and spending constraints

The disadvantages are if commissioning was led by health, an over-emphasis on health care needs, and inequities between patients from different practices

There are challenges in terms of professional and personal resistance to change; it is difficult to change entrenched attitudes even through inter-professional education. Sometimes professionals disagree about the causes of and the solutions to problems, they may have different objectives because of different paradigms (Pierson & M, 2010). There are also several concerns for SWs which include not knowing which assessments to use, appearing to be different or work differently from others in the team, not being taken seriously or listened to by colleagues and not having sufficient time or resources because of budget constraints (Warren, 2007). Some of the reasoning for this pessimistic mood is feelings of inequality and rivalries, the relative status and power of professionals, professional identity and territory. Different patterns of accountability and discretion between professionals, are all contributing factors to these feelings (Hudson, 2002). Thompson (2009) suggests that instead of the SW being viewed as the expert with all the answers to the problems, they should step back and look at what other professionals can contribute. Collaborative working offers a way forward, in which the SW works with everyone involved with the clients; carers, voluntary workers and other professional staff, to maximise the resources, thus giving an opportunity for making progress and affording the service user the best possible care.

Weinstein, et al, (2003) stated that although there are problems with collaborative working, the potential positive outcomes out-weight the negatives. There could be a more integrated, timely and coherent response to the many complex human problems, fewer visits, better record keeping and transfer of information, and some reduction of risk; therefore the whole is greater than the sum of the parts. If SWs work in ‘silos’, working in a vacuum, they are unlikely to maximise their impact (Brodie, 2008). It is important to use collaboration and an interprofessional/multi agency working culture in Social Work in order that the most vulnerable service users receive the best possible assessments of their needs.

The advantages are better understanding of the constraints of each agency and system overall, shared information on local needs, reduction in duplication of assessments, better planning, avoiding the ‘blame culture’ when problems occurred and accessing social care via health less stigmatising. Greater knowledge of the SWs roles and responsibilities by other health care professionals will ensure that the SWs role is not substituted in assessment of the service users circumstances and needs (Munro, 2010). The Munro Report (2010) also states that if everyone holds a piece of the jigsaw a full picture is impossible until every piece is put together.

Working together to Safeguard Children states a multi-professional approach is required to ensure collaboration among all involved, which may include ambulance staff, A&E department staff, coroners’ officers, police, GPs, health visitors, school nurses, community children’s nurses, midwives, paediatricians, palliative or end of life care staff, mental health professionals, substance misuse workers, hospital bereavement staff, voluntary agencies, coroners, pathologists, forensic medical examiners, local authority children’s social care, YOTs, probation, schools, prison staff where a child has died in custody and any others who may find themselves with a contribution to make in individual cases (for example, fire fighters or faith leaders).

In a study by Carpenter et al (2003) concerning the impact on staff of providing integrated care in multi-disciplinary mental health teams in the North of England, the most positive results were found in areas where services were fully integrated.

There is much evidence to suggest that collaboration represents an ethical method of practice where differences are respected, but used creatively to find solutions to complex problems. In essence the service user should be cared for in a holistic approach and to achieve this collaboration is the answer. (1516)

Professor Munro askes “Some local areas have introduced social work-led, multi-agency locality teams to help inform best next steps in respect of a child or young person, including whether a formal child protection intervention is needed. Do you think this is useful? Do you have evidence of it working well? What are the practical implications of this approach?” (http://www.communitycare.co.uk/Articles/2011/01/04/116046/munro-asks-frontline-workers-what-needs-to-change.htm)