Author: Andre Coleman

Discuss the role of Housing Associations in delivering housing and regenerating housing estates and areas. To what extent should Housing Associations be more than housing providers?

The first section of this essay will give a brief historical background to the origins of Housing Associations and philanthropic intervention within housing provision. The second section will address the role of the Housing Corporation in monitoring the role of housing associations. Section three will address issues of socially excluded groups and subsequent sections will address the effects of globalisation, politics and demography within social housing – and the regeneration of housing estates and areas. The final section will look at the constraints of housing Foyers and associations and will debate the expanding role of housing associations questioning the extent to which housing associations should be more than housing providers.

The origins of Housing Associations

Housing Associations have their origins in the twelfth century. However, Philanthropic activity became more evident from the eighteenth century when the ongoing issues of famine, ill health, overcrowding, homelessness, unemployment and squalor were rife throughout Britain. The condition was exasperated by the lack of interest shown by the government and the wealthy. Social reformers such as Samuel Peabody donated ?150,000 into providing homes for the destitute. This praiseworthy gesture assisted but failed to eliminate the homeless crisis that ravaged the working classes. In her book Built to Last, (Grant 1992) speaks about the person centred approach of Octavia Hill a wealthy property owner who in the 1880s operated from a stance of professional Helper. Hill attempted to provide a service that extended beyond the sole role of housing provider to that of a Social landlord. She believed in the rehabilitation of people as well as properties and utilised the opportunity to personally collect rent and offer her tenants cleaning, building & maintenance employment, housing management advice and support which she seemingly viewed as an opportunity to impart a sense of self respect and responsibility. She seemed to be of the opinion that housing and tenants could not be addressed separately but holistically. (Grant p.20).

This fundamental approach is essentially the key to the regeneration of housing estates and areas in the twenty first century. In order for regenerative work to be successfully maintained, a set of guidelines and principles must be in place to ensure that the housing problem is being tackled effectively. This leads to the role of the Housing Corporation

The housing Corperation

The role of the Housing Corporation in regeneration is to ensure that taxpayer’s money is managed and spent effectively, efficiently and economically. They provide the finances to housing associations and require that all housing providers are registered and operate within They are also responsible for ensuring that RSL (Resident Social Landlords) comply with Audit Commission guidelines that stipulate and promote tenant participation, capacity building and empowerment in order to make their views heard regarding the management of their homes and to influence policies that affect their lives. Essentially, their overall aim is to minimalise social exclusion, ensure that housing is affordable, and build strong communities. www.housingcorp.gov.uk. The NFHA 1995 (national Federation of Housing Associations) p.1 states that housing associations should only manage estates where basic facilities and good transport links are provided. In other words, the idea of regeneration is to increase accessibility to public services and to reduce isolation which breeds exclusion. There are several factors that affect the role of housing providers in regeneration, namely politics, globalisation, and demography.

Politics

The common factors that existed between the 1880s and the present time is that housing associations are non-profit making organisations, have various titles such as trusts, charities and co-operatives and essentially are altruistic. All are required to be registered and monitored and are accountable to the Audit Commission who is responsible for ensuring that tax-payers money is protected and spent economically, effectively and efficiently.

The core and expanding role of housing associations and the effects of demography.

The core role of housing associations was originally to provide adequate homes for low-income families. Throughout the 1960s and early 1970s, there was further development of high-rise council estates which was built to house low-income families. This did little to quell or include the housing needs of socially excluded groups such as single people, pensioners, minorities, the disabled and lone parent families. Other urban issues such as health were more prominent on government agenda. However, Conservatives 1979 election attempted to alter the perspective of social housing and the welfare state with the view of individualism and self-provision as opposed to state dependency. The cessation of new build and the introduction of housing schemes as shared ownership, Homebuy and the selling off of council properties were hoping to usher in a sense of independence and ultimate vision were of a nation of homeowners, privatisation of services and CCT (Compulsory Competitive Tendering). Presently the role of housing associations not only includes housing provision but regeneration initiatives. They provide a range of services which include training and employment opportunites for the low-paid, community safety, health, education.

Arguments for and against Housing Associations

Arguments against the roles of Housing associations and constraints and challenges faced by them. as providers of housing is still seemingly an issue today as it was in the eighteenth century. White questions in (Grant 1992 pp.4-5) the role of Philanthropists and Semi-Philanthropists where he asked

“Was Philanthropic response a genuine response to housing need or a hard headed use of capital to quell working class unrest?

These cyclical issues bear a somewhat striking resemblance to the 1980s urban riots which emerged as a result of an attitude that silently assumed that problems would be resolved independent of state intervention or laissez faire on part of the government. (Malpass and Murie 1999) quote Tory argument who believed in personal responsibility and self -provision as opposed to what they felt Britain was a culture of dependency to: “State intervention as the cause of housing problems rather than the solution

Since New labours 1997 election, the notion of rights and responsibility have been at the forefront of the government agenda. Malpass and Murie 1999 further argue on pp 101-2, the Housing Act 1988 which included the provision of housing providers to give their tenants the right to choose their landlords. Local Authorities desire to maintain an influence on Housing associations but housing Associations want to maintain their autonomy, Central Government funding is sometimes insufficient to maintain existing programmes and initiatives. In some instances such as with CP estate, the negotiation of further funding has to take place in order to preserve the sustainable communities achieved via funding. Chief Executive for Clapham park describes the allocated funds as a “drop in the ocean” (Johnson. A 2006)

Arguments for Housing Associations

is the emphasis on them by the government to provide housing by investment via the NFHS (National Federation of Housing Societies) to provide loans for non-profit making organisations to provide new housing. Malpass and Murie 1999 p. 73-4) Local Authority increased its support to enable HA to rehabilitate and convert existing council properties and by the transference of completed estate sites for development and rehabilitation. (Balchin 1995 pp146-7) confirms that research by the Housing Corporation showed that Housing Associations had a better record than Local Authorities at helping the elderly, single people, unemployed families, minority groups. It seemed that government housing agenda of the day chief concerns was to re-house families as a household was considered or consisted of husband wife and two point four children. Demography in terms of mass urbanisation, or divorce was not taken into account that’s why the excluded groups as above mentioned were sidelined. www.nfpi.org.uk press release December 2005 speaks about how demography and new working patterns are affecting British households, for example, one in five children live in single parent homes. Housing associations were now seen as the “principle agents of urban renewal” Malpass and Murie 1999 pp.146-7. Neighbourhood management involve and integrated set of principles that involve Social Services and Education bodies. This ensures that all key players in regeneration are working jointly to reduce homelessness by dealing and communicating with each other to address issues of ASB Anti sociable behaviour, human economical and social capital. Malpass and Murie further encourage the holistic regenerative approach due to the synergy brought about as resources could focus on problems which usually had multiple origins.

Or furthermore goes as far as to question the term humanitarianism which Grant feels does not exclude self interest as the upper classes of the 1880s main interest was mainly focussed around the five percent profit that they made out of housing the poor.

Arguments for Housing Associations

The role of Housing Associations is to provide and run their properties economically, efficiently and effectively. Economically to ensure that rents are accessible to low-income households, efficiently in terms of repairs and adequate structures that allow for adequate ventilation and space effectively with the main beneficiaries being the tenants and their right to peaceable enjoyment of their homes. (P.1 grant 1992) Local Authorities were sidelined as providers of social housing by the private sector and were given the job of filling the large gap in provision. This was due to the fact that the Conservative parties cessation of new build social housing and placing the responsibility of housing upon the citizen and thus reduce state dependency.

Housing Associations should be more than housing providers as urban problems are multi-faceted. (Malpass 2005) suggests;

Housing Associations do not confine themselves to the sole position of providing housing as some are also involved in the provision of care homes. Metropolitan for example state that they go beyond bricks and mortar to provide the quality support that nurtures thriving communities”. www.mhp-online.co.uk.1 .the definition of regeneration can be described in terms of /as a comprehensive approach that tackles the socio-economic, environmental aspects of society. It is an integrated approach with a single vision through coordinated programmes. The fundamental principle that underpins sustainable communities is;

“that everyone should have the opportunity of a decent home at a price they can afford in a place which they want to live and work”. www.communites.gov.uk.

Regeneration

In order to make lasting change within communities, a detailed area gap analysis of specific area needs should be carried out that can target particular issues with precision. (Roberts and Sykes 2000). A detailed analysis will consider key factors and devise individually tailored packages to suit particular neighbourhoods. In other words the one size fits all philosophy should be non applicable as the true picture of community composition will vary greatly. Although some urban communities experience the same issues, their response and profile will vary according to race, age, employment status, social capital. (CHANGE THIS(

Regeneration can be defined as an interventionist an strategic method of bringing about lasting change by promoting sustainable communities to the physical, environmental and socio-economic status to areas stigmatised by ill health, high educational underachievement, high unemployment and crime. It seeks to bring about improving the fabric of areas through joined-up interdependent working with the private, public, voluntary and community sectors. In terms of regeneration of areas and estates, I will draw from an example from the Clapham Park Estate in South London. This particular estate was notorious for high crime, low educational attainment, structural disrepair, high levels of unemployment and drug dealing. Residents on this particular estate were very disillusioned about their estate and felt ignored by the government who had as quoted by Keith Hill MP “regeneration tourism” to describe the ad hoc approach hurriedly taken by previous governments to address issues on the estate. The Home is where the heart is DVD showcased CP residents accounts of their housing situations making mention of damp, disrepair and neglect of the estate. The turning point for CP came for Clapham ?56 million was invested by the DCLG department for Communities and local Government to regenerate the area by creating training and educational opportunities as well as partnership working with the PCT (Primary Care Trust) to tackle and address ill health, the metropolitan police to deal with crime and the establishment of residential and Board members and Stakeholders neighbourhood management and stock transference. MHP (Metropolitan Housing Partnership) became the SRL (Social Registered landlords) by vote of the CP (Clapham Park) residents. These homes are being renovated to the Decent Homes standard 2010. For example, Metropolitan Care and repair which was set up to help the most vulnerable such as the elderly and disabled by improving and adapting their homes to improve accessibility, installing anti-burglary devices and gardening schemes. In partnership with the NRU (Neighbourhood Renewal Unit) who aims to

“Improve the quality of life for those living in disadvantaged areas that experience poor job prospects, high crime levels, educational underachievement, poor health and problems with their local environment”. www.communites.gov.uk. In an interview conducted with Denise Adolphe 2006 Communications and marketing manager of the CPP (Clapham Park Project), the issue of the hard to reach was addressed. Since the stock transfer in 2005, MHP has attempted to increase social capital by the method of mixed tenure to help low income households own their homes through shared ownership. This enables the buyer to purchase their homes in increments of between twenty-five to a hundred percent shares by stair casing. This gives the tenant the choice of owning a percentage of their property and part renting, or stair casing until they own the property outright at one-hundred percent. Social capital can be achieved by Partnership with financial institutions such as The Credit Union helps low earners to have access to low interest loans and savings. These groups will other wise be overlooked by the major high street bank due to their income or the post code lottery.

NFHA 1995 (National Federation of Housing associations) p.v.1 Housing associations should only manage estates were they can be integrated with the surrounding areas where basic facilities are provided and there are good transport links. These are important to avoid isolation of communities which works in total opposition to cohesiveness. This begs the question, or questions the methods and engagement strategies used to reach entire communities. To make lasting and effective change customers must be made aware of the choices available to them via capacity building, consultation and awareness. Key actors in regeneration need to be aware of barriers that may hinder resident participation such as language, race, religion, MHP for example work according to Audit commission |guidelines which stipulate the importance of resident participation. They provide a free phone service where residents could enquire about free capacity building workshops and various forms of training focussed around tenant participation. The Lorrimore Centre in Southwark South London experienced numerous failed attempts at reaching the black community. They realised that their traditional method of leafleting was not working so they adapted their outreach strategy by holding information stalls at local events where they actually engaged in one-to-one conversations with residents finding out their reasons why they were not utilising the service, conducting qualitative research. These strategies gained a positive response.

The role of Housing Association is to make areas and estates communities where people want to live and work and feel safe. There are various means of regenerating areas for example, by building shopping centres, improving transport links, positive press coverage to assist in the minimalisation of stigmatisation of particular areas, altering the fabric of areas by erecting trees, preserving nature and national heritage to help the area become attractive and inviting.

“People want to live in mixed communities which offer decent housing, jobs, good public services, transport and a local environment to be proud of” (Prescott 2004). Areas need to be inviting and opened up not closed off causing isolation. The benefits of urban regeneration should not only benefit the locals but should be far reaching nationwide. www.westhendon.com are regenerating a new housing scheme. in order to make the area accessible, around 680 homes were surrounded by the gyratory system along the A5. Traffic lights had to be relocated and additions made, more bus routes were introduced, as were pedestrian bridges to allow access to leisure and amenities as well as nature reserves and other public services. Thoughtful Planning and thorough investigation into the area must be taken into account when regenerating areas, local issues around suitability in relation to new build. As buildings alter the physical appearance of areas.

Parents serve an important role in the socialization of children by modeling important values, principles, ideals, attitudes, actions and behaviors that influence the physical, emotional and social development of the child. Fathers and mothers have unique differences that cause them to have different parenting roles, that when combined, provide the most comprehensive model to help the child develop successfully. For this reason, children need both parents to help them develop the skills to help them build successful social relations, engage in responsible behavior, develop the confidence and skills to be successful in school and to become well-rounded emotionally, physically and psychologically. Over the last two decades, researchers have begun to pay more attention to the idea that fathers make important contributions to child development (Parke, 2004; Davis & Perkins, 1996). Evan (1995) indicates, however, that while fathers have now become the subject of studies and review, this is a relatively new area of study. Given the potential role involved fathers have on the development of their children, it is important to understand how fathers perceive their fathering role and its impact on children. The goal of this paper is to examine the role of fathers in the lives of their children in the literature and to identify a gap in the literature in order to come up with a research question for a future study.

Review of the Literature

Schock and Gavazzi (2005) observe that despite the expansion of fatherhood literature over the last several decades, not much is understood about the role of fathers in their relationship with problematic adolescents. This has prompted researchers to examine father’s parental skills. For example, Nicholson, Howard and Borkowski (2008) investigated whether fathers were able to display metaparenting skills during the first two years of their children’s lives. Metaparenting refers to a mental plan that parents use when caring for their children across five domains: responding, preventing, monitoring, mentoring, and modeling. To determine how fathers think about and conceive of their parenting strategies, the researchers looked at the two main factors contributing to paternal identity: father absence and the availability of positive parenting role models. The participants included 87 fathers. Fathers were also evaluated for their metaparenting beliefs and behaviors, and assessed for parenting stress, parenting style, knowledge of child development and child abuse potential. The study revealed that positive parenting role models and intelligence were associated with working models of parenting based on the five components of metaparenting. Furthermore, authoritative parenting and a decrease in abuse potential were related to higher levels of metaparenting.

In a previous study, Schock and Gavazzi (2005) used a modified grounded theory approach (i.e., one based on the participants’ meaningful experiences) to examine the intra-psychic and interpersonal difficulties that fathers had with adolescent daughters who are involved in the court system. Fourteen fathers (mean age=46.6 yrs.) and their daughters (mean age=15.6 yrs) who participated in a family-based diversion program for their at-risk adolescent daughters took part in the study. The goal of the program was to help each family identify and support the developmental needs of their adolescents so that they can successfully move into adulthood. The fathers completed face-to-face semi-structured interviews with the questions addressing topics such as the fathers’ perception of their relationship with their adolescents, fathers’ unique skills to cope with the adolescent’s problematic behavior, and barriers/facilitators for participating in the program. The results indicate that fathers of female adolescents had feelings of uncertainty about their role as parents in four areas: poor understanding of their daughters’ female issues (e.g., dating, menstruation, etc.), communication barriers related to conversation topics and style of communication, limited involvement due to the absence of shared interests, and indecision about how to address their daughter’s problematic behavior. Based on the findings by Schock and Gavazzi (2005), it is possible that fathers have communication problems with their teenage daughters because they did not form secure attachments with their daughters during the first two years of their lives.

Later studies found similar connection between children’s attachment with their fathers and father involvement. McDonald and Almeida (2004) used an ecological perspective to examine the differential impact of work experiences on fathering experiences at home in 290 fathers (mean age=40). The participants first completed a 30 to 40 minute telephone interview about their daily experiences after which they were mailed a written survey, which asked them questions about how their time was spent in the past 24 hours (e.g., cutbacks at work, and their daily work/family stressors. The authors found that fathers tend to report a greater likelihood of providing emotional support to their children on those days when they experience overloads on the job as well as on days when they cut back their workload. The amount of time that fathers spent with their children was found to be moderated by how much control or latitude they have at work. The authors conclude, however, quantity of time alone may not impact the quality of the fathering experience. This conclusion is supported by Newland, Coyl and Freeman (2008), who investigated the relationships between preschoolers’ attachment security, father’s involvement and fathering context in 102 culturally diverse U.S. fathers of preschoolers age 2-5. The results indicate that father’s secure attachments with other adults and their use of social support were related to parenting and co-parenting behaviors. These in turn, predict child attachment security. The use of rough housing play was considered the most important predicator of child attachment security, more important than fathers’ sensitivity and consistency. According to the authors, the findings suggest that fathers play an important role in their children’s attachment security, and that shared father-child activities, parenting consistency and co-parenting behaviors should be emphasized among fathers.

An important finding in the literature is that fathering strategies are related to paternal role identity. Maurer (2007) assessed caregiving identities, perceptions of partners expectations and the perceived caregiving behavior in 73 fathers (mean age 33.7 yrs). The researcher found that the perceived behaviors of other fathers were significant predictors of fathers’ behaviors toward their own children. Bronte-Tinkew, Carrano and Guzman (2006) argue that it is important to determine how fathers identify themselves as parents by examining their perceptions of themselves as fathers. As a result, they investigated the perceptions of resident fathers (i.e., fathers who live with their children) regarding their roles in the lives of their children and how this affect their involvement with infants in five areas: caregiving activities, paternal warmth, nurturing activities, physical care, and providing their child with cognitively stimulating activities. Most of the resident fathers believed that their role as fathers play an important part in their children’s development. The results further indicate that while most fathers were highly involved in providing physical care to their babies, they were not highly involved in cognitively stimulating activities such as reading with their children. The fathers’ sociodemographic characteristics (race, marital status, education, and socioeconomic status) impact their perceptions of fathering (e.g., Hispanics and other race fathers had significantly lower positive perceptions of their roles compared to other participants). Married fathers and fathers living above the poverty line had higher scores that unmarried fathers and fathers living below the poverty line. Fathers with infant sons had stronger belief in the importance of their roles and more paternal involvement than those with daughters. The latter finding is supported by Schock and Gavazzi (2005) who found that fathers of adolescent daughters face challenges when communicating with their adolescent daughters, which is a factor in their indecision about how to deal with the problematic behavior of their daughters.

A later study by Wilson, Dalberth and Koo (2010) support and expand the findings of Schock and Gavazzi (2005) and Bronte-Tinkew, Carrano and Guzman (2006) in terms of father’s involvement in their lives. The perspectives of 131 fathers on their role in protecting their pre-teenage children from sexual risk was investigated. The results indicated that while fathers take a strong role in keeping their children safe and successful, some did not talk openly and frequently with their children about sex. Though almost all the fathers agreed that fathers’ perspectives on the issue of sex are important for children to hear, the gender of their child determined how comfortable they were discussing sexual matters. Fathers felt that they were better suited to discuss topics such as male puberty than female topics such as menstruation. Race also played a factor, with Hispanic fathers reporting that they were more protective of their daughters than their sons. According to Gonzalez-Lopez (2004), Hispanic fathers believe that delaying sex and using protection are important for protecting their daughters from becoming pregnant and for increasing their opportunities to attend and graduate from college.

Gaps in the Literature

One area that is has not been fully explored in the literature is the relationship between paternal role identity and fathering outcomes. In other words, none of the studies identified looked at the relationship between how father’s perceive their roles (i.e. how they identify themselves as fathers) and how children actually percieve their relationship with their fathers (i.e., outcome of father’s involvement). Maurer (2007) suggests that father’s perception of societal fathering roles is a good predictor of fathers’ behaviors. Newland, Coyle and Freeman (2008) found that parenting and co-parenting behaviors in fathers were predictors of child attachment security. Schock and Gavazzi (2005) suggest that a lack of secure attachment between fathers and their daughters lead to communication barriers and indecision about how to address problematic behaviors in their teenage daughters. Bronte-Tinkew, Carrano and Guzman (2006) found that higher positive perception of fathering roles were associated with high father involvement in mentally stimulating activities with their children such as reading. These findings suggest that fathers who believe that they have an important place in their children’ development are more likely to achieve better fathering outcomes such as providing their children with caregiving activities, paternal warmth, nurturing activities and cognitively stimulating activities.

Research Question

The following research question can be used to address the gap in the literature regarding father role perception and fathering outcomes: What is the relationship between paternal role identity and fathering outcomes? The independent variables related to father involvement were cognitively stimulating activities, physical care, paternal warmth, nurturing activities, caregiving activities.

As a potter molds clay to form a beautiful creation, so does the strong family support and good values does. Family bonds are a link from the beginning and guide to future. Early influences are fundamental to individual development. Everyone wants to belong and feel accepted. A sense of belonging is derived from the strong bond of family. Family is where roots take hold and grow. We are molded within a unit, which prepares one for the experiences of the world and reactions to those experiences. A close family bond is like a safe harbor where one finds refuge. From trusting that someone will pick us up when we fall, as a toddler, to someone being there for us as we experience the storms in life. Family bonds help to instill trust, hope and belief in ourselves. The other hand if family doesn’t have attachment, poor relationship, insecurity and anger can lead to negative consequences like isolating, low self image, anger and pain inside them. If one isn’t loved as a child, they may later seek love and acceptance in a way that brings them harm. This not only affects the emotional, physical and social well-being. The poor self-image may be with the patients throughout life, causing inability to make positive choices or be close to others. Strong family bonds help us to thrive in all aspects of life. Lack of these bonds can lead to forever seeking that something which is missing and one should not take the value of family bonds for granted.

Along the farm duties, family usually faces burdens. Yip (2005) identified three types of burdens in family care giving of persons with mental illness. Objective burdens are financial burdens, time and effort in care giving of family caregivers. Subjective burdens are feelings of loss, shame, worry, anger, and hopelessness of family caregivers towards their relatives with mental illness. Finally, there are burdens in management of problem behaviors like assault, mood swing, unpredictability, and other negative symptoms due to mental illness of a family member.

Along with the burdens, there are benefits when family stay with mentally ill person. Often patients listen to their family because they are close to each other and every disease needs cure and family is the major support. They can help their family member to involve in the social and family activities, by involving them in rehabilitation program, encouraging other family members and friends to invite the ill family member to join them in activities and by respecting the need of solitude.

Scenario:

My patient was a 17 years old female, forth among seven siblings, with the diagnosis of schizophrenia. Her pre morbid personality was that she was always a different child, quite and always thinking. She had no friends and was never interested to talk to her sisters as well. She never took part in household chores and when asked to help, she used to get angry, and never participated. She had a jealousy component in her as the mother always admired her elder sister and degraded her. Before hospitalization she even had hallucinations and delusions. While talking to the patient, she verbalized that “I don’t like my sisters because everyone compares them with me.” Patient’s mother also accepted that she had always given importance to the elder sister and pointed out the client that she is the laziest person of the family. May be this could be a reason of patients anger, frustration and not having a caring attitude towards family.

Significance of family support in Pakistani context:

Family support is a very important part of our entire Pakistani nation. Family support is given a lot of importance in terms of family bonding, love and affection. On the other hand there are few families which do not pay attention to this important issue. The family support is important because it effects on physical, psychological and social well being of an individual. In the Pakistani context no such study is been done on family’s role in one’s life. According to Mansoor (2008) “Family system in Pakistan” states that “each member of a Pakistani family has respect for the older family members. The parents feel responsible for teaching their children the basic beliefs of the chosen religion.” Looking at the scenario mentioned above the family has paid less attention to the child because of huge family, house hold responsibilities and low socio-economic system. According to my understanding when a child grows in a close kit family they learn to appreciate all the members of family and never hesitate to accompany their elders or younger’s in public. I believe that strong family bond serves as catalysis for everyone’s joy. This is because the family has its rules and regulations and when these rules and regulations are strictly followed it brings joy to the whole family and helps in community building. There is always the belief that good families can make a good society. Strong family bonds create an atmosphere of interference in the affairs of one another. For example a strong and united family the elders do not abandon the family, but they keep taking care of their parents and their younger ones in times of troubles.

Significance of family support in western world is on appendix 1.

Analysis of concept in the light of literature:

During the 1950s, Murray Bowen gave family system theory. Theory affirms that the individual can change behavior if aware of the impact of current and historical family behavior. It works on family as well as on the emotional health of an individual. Bowen summarized his theory using seven interlocking concepts. First three concepts apply to overall family and other four are related to family characteristics.

Differentiation of self

The concept of differentiation of self measures all human functioning on a continuum from the greatest emotional fusion of self boundaries to the highest degree of differentiation or autonomy. In my patients scenario “self” was suppressed from the childhood in the result of that her family relationship were not strong. A lot of family criticism was there. Children were not allowed to take their own decision; instead they have to do whatever parents asked. The example is secular studies were compromised and the client was put in Madrasa to learn and recite Quran. As a result the family bonding went down. Her issue were not given importance and taken as a least important person of the family. She was never paid attention for whatever she did; the reason could be huge family, less differences between children and poverty.

The continuum of differentiation of self is discussed more in detail in appendix 2.

Triangles

Triangle is a predictable emotional process that takes place when difficulty exists in a significant relationship, and the third entity is included. In my patient’s scenario, the triangle has three ends. One is father, another mother and the third is the patient. The conflicts between parents have a great impact on child and that can leave lifelong effects on one’s life. In my clients scenario the parents had conflicts between them and research indicates that the longer parental conflict continue, greater the tension between the parents, the greater the likelihood that psychological difficulties will result for children such as emotional and behavior problems, anxiety, depression, sleep problems, low self-esteem, school problems and a number of other difficulties.

The example of family triangle is on appendix 3.

Nuclear Family Emotional System

These are patterns of interaction between family members and the degree to which these patterns promote emotional fusion. In my clients picture she was always projected that she never participates in house hold chores and is the laziest person of the family. This indeed led to low self esteem and hopelessness. Most of the patients develop hopelessness because of shame and guilt of being poor. According to Patel & Kleinman (2003) stated that “hopelessness is a core experience: it is associated with spouse and family abuse, forced marriages, limited educational and work prospects, stigma for failing to produce a son, and the migration of husbands to urban areas for employment.”

The family projection process

It is the projection of spouses’ problem onto one or more children to avoid intense emotional fusion between the spouses. This also fits into the clients scenario that because of poverty and low socio economic status parent and child were not able to create bond between them. “The economic stressors such as unemployment, low income, and lack of affordable housing, are more likely to precede mental illness.”(Hudson, 2005 )

Multigenerational Transmission Process

This refers to the transmission of a family projection process. The nature and degree of intensity of emotional responses are passed down from generation to generation. Levels of differentiation are affected through generations based on levels of differentiation of partners as they marry. This was not exactly explored during the interaction but it could be a part of patient’s illness.

Emotional cutoff

The concept of emotional cutoff describes people managing their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them. In my patients case she became isolated from the family. This could be because she has some concerns from the family but they were never addressed and she got emotionally cutoff from it.

Sibling’s position

There is an impact of sibling position on development and behavior. Most of the time it is practiced that older child is the leader and the younger’s are the followers. My patient follows exactly in this category. She is forth among seven siblings. She never liked her mother to say that “be like your elder sister” and never liked to follow her elder sisters. (Stuart, 2001)

See appendices 4 for the factors left.

Intervention:

At individual level, a mental health nurse can take time for the patient and encourage them to ventilate their feelings. Moreover, while giving teaching to the patients, nurse can discuss the coping strategies. She can provide holistic care and address the problems and concerns accordingly, as the need of the individual. The nurse can provide the most important information’s to the patient that is the need for the understanding their own responsibility. Make them aware of the importance of family support which is necessary for them. The interventions done on the client includes family teaching on dealing with hallucination and delusions that was informal. Mother was given teaching on stress management and coping mechanism. Client was involved in occupational therapy example making sit upon, coloring, drawing, collage work, making bands and so on to see the concentration level and keep the patient busy and asked the family to keep patient involved.

At group level family can also involved with patient, to be aware of patient’s condition and involve them actively in patient’s care. The individual can be involved in group therapies for example milieu and occupational therapy. Moreover, in Pakistan, organizations should be made which can involve families who have clients with mental illness so that they can share their concerns, ventilate their feeling and reform solutions to problems. Some organization can also work to reduce the poverty and socio-economic instability, which is one of the leading factors of mental illness.

At institutional level different groups of health care professional can be train for the risk assessment, can conduct the educational session on importance and role of family in one’s life. Moreover, seminars can be held for general public regarding awareness of mental illness, coping skills to reduce stress and to ventilate their feeling. Hence, I would like to recommend that health care workers should be more vigilant towards client’s health.

At governmental level, organizations should be made to teach skills to clients for earning and to feel them self-empower. In addition, it is role of a nurse to identify the concerns in clients, spend time with the clients for their ventilation of feelings, should not be judgmental regarding clients complains and try to resolve their issues collaboratively with clients, families and other health care providers.

My own learning & Reflection:

Through this paper writing my horizon of thinking about family role has more broaden. I always had a thought that mental illness occurs more often with parental conflicts but it has many other dimensions to look at. Going through different researches I came to know that love and affection are the important aspects which can help a mentally ill patient to live a normal life and when one is deprived from it can end into many other issues. The misconceptions I had before about mentally ill patients were that they are harmful and attacking but now I realized that they are only looking for love and someone to listen them. Mentally ill patients are also human and they should be treated as human beings, this is their right and they should get it.

Conclusion:

In conclusion, low family sociability, the extent to which family members derive and seek gratification from social interaction with others along with a lack of cohesion explicitly, the extent to which family members have bonding towards one another is important. Conflicts between family members, authoritarian family styles, the extent to which parents dominate the locus of rule making and low family sociability play’s a significant role in one’s life. Importance of Family lies in the fact that one can discuss matters with the other family members and search solution from discussions. At times, conflict appears in a family but enough space should be provided to their opinions and views. In modern days, we have seen that joint families have broken up into nuclear families and a nuclear family consists of a couple and their children. In western countries, nuclear families are the norm but in many eastern countries, joint families still exist. Children receive guidance from the family as to what they should do or what they should not do. The Importance of Family lies in the fact that it determines to a large extent the social roles that the children will perform. Family support and bond can help an individual to come out from stressors, mental illness and other health problems.

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Appendices 1:

Significance of family support in western context:

According to Sven.D. 1998 “There are regions where traditionally the family group has priority over the individual and others are opposite, with the individual and there values having priority over everything else. The geography of these family systems suggests that North America, center and northern Europe has been characterized having relatively weak family links. There are indications that these differences have deep historical roots. There is little to suggest that they are diminishing today in any fundamental manner. The way in which the relationship between the family group and its members manifest itself has implications for the way society itself functions.” According to my thinking, in western world, families have less importance, may be because of their fantasy world, interference they don’t like or freedom they are fond of. In the west, kids are allowed to leave parents at the age of 18 as they are mature and can take their own decisions and responsibility and parents don’t mind it because it’s their trend, as a result single parent family comes into existence. According to Jill Francis, of the National Children’s Bureau, “There are four main reasons why teen age unmarried girls in Britain become pregnant. “The likelihood becoming pregnant as a teen increased if one had parents who were inattentive, unloving, or failed to instill moral values with no family bonding. Girls whose mothers were teenage mums are more likely to do the same”. Here the question arises that if this situation will continue, will there be family bonding in upcoming years? It is important for the family to understand the importance of family role in order to save the generation from mental illness, as families role is one of the biggest factors contributing towards mental disorder. The concept of family is somewhere far but those who belief in family bonding are still holding their hands together.

Appendix 2:

High differentiation

Low differentiation

Fusion with others. Personal autonomy

Blends thoughts and feelings. Distinguish between thoughts

Emotionally reactive when stressed. and feelings. Retains objectively

when stressed.

Interrelationship can be defined as a “mutual or reciprocal relation” (Oxford University Press, 2012). A theory in social work is a “framework for understanding” (Thompson, 2000a, p. 22). It provides the practitioner with an understanding of client behaviour and emotions. Where theory enables understanding the client and the situation they are encountering, practice is how the practitioner interprets this ‘knowledge’ and uses it. It is the process of interviewing, accessing and assisting the client. Thompson (2000a) states “the relationship between theory and practice can be seen as a direct parallel with that between thinking and doing” (p. 4).

Social work practitioners learn theories so they can be more competent and professional in their practice. Without theory and a solid knowledge base, the social work practitioner inadvertently becomes less effective (Thompson, 2000a). Howe states (as cited in Collingwood, Emond, & Woodward, 2008) some social work practitioners “believe that theory is not required and that the best decisions are based on pragmatism and common sense” (p. 72). However, according to Fisher and Somerton (as cited in Collingwood et al., 2008) “theory may not be explicitly articulated, and it may not be used well, but there is no such thing as ‘theory-less’ practice” (p. 72).

An example of a how theory interrelates with practice is what Connolly and Healy (2011) call mountain-moving theories (p. 28). These are “approaches that aim to shift oppressive structures and/or dominant discourses so that we can move towards a more equitable society” (Connolly & Healy, 2011, p. 28). Social work practitioners are considered to have power and influence, therefore they need a practice that does not discriminate, oppress or show prejudice in terms of “sexism, racism, ageism and disablism” (Thompson, 2006, p. 40). Anti-oppressive practice is the practice in which a social work practitioner strives to “reduce, undermine or eliminate discrimination and oppression” (Thompson, 2006). When working with a person with a disability, a social work practitioner must be careful not to oppress the client themselves, therefore social work practitioners follow the “principle of minimal intervention” (Connolly & Healy, 2011, p. 29). They need to use skills that involve empowerment which means “believing that people are capable of making their own choices and decisions” (Connolly & Healy, 2011, p. 28). The social work practitioner would use their knowledge, access to resources, and power to enable the client to feel powerful and supported. They would not make decisions for the client but would let them decide for themselves, giving the client the tools necessary to “realise their potential” (Connolly & Healy, 2011, p. 28). By using the right theory in their practice the social work practitioner has enabled the client to feel validated, giving them greater control of their lives, therefore building up their confidence and allowing them to be valued members of society (Connolly & Healy, 2011). Connolly and Healy state “anti-oppressive practice provides a theoretical explanation, guidance in terms of approach, and techniques for responding to the needs of people” (Connolly & Healy, 2011, p. 28).

According to Thompson “a paradigm is a theoretical approach which encompasses a number of related theories” (2000, p. 27). Theoretical paradigms play an important role in social work as they guide the practitioner on what may be happening in the client’s world. Social work practitioners can choose which approach to take by which paradigm they deem more appropriate to the situation (Thompson, 2000b). They can choose to focus their practice on a particular or singular paradigm or use multiple paradigms, in an eclectic manner (Poulter, 2005). Poulter states “eclectic workers argue that not being locked into one particular paradigm frees practitioners to determine what actually works best in practice” (2005, p. 1999). Although there are many theoretical paradigms of social work one main one is systems theory.

An understanding of systems theory involves looking at the sociological effects of society on the client and how they are being affected by them (Thompson, 2000b). With Bronfenbrenner’s ecological theory, the social work practitioner takes the client’s current environment into account. This theory includes microsystems, mesosystems, ecosystems and macrosystems (Connolly & Healy, 2011). It is a valuable theory because it allows the practitioner to look at the whole picture. For example if there was a problem with a child, the social work practitioner would firstly look at the microsystem surrounding them. This includes the child’s family, school, peers and neighbourhood which interact daily with them (Santrock, 2011). The social work practitioner would then look at the mesosystems that impact the client’s life; this is the relationship between the child’s microsystems and how they affect each other (Santrock, 2011). The ecosystem “consists of links between a social setting in which the individual does not have an active role” (Santrock, 2011, p. 29), examples of this are parents work places and social welfare services. Here, the social work practitioner looks at how the parents’ work place or hours of work affect the child or how social welfare is influencing the family’s life (Payne, 2005). The macrosystem “involves the culture in which individuals live” (Payne, 2005, p. 29). This is the family’s values and beliefs and how this affects the child. By looking at the whole picture the social work practitioner can obtain a true picture of the child and his / her environment. By using a theoretical paradigm the practitioner has managed to fully comprehend the client’s situation and what its influences are; now they can use their knowledge of practice to provide assistance to the child and family.

As theory and practice are interrelated, it is accurate to say that they shape one another as well. Sheafor and Horejsi determine that, not only is it hard to separate theory and practice but “practice is the process of using knowledge and applying theory in order to bring about specific change” (2008, p. 46). During the process of time and practice, a practitioner’s knowledge base develops, changes, and becomes more comprehensive. To help recognise when change is needed, part of the social work practitioner’s role is to “constantly reflect upon what they do and what they think about what they have done” (Dominelli, 2004, p. 250). Reflexivity practice is cyclic, and begins with the experience of the task, reviewing what has happened, conceptualising and trying to understand relationships and finishing by predicting what to do next, thus giving the practitioner a new idea of how to proceed next time (Chenoweth & McAuliffe, 2012). Reflexivity “provides an opportunity to understand the way in which the worker’s personal views and interpretation intersect with practice-in-situation” (Harms & Connolly, 2011, p. 6). Reflexivity leads to praxis when an ideology is added; this is the process of strengthening our practice and a form of continual growth for the practitioner (Harms & Connolly, 2011). During this time theories will also grow and change, leading to a change in practice. As most social work practitioners want to bring about change and ‘help people’, they are more inclined to promote social action (Shaefor & Horejsi, 2008). Examining social injustices and inequalities in society is just part of the social work practitioner’s role (Payne, 2005). According to Payne (2005) “this has led to the development of perspectives that broaden the range of factors that lead to inequality and injustice” (p. 230).

Culturally sensitive practice in New Zealand was developed in order to promote perspectives that encompassed MA?ori value and beliefs. Social work practitioners saw the need to treat MA?ori within the context of their culture, not the dominant culture of the Pakeha. MA?ori well-being is viewed as holistic, containing characteristics from the spiritual, mental, physical and extended family (Durie, 1994). Where a psychodynamic theory might work with a Pakeha, the one to one dynamics and required openness of the dialogue, does not encompass the culture of MA?ori. This led to the development of mA?ori models like the ‘whare tapa whA?’ model, Te Wheke and NgA? Pou Mana” (Durie, 1994). The whare tapa whA? model was formed from the findings that MA?ori health was suffering due to the westernised treatment of them while sick (Durie, 1994). The standard dominant Pakeha model of health was not allowing MA?ori to follow their cultural beliefs; therefore a new theory or models were developed to encompass MA?ori culture. This in turn led to improved practice. Social work practitioners now understand when working with Maori that it is not just the individual that needs to be considered but the collective (Durie, 1994).

In conclusion, the interrelationship between theory and practice denotes that they are reliant on one another for the social work practitioner to develop their professional selves. For quality practice, a social work practitioner must have a sound knowledge base of theory and practice. The developments of new perspectives enhance the ability of the social work practitioner to have an ethical practice. Thompson states (as cited in Thompson, 2000a) “practice which does not take into account of oppression and discrimination cannot be seen as good practice” (p. 10). The use of theoretical paradigms in social work practice provides the practitioner with an understanding of ‘where the client is at’ in their situation, what they will do to assist the client and how they will do it. Theory shapes practice in the way that what the practitioner learns will affect the way they practice. Similarly how the practice is developed, is based not only on theory but also experience, so this shapes theory in that it may be modified to suit. The process of reflection helps the practitioners ability to look back on their practice and the theories they have used, allowing them to review their thoughts and feelings. A change in theory and practice has enabled MA?ori to be treated in a way that is more in line with their culture, making the practitioner more sensitive and well-rounded which leads to an improved practice.

For my essay I have chosen to look at the role of a mental health social worker (MHSW). MHSWs may be incorporated into a multi-disciplinary community mental health team or they may work as part of a generic team and I have chosen to focus on the former. Many MHSWs although formally employed by a local authority are often permanently seconded by health and work in health and social care trusts that are partnerships between health and local authority employers. (Wilson, Ruch, Lymbery and Cooper, 2008). Community mental health teams (CMHTs) work to help people with complex mental health disorders such as schizophrenia and bipolar disorder. They provide day-to-day support that allows service users to remain in the community. The Care Programme Approach (CPA) used by CMHTs has been central to government policy since 1991. It was crucial to ensure that, following the closure of the old, long stay, hospitals, people with mental health problems received the care they needed, rather than lose contact with services and end up homeless or exploited. The Care Programme Approach (CPA) requires that everyone accepted for treatment or care by mental health services should have their needs assessed, a care plan to meet those needs, a named mental health worker and regular review of their needs and their care plan (Department of Health (DOH) 2010).

A mental health social worker’s contribution to a CMHT ‘is ideally found in a combination of systematic, psychodynamic and broadly relationship-based skills and perspectives’ (Wilson, Ruch, Lymbery and Cooper, 2008:586). A MHSW performs roles that can be divided into three broad categories: advocacy role, direct change agent role and executive role (Beckett 2009). Very often these roles are performed simultaneously and this may cause conflict. Advocacy can be defined as ‘the exclusive and mutual representation of a client(s) or a cause in a forum, attempting to systematically influence decision making in an unjust or unresponsive system(s)’ (Schneider and Lester, 2001:65 cited in Beckett 2009:118). Advocacy is a very important role played by social workers especially as mental health service users are a group ‘marginalised in some way by society’ and it is ‘about redressing the balance and helping voices to be heard, which otherwise would have gone unheard’ (Beckett 2009:122). People with mental health problems experience discrimination in many areas of life. Social workers by virtue of their professional status possess a lot of power and need to be aware of this when they are trying to build a relationship with a service user group that has been effectively disempowered by society. As advocates social workers can use their power to challenge the oppression faced by mental health service users. A mental health social worker can act as either a ‘direct advocate’ or an ‘indirect advocate’. As a direct advocate they would speak on behalf of a service user. As part of a multi-disciplinary team social workers are expected to work with other professionals such as psychiatrists, nurses and occupational therapists. In recent years the primary agency responsibility for mental health work has shifted decisively towards the health sector and there are those that argue that ‘operating within the medicalized paradigm of practice reduces human potential to the confines of drugs and mental patient role reproducing programs, thus short-circuiting social development and reproducing the conditions of oppression’ (Rose and Black, 1985:58/9). This has had a big impact on social workers as difficulties arise from a clash in values of the medical model and social models of mental health care. In addition competing demands of the various professionals working in the team faced by limited resources may lead to further difficulty. A MHSW may have to advocate for a service user when dealing with other professionals and must be skilled in diplomacy and communication in order to achieve the best possible result for the service user when dealing with other professionals. As an indirect advocate a MHSW helps service users speak on their own behalf. Social workers are frequently in a position which makes it impossible for them to be truly independent and represent only the service users’ wishes. For example, when a social worker needs to act on behalf of more than one family member who have conflicting wishes or interests, when service user’s wishes conflict with the social worker’s assessment of what is in the best interests of the service user, and when conflict arises because social workers have a responsibility to manage public funds and prioritise limited resources and this may conflict with the service user’s wishes/needs. Advocacy skills are important to social workers, but they must also have the knowledge required to advise service users to find independent advocacy appropriate to their needs.

In the direct change agent role a MHSW through interaction with individual service users or groups of service users can work to bring about change. Bringing about change will require assessment of the service user’s needs and looking at ways in which their circumstances may be improved and this will involve significant skills in problem solving. Social workers in a CMHT may borrow from therapeutic/counseling techniques and ‘past’ or ‘present’ oriented approaches (Beckett 2009:47) such as psychodynamic and cognitive behavioural theories can be used to help the service users bring about change in their lives. ‘Mental health problems are intensely personal experiences for the person who is directly affected, but also for those close to them’ (Wilson, Ruch, Lymbery and Cooper 2008:566). Working with a service user to bring about change may involve working with carers and/or family members as a mediator to resolve conflict or as an educator. This can be very useful as service user problems can sometimes be linked to those around them and part of bringing about change would require change from them. Some of the skills required by a MHSW in a direct change agent role would be communication, negotiation and counseling.

The executive role deals with the practical side of being a mental health social worker. As a care co-coordinator the MHSW would be the first point of contact between the service user and various professionals involved in their care. A social worker acting in this role should be able to explain to the service user how different services are responding to their different needs, while at the same time relaying any of the service user’s concerns to the appropriate professionals. Part of the executive role includes the social worker acting as a control agent. This role ‘regulates and enforces boundaries of behaviour in order to protect vulnerable people either from being harmed themselves or from harming others’ (Beckett 2009: 12). Under the Mental Health Act (MHA) 1983 Approved Mental Health Practitioners (AMHPs) have a ‘statutory role in arranging compulsory admission to hospital’ (Brammer 2010: 446). This role creates an ethical dilemma for the MHSW as they are expected to balance the rights and welfare of the individual against public welfare and this may mean compulsory detention for assessment or treatment. AMHPs work closely with medical practitioners who are required to first recommend compulsory detention for assessment or treatment, ultimately the final decision lies with the AMHP. The AMHP must also consult the service user’s nearest relative (Family member, spouse, civil partner, or someone who has resided with the service user for five years) before an application for treatment or guardianship is made (Brammer 2010:448/9). The role of control agent poses an ethical dilemma as the social worker ‘ sees herself as facing a choice between two equally unwelcome alternatives, which may involve a conflict of moral values’ (Banks 2010:13).

A MHSW can apply various theoretical perspectives in their area of work. I have chosen to briefly explain the person-centred approach, cognitive behavioural therapy and the strengths perspective. Following this I will describe in detail how the strengths perspective can be applied in a CMHT.

The origins of the person-centred approach can be traced back to Carl Rogers in the 1950s and 60s. Rogers placed immense value on the therapeutic relationship and identified six conditions ‘”necessary” and “sufficient” for therapeutic change to occur’ (Dykes 2010:114/5). These conditions are psychological contact between client and therapist; client’s state of incongruence; therapist’s congruency or integration in the relationship; the therapist’s unconditional positive regard for the client; the therapist’s empathic understanding of the client and communication of empathic understanding; and positive regard achieved to a minimal degree. To use this approach successfully social workers do not ‘claim to have superior expertise to their client and they do not claim to be able to explain or interpret their clients to themselves, they simply help their clients to draw on their own expertise and their own problem-solving capacity’ (Beckett 2009: 66). This approach empowers service users and gives them confidence to come up with their own solutions. In this process the helper grows personally while helping the service user to do the same. In order to help the service user the social worker needs to ‘already being the place where the client needs to get in order to deal with his own problems in his own way’ (Beckett 2009: 69). This approach comes with some difficulties as social workers can be expected to play different roles at the same time. When a social worker acts as a control agent it is virtually impossible to offer the “acceptance” that the approach requires. The social worker cannot just accept the ‘client’s world’ without ‘evaluating and judging’ especially when there is risk of harm to the service user or others. In some situations it is also possible that a social worker may have to disclose information revealed by a service user to other professionals or agencies. A social worker cannot just accept what a service user has divulged and may be required to act on the information whether or not the service user wants them to. This may not foster the type of trusting therapeutic relationship that Rogers envisioned.

Present day cognitive-behavioural therapy represents an evolutionary merging of behaviour therapy and cognitive therapy (Dykes 2010). It is an approach supported by the National Institute for Clinical Excellence (NICE), the body set up to review the effectiveness of clinical treatments for the National Health Service (Wilson, Ruch, Lymbery and Cooper 2008). It is the method of choice in mental health services due to empirical evidence of its effectiveness and its overall cost-effectiveness as it can be offered on a short term basis. The underlying theory of the cognitive-behavioural approach is that behaviour and mood are largely the result of the cognitive processes with which we interpret the environment that surrounds us. From his early research Aaron Beck realised the need for theory that ‘drew together meaning and behaviour in both normal and abnormal emotions’ (Salkovskis 2010:146). Beck’s cognitive theory of emotion is integral to the understanding of mental health problems from a cognitive-behavioural perspective. The cognitive theory of emotion suggests that it is the meanings that individuals take from a situation that create emotional responses. If the meaning is negative, the emotional response will be negative and vice versa. Particular emotions are typically linked to particular meanings. For example anxiety and fear are usually linked to personal threat and danger (physical, social or role-related)These meanings are not always conscious and may require a social worker to carefully question an individual so that they can be identified, therefore communication and counselling skills would be essential. The cognitive theory identifies that normal emotions become disordered when an individual continually takes certain meanings out of situations with persistant negative responses. A practitioner using the cognitive-behavioural approach offers, a safe environment, acceptance and congruence, actively challenging self-destructive and negative thought processes that may be destructive. The practitioner seeks to facilitate the client’s own understanding of their behaviour and feelings and thus effect a change of view of the way in which they see the world and how it impacts on them. Seeking to alter irrational into rational beliefs, which are less likely to result in poorly adapted behaviour and disorders such as depression. It is very important for the practitioner to assist the individual in making clear both the problems they want help with and the goals they want to work towards.

The strengths perspective originates in North America from the works of Saleebey, Rapp, Weick and others. They advocated for professionals to challenge key concepts in biomedical and psychiatric discourses that focussed on deficits. The ideas behind the strengths perspective are an effort to correct a strained and often destructive prominence of what is absent, wrong and abnormal. Practicing from this perspective does not ask social workers to ignore the real problems that impact people and their sense of future possibility as in ‘the lexicon of strengths, it is as wrong to deny the possible as it is to deny the problem’ (Saleeby, 1996:297). The strengths perspective is strongly aligned with solution-focussed and empowerment approaches. Features of the strengths perspective are consistent with the empowerment approach as the aim for both is to build service user confidence in their own abilities. The empowerment perspective ‘can be seen as a bridge between the strengths perspective and anti-oppressive approaches in that it combines core elements of both practice perspectives’ (Healey, 2005:157) The perspective draws on theoretical knowledge and empirical research in social sciences and social work. The perspective assumes that all people have strengths, are resilient, have the ability to determine what is best for them and that professionals tend to focus on the clients’ problems and deficits and shy away from collaborative partnerships with service users because they want to protect their professional power (Healey 2005). The key practice principles of the strengths perspective are adopting an optimistic attitude, focussing primarily on assets, partnership with the service user, working towards long-term empowerment of service users, and creating community.

According to Rapp (1998) mental health workers must have a belief in people and the capacity to better their lives and that the ‘practice perspective must reek of “can do” in every stage of the helping process’ (Rapp, 1998:54). The strengths perspective embodies social work values of respect and service user self-determination (Healey 2005). Optimism is essential if a social worker is to build on the service user’s strengths and ‘social workers have a professional duty to assume a positive and optimistic attitude towards service users’ (Healey 2005: 158). A MHSW will need to acknowledge their client’s strengths and respect the direction in which clients want to apply them. This may require a MHSW to challenge themselves and others to question approaches that focus on the problem or deficit that the service user has. Instead the MHSW would look for strengths that the service user possesses and focus on these as ‘we can build only on strengths, not on deficits’ (Healy 2005:159). It is also important to focus on the strengths of the service users families and community as inherent in the perspective is the belief that all people, families and communities possess strengths that can be called on to improve the quality of their life. The social worker must be able to convey their belief in the service user and vital to this would be their use of language. Instead of referring to a service user as a schizophrenic, they would be referred to as a person with schizophrenia (Healy 2005). Separating the service user from the problem that has brought them to the agency is an integral part of the approach. Listening and identifying strengths and resourcefulness that a service user has is an important part of the strengths perspective. A social worker must be able to listen to a client’s account of a situation and identify the service users’ capacity to make positive changes. For example, when dealing with a service user that suffers from severe anxiety the social worker can help the service user to identify periods when they are not anxious. Service users then realise that they are not in a permanent state of anxiety and identify what it is that helps then remain in a state of non-anxiety. Client goals and visions then become the base for intervention plans.

The strengths approach requires that the service user and social worker have a collaborative partnership and this is consistent with social work values. Working in partnership increases the likelihood of a positive outcome as the service user is involved from start to finish. A MHSW would have to use their listening skills and it would be essential for the partnership that the service user feels that their views are being listened to. It would be important for the MHSW to ‘create opportunities for the alienated and distressed to seize some control over their lives and the decisions that are critical to their lives’ (Rappaport cited in Healey 2005: 163/4). Empowering service users to make changes would be a key role for a MHSW.

The strengths perspective demands that workers regard their practice from a different viewpoint. Service users and those who surround them need to be seen for their capacities, abilities, competencies, ideas, values, and hopes, however affected they are by situation and oppression. There are those that criticise the approach because it ignores real problems, however, the perspective does not downplay or ignore real problems. Problems are what bring the service user to the agency and they are compelled to talk about them. They need opportunities to express themselves, and recount the barriers to their expression and value. How a MHSW would relate to these problems is pivotal in the strengths perspective.

Social work is a diverse role that requires many varying skills. These skills are used to support members of society who have been marginalised and disempowered and social workers attempt to correct these inequalities in the many different agencies that they work. In order to make decisions social workers require a firm understanding of theory and their ability to use the appropriate theories for a given situation or to be able to select different principles from varying theories and use them in combination for the benefit of the service user is equally important.

This essay gives an overview of the risk assessment and decision making in adult protection. The main purpose of this essay is to bring a more clear concept of risk; meaning of risk assessment and risk management decision making in adult protection and further it will examine existing based on upon research and evidence finally, it will critically analyse national and local reports which are related to risk assessment. It also contains a section dedicated to the specialized agencies in social assistance and their role in helping vulnerable adults, by creating procedures meant to assure the proper protection and care, offering them security, assistance and guidance to create a normal life. Identify a series of definition of risk and risk management for better understanding the concepts that are aiming to develop. Next, it will connect the existent literature review on this topic to own research. Furthermore, it will present the risks that the adults with disabilities are exposed to, that can cause their injury, or even death, as we will understand from a presented case study.

Discussing about risk management, risk assessment, it can automatically presume that are referring to a situation in which something might go wrong. According to Hope and Sparks (2000) risk assessment may only able to identify probability of harm or danger, consider the impact of risk on individuals key and pretence intervention strategies which may reduce the risk or minimize the harm. However, assessment does not prevent risk.

‘Risk level’ (or simply ‘risk’) should be seen as a continuous probability statement, rather than a dichotomous variable (risk or no risk) since risk levels are often not stable but fluctuate over time and context, estimates of risk should be in the form of ongoing ‘assessments’ rather than one-time ‘predictions. “

The above definition speaks about the fluctuations of risks in time and in different contexts. It recommends that risk should be continuously monitored. Further, in their study, the authors refer to clinical risk assessment, a more related issue to this study.

“A frequent suggestion for improving the validity of clinical risk assessment is to take into account predictor variables reflecting the ‘environmental’ or ‘situational’ context in which violent behaviour is likely to occur, in addition to measuring dispositional, historical, or clinical factors. “

(Monham and Steadman 1994, p. 8)

A more precise definition of the term is offered by Oxford Advanced Learners Dictionary (2010, p.1) “the act of identifying possible risks, calculating how likely they are to happen and estimating what effects they might have”. Risk is closely linked to dangerousness, resulting in harm which seems to be agreed means harm to self or others and extend of harm which constitutes a risk in various situations especially adult with learning disabilities.

Brown (2005) states assessment of risk for adult with learning disabilities which should be evolutionary in nature constantly informed and shaped by changes of circumstances upon service users needs. The practice of risk assessment and management is the process of data collection, recording, interpretation, communication and implementation of risk reduction plan (Brown, 2005). According to Kemshall and Pritchard (2001) every human being becomes vulnerable during their lifetime for many of reasons they all respond differently to events that happen to them because of who they are and the lack of support that they have For the risk of learning disability, clinical model of risk assessment have become the norm. There are two kinds of risk that are relevant to work people with learning disabilities, risk of unnecessary exposure to undesirable events or experience, and risk of negative consequences when possible benefits and desirable experiences are perused (William et al, 2006).

Further present a series of acceptance regarding the risk management concept.

“Risk Management aims to facilitate the exchange of information and expertise across countries and across disciplines. Its purpose is to generate ideas and promote good practice for those involved in the business of managing risk.” (Palgrave-journals, 2011, p.1.).

In this definition, the risk management is perceived as a discipline, moreover, as a business solution meant to ease the communication flow and to propose a model for the risk management practice across countries and business areas. The concern of this study is not so general. Main focus is upon the risk management in the protection of vulnerable adults.

Increasingly responding to the risks of others, preventing risks to vulnerable adults or running risks to themselves is all in day’s work for the busy practitioners and manager in the field of social care (Brearley, 1982). Adult with learning disabilities are subject to risk all time due to their vulnerability they sometimes abused by those who have control over them or by those who realize that they are vulnerable because of their disabilities they often find it very much more difficult to assess risk the way most of social carer and services do.

According to Vaughn & Fuchs (2003) adult with learning disabilities they always find this difficult and also fail to recognize any risk at all as they can’t explain due to lack of communication. Nevertheless, take risks because they feel vulnerable to a point approaching hopelessness (Fischhoff et al., 2000). In either case, these perceptions can prompt adults to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. According to Kemshall and Pritchard (2001) there has been much debate about a welfare model or a criminal justice model should be adopted.

Alaszewski (1998) states that, risk is used different ways. It is possible to identify a narrow common sense definition of risk which risk is equated with danger and the negative outcomes of events. Kemshall and Pritchard (2001) indicate that, adult’s vulnerable protection systems are likely to come under close scrutiny.

Protecting ‘Vulnerable Adults,’ Valuing People (2010, P. 93) states:

”People with learning disabilities are entitled to at least the same level of support and intervention from abuse and harm as other citizens. This needs to be provided in a way that respects their own choices and decisions”.

Vaughn & Fuchs (2003) state that, the difficulty for a person with learning disabilities is that carers often do feel often they are expected to make these choices for them. The law of negligence often can appear to inhibit decision making personal freedom and choice sit uncomfortably next to the concepts of duty of care and professional liability.

Above the study and definition, it needs to identify the risk that a vulnerable adult was exposed to. However, it will not be able to make precise mathematical calculations to exactly identifying the risk factor that the vulnerable adult was submitted to. These studies are mostly concerned with the risk assessment that a mental disordered person can cause to others and to himself/herself. An orientation towards the abuse that other people or the society, through its system, can cause to a disordered person is not clearly presented.

The murder of Steven Hoskin has been rendered cold bloodedly by a five peoples in St. Austell, Cornwall on July 6, 2006 (BBC, 2007; Daily Mail, 2007). Hoskin was a 39 years old man with an IQ level equal to a six year old child and living lonely in bedsit when the perpetrators made friendship with him to accomplish their brutal task (Society Guardian, 2007; BBC, 2007). Darren Stewart, the ring leader of the gang, along with his accomplices arrived at his apartment during the night of 5th and 6th July, 2006 (Daily Mail Online, 2007; BBC, 2007). Soon they started torturing and burning his body with cigarettes out of their hate toward his learning disability (Daily Mail Online, 2007). Later on, they coerce him to swallow more than 70 pills of Paracetamol which severely damaged his liver (BBC, 2007). Then they dragged him to the nearby viaduct where he was again stamped on and lashed out by the felons (BBC, 2007; Daily Mail Online, 2007). He was then forced to jump from a 100 feet tall bridge (Daily Mail Online, 2007). Later on, he was found dead in the river (BBC, 2007).

The crooks were later arrested and penalized by the court (BBC, 2007). The question arises here is that why this event occurred in the first place? Why the concerned authorities failed to protect him from the perpetrators even after the fact that some agencies (e.g. adult social care) know about his mental condition (Ahmed, 2007) and let him die helplessly? This is the subject of next discussion.

It was found in the investigation report of multiagency that Hoskin has cancelled his contact with the adult social care unit some days before his death (Society Guardian, 2007; BBC, 2007). This unilateral suspension was not taken seriously by the authorities and did not bother to inquire into the matter seriously (Ahmed, 2007). It was also found that he tried to contact many emergency service agencies nonetheless the matter was considered as a routine and over looked by the officials (Ahmed, 2007).

Cornwall Adult Protection Committee (2007) report, before his death Steven Hoskin gave up his social care protection. “Hoskin was placed in a bed-sit by adult social care in April 2005 and he was allocated two hours of help each week, but he chose to cancel the service in August and by September the council closed his case” (Community Care, 2007, p.1). The institutions involved in investigating Hoskin’s death and the reasons for which the specialized social cares agencies failed to prevent his death, didn’t searched on how and why did the man gave up his rights of social care.

The multiagency report further indicated that every single agency (i.e. Police, the housing association, emergency ambulance and adult social care etc.) did posses some piece of information regarding the conditions of Hoskin owing to the complaints of his neighbours or of himself (Ahmed, 2007). On the other hand no one of them has the complete information that can be used to see the big picture of the situation at hand (Ahmed, 2007). Each one of them was analysing the matter in an isolated environment (Ahmed, 2007). Perhaps, this can be better understood by following the jigsaw approach (Aronson, 1990). In this approach, every member of the group has some minor but important piece of information, nonetheless to make the whole picture complete, every ones contribution is essential (Aronson, 1990). Likewise, in the case of Hoskin, every agency has some minute but important pieces of information about him that can be used to make out what is actually going on with him and help can be launched to stop the danger approaching toward him (Aronson, 1990). For example, police knew that Darren Stewart, the main murder of Haskin, has already criminal record nonetheless this information was hidden to the adult social care which has the information that Stewart is now being seen with Hoskin (Ahmed, 2007). If these two pieces of jigsaw put together, it is very easy to conclude that Darren Stewart may be planning to do something wrong to the vulnerable Hoskin. Hence, it is clear that the lack of integration was the first drawback found in the previous setup.

Second main problem was that there was no mechanism to assemble discrete complaints from the same address several times at the emergency helpline service (Cornwall Adult Protection Committee, 2007). In the multiagency report, it is found that police and ambulance services visited the resident of Steven several times however, these individual complaints were not considered sufficient to alert an authority (Cornwall Adult Protection Committee, 2007). At the call centre, each time when a person in emergency calls, the phone is picked by some random person and the information remain isolated from the other people. There was no such system in place that can assemble the complaints from a unique address which can be used to raise alert (Cornwall Adult Protection Committee, 2007).

Third important problem was the lack of effective communication within an emergency service agency (Ahmed, 2007). For example, Carol Tozel, the director of adult social care, was unaware of the death of Hoskin until June 2007 (Ahmed, 2007). Carol Tozel was taken aback at the extreme lack of intra-communication in her department (Ahmed, 2007). Moreover, she was not provided any risk assessment review regarding the unilateral suspension of adult care services by Hoskin (Ahmed, 2007). This may be due the absence of any alert which her agency failed to raise for Hoskin or the common red-tape problem prevalent in governmental agencies almost all over the world.

Another significant issue was the reduction in the budget of social care services agency for disabled and old aged (Forder and Fernandez, 2010). The politicians have played a prominent role in the reduction of budget for this purpose (Forder and Fernandez, 2010). It is sorrowful to know that there are millions of pounds available for buying bombs to through at Iraq and Afghanistan however there is little money available to spend on the social care services of helpless and disabled persons.

Steven Hoskin was a vulnerable man who did not receive the professional help that he ought to. The specialized institutions mistreated the case and because he had no protection, the man was brutally murdered. Only after Steven’s murdered his case considered and in addition identified as a vulnerable adult. The agencies responsible for social care did not make the clear connections to determine the man a vulnerable adult while he was still alive.

According to the Adult Protection Act.(1989 p.1) R.S., c. 2, s. 1 an

“adult in need of protection means an adult who, in the premises where he resides, (i) is a victim of physical abuse, sexual abuse, mental cruelty or a combination thereof, is incapable of protecting himself therefore by reason of physical disability or mental infirmity, and refuses, delays or is unable to make provision for his protection therefore, or (ii) is not receiving adequate care and attention, is incapable of caring adequately for himself by reason of physical disability or mental infirmity, and refuses, delays or is unable to make provision for his adequate care and attention.”

After learning the atrocities that Hoskin was exposed to, there is no doubt about the fact that he was a vulnerable adult, in need of protection. According to a report issued by Devon County Council (2007, p.1) an abuse to a person in need is also when he/she is neglected and specialized authorities failed to act upon his/her problem. Hoskin’s problems were long time ignored and through the end of his life he did not benefit of the protection guaranteed by his rights as an adult in need, also because of the bureaucracy of the social care system, which at the time implemented a “ration of the time and resources”. Hence, because the man was not considered a vulnerable adult (his needs criteria were established within “low” to “low moderate”), the authorities just pulled him out of their system (An independent management review, cited in Community Care, 2007).

From the Community Care website we find out that social care representatives are being investigated for failing to prevent the abuse upon Steven Hoskin. According to the online publication Community Care (2007), the agencies in charge with protecting Hoskin missed more than 40 opportunities to help the man and to prevent him being killed.

As keep on investigating this subject, other interesting facts about this case are being revealed. According to Health Service Journal (2008, p.8) the man who took advantage of Hoskin’s mental state, into living with him, was also a mental disordered person. “His own history was chaotic: from being a runaway child, he became a violent and self-harming young man, leading a nomadic existence and making frequent suicidal gestures. He had convictions for arson and assault.”

Here is another case of authority’s incompetency. Because of the repeated calls to hospital, the ambulance service representatives acknowledged the fact that Steven Hoskin was sharing his accommodation with Darren Stewart, who was no stranger to them. They even called police to join them in several actions, to Steven’s apartment, because they knew that Stewart, who shared the bed-sit with Steven, was a very dangerous man (Health Service Journal, 2008). Evan so, because neither the police nor the ambulance service communicated this fact to the social assistance institutions, the case was further neglected.

Further discuss about some procedures that the social care institutions need to follow for avoiding cases like Steven Hoskin’s to happen. Actually, Hoskin’s case was the base of many new regulations for the social care institutions: No Secret refers to this case.

Created in November, 2003 the Adult Protection and Decision Act. “Provide a rate of tools to assist adults (19 and older) who have some diminished ability to make their own decisions” (Health and Social Services, 2010 p.1). The No Secrets (2000) guidance refers to the adult being any person of 18 and older. According to Health and Social Services (2010), the tools refer to decision making and representation agreements, guardianship appointed by court and adult protection for persons who are unable to look out for them and to search for help when abused or neglected.

Hence, the Health and Social Services (2010) definition of a vulnerable adult, the adults who need protection are the ones who are not able to make their own decisions Studying Hoskin’s case; we learnt that the man cancelled his social care assistance. Knowing these facts, an interesting question arises how was Steven Hoskin allowed to cancel his social care program if he was acknowledged as a vulnerable patient, incapable of taking decisions and to protect himself?

Unfortunately there have no evident information to understand the context in which the man gave up his social care rights and what authority and on what grounds approved the man’s request, as these issues were not investigated. The single information that have for this issue, was found in the Community Care article (2007), which presented Ray Jones’ (former social service director Cornwall Council) findings on the case. The Cornwall Council was, at that time, limited to adult care with critical needs. As seen above, Hoskin was considered a low to medium low case, so his was dropped, according to Ray Jones. This is the only statement that we found regarding Hoskin’s cancellation of his social assistance rights.

No Secrets (2000) sates that, guidance defines the term abuse as “a violation of an individual’s human and civil rights by any other person or persons.” (2:9).

Cornwall Adult Protection Committee (2007) presents in its serious case review study the measures created in order not to neglect adults with mental disorders and to prevent them of being harmed. A first recommendation would be to identify the disabled adults who live in a certain community (within conferences and meetings between multi-agencies meant to discover the persons who abused the ambulance or police services and that neighbors identified as problem-makers or disordered persons; by enhancing the communication between the social care institutions through trainings and communication conferences; by improving the information sharing across the statutory agencies; by raising community awareness and understanding about the identity and the possible behavior of vulnerable adults).

The No Secret (2000), guidance also imposes procedures for the statutory agencies to follow, when dealing with a case of vulnerable adult abuse. It is needed to indentify the “responsible and relevant agencies” (3:14). This is a very serious concern, because in order to understand how a vulnerable adult should be taken care of, one needs to understand which the institutions are involved in offering protection and support to vulnerable adults. Among the statutory agencies, such as commissioners of health and social care services, providers of sheltered and supported housing, police, regulator services, the guidance also specifies other actors as relevant agencies: voluntary and private sector agencies (3:14).

The guidance also suggests creating a multi agency management committee, which should consist of the leaders of the appointed agencies, in charge with identifying objectives and setting priorities, coordinating activities between agencies, creating training programs, monitoring and reviewing the progress of the institutions responsible for the vulnerable adults’ welfare. (3:15).

From studied case, Steven Hoskin was also the victim of the agencies’ negligence. The specialized institutions who were in charge with the man’s health status did not communicate amongst each other the reactions that they observed his behaviour.

Other actions established in the No Secret’s (2000) guidance frameworks, to identify roles and to appoint authority; to develop procedures that need to be followed by the agencies involved in the social care system. To protect the vulnerable adults’ confidentiality, as much as possible (the act specifies that a disabled person’s identity should only be communicated on need to know basis); to involve the local authority in this matter (for instance, local police should work closely to the directly appointed agencies by communicating their observations) and all the actions that the multi-agency management committee undertake should be submitted to an annual audit in order to establish if its policies and strategies were correctly applied (No Secret’s 2000,3 : 15, p 17, 18).

The Adult Protection Committee (2007) serious case review, also proposes an induction procedure, as part of the training policy, which is to be undertaken every three years. Within the training plan, as part of the supervision, there is also included a day to day supervision. (Cornwall Adult Protection Committee 2007, p.16). These procedures are followed in Cornwall district but this seems to be an effective model that could be established in the social care system, in general.

Following these rules and suggestions, the risk assessment is supposed to decrease. Just by communicating certain observation that an institution makes upon a vulnerable adult, this could bring many changes. Should a care assistant observe certain reactions at a disabled person and he/she doesn’t assure that the monitored observations are treated with the proper gravity, the treated vulnerable adult can suffer greatly, because his/her symptoms were not detected on time (Adult Protection Committee, 2007).

This is why, all the social care workers should be trained and their tasks and completion of their work to be daily supervised. This requires a more complex system, in which there should be included different levels of co-ordination. Within such a bureaucratic system, another risk factor interferes, the long communication flow which can cause information losses or redundant data (Adult Protection Committee, 2007). This also encounters a beneficial factor the different interpretation forms of certain information. According to Adult Protection Committee (2007), as in the case of a common work of different specialized social care institutions, the agencies can interpret differently a communicated problem related to the vulnerable adults’ monitored problems. Consequently, inter-communication and the information exchange between multi-agencies are so important. If certain information regarding the disabled adult might seem unimportant for a care institution, one other specialized care agency might find it crucial.

Like in the case of Hoskin, the police and the ambulance service didn’t consider very important the fact the that man made so many phone calls to hospitals and neither the fact that he was living with another disabled man seemed to be reflected as a problem for the police or the ambulance. If these facts would have been further communicated to the social care specialized agencies, the man’s live could have been saved.

According to Sellars (2002) risks change constantly and people grow, change, and develop. It is important to review risk assessment regularly, and aim always to increase choice and freedom for the people with learning disability. The presented and analyzed case is a serious, sad and unwanted example for understanding that the social care agencies, and other departments involved in the protection of vulnerable adults did not properly did their jobs. After studying the reports and the publications that treated Steven Hoskin’s case, conclude that the man was the victim of the institutional abuse. His problems were not treated with seriousness, even more; the man was considered a danger to his community because of his lout outburst and violent behaviour.

Hoskin’s case is a clear prove that the institutions didn’t take into consideration the man’s repeated outburst, obvious factors of risk assessment: his repeated calls to hospitals, requiring ambulance services to his home; the police’s visits to his bed-sit (in many occasions required by the ambulance service, aware of the fact that Hoskin was leaving with a dangerous, ex-convicted man, the noisy visits that the neighbours identified with a few months before Steven Hoskin’s death, coming from his apartment). All these examples were neglected by the agencies responsible for Hoskin’s case. Actually no institution took into consideration that the man was vulnerable. He was known to have severe learning problems, having the IQ of a six year child. These are serious facts which prove that the man was a vulnerable adult, not able to make decisions for his own welfare and not able to take care of himself. The authorities involved in Hoskin’s case didn’t properly manage the man’s life. They didn’t even properly investigated the man’s abuse and the reasons that brought him in the situation that caused his death (what determined him to cancel his social assistance program, or did he really cancelled it, who approved this, how did Hoskin come to share his bed-sit with one of his murderers, months before his death).

A significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), with a reduced ability to cope independently (impaired social functioning); and a condition which started before adulthood, with a lasting effect on development (Scottish Executive, 2010).

People with learning disabilities comprise of a highly vulnerable section of the society, who have limited access to health care facilities / services offered to them. They are often faced with obstacles and challenges while copying with grave situations such as loss and bereavement of loved ones, personal illness, death etc (Elliott, 1995). This, in turn, tends to aggravate their situation and increase their dependence on the society – which includes their friends, family and loved ones as well as the community in general. They are known to have been ignored persistently in terms of providing services in the need of personal illness, death, and other challenging life situations, thus increasing their vulnerability all the more.

Risk & vulnerability:

People with learning disabilities are one of the most vulnerable groups in the society (Department of Health 2001). People with learning disabilities has probably one of the worst histories is neglect and ill treatment in any group of society. Among the most vulnerable members of society they can’t speak up for themselves. Concepts of risk assessment and management in psychiatry increasingly reflect public and professional anxieties that people with a mental disorder may harm others (Simon Halstead (997).

At risk are the men’s victims whose suffering was often exacerbated by service providers’ failure to protect them. For example, if consequences are limited when a man with learning disabilities abuses another person with learning disabilities, the victim may be left with the idea that such behaviour is normal and acceptable, and that services will provide little protection and that their complaints will not be heard. It may also increase their vulnerability to further abuse because abuse can become normalised (McCarthy and Thompson, 1996).

The oxford dictionary define noun ‘risk’ as meaning a hazard, a dangerous, exposure to mischance or peril, as verb it also similar which means ”hazard, to danger, to expose to the chance of injury or loss”(P. Parsloe, 2005). Risk is closely linked to dangerousness, resulting in harm which seems to be agreed means harm to self or others and extend of harm which constitutes a risk in various situations especially adult with learning disabilities.

‘If you don’t know for sure what will happen, but you know the odd that is risk and if you don’t know the odd that is uncertainty’ (Knight, 1921).

From this definition of risk concentrate upon the probabilistic components in knowledge, and is agnostic as to whether this involves probabilities of good of bad outcomes. Royal Society(1983), risk assessment which saw as the probability that a particular adverse event occurs and social services has been concerned predominate with risk assessment to prevent harm.

They may also suffer further if they have to deal with seeing their perpetrator on a regular basis, and may be subject to further assaults in retaliation of their initial complaint. It has been noted above how services frequently respond inadequately to the abuse of people with learning disabilities by men with learning disabilities: only rarely will the police be involved

and most victims will have no option but to continue to see their attacker on a daily basis (Thompson, 1997). In addition to the risks to existing victims, poor responses may result in increasing numbers of people being abused.

Definiation of ‘vulanarable adult’ in section 80(6) care standard act 2000 states that-

(a) ”an adult to whom accomodation and nursing or personal care are provided in care hom” (b) ”in adult to whom personal care is provided in their own home under arrangements mad by a domiliciary care agency”.(Ian. Peate&D.Fearns-2006)

Adult with learnign disabilities, and thos peopl who have a lescapcity like who have mental illness, old and frail,need protection from potentially abusive sitaution over which they might have little control (Department of Health,2000). Learning Disability Adolescents obviously do not always act in ways that serve their own best interests, even as defined by them. Sometimes their perception of their own risks, even of survival to adulthood, is larger than the reality; in other cases, they underestimate the risks of particular actions or behaviours. It is possible, indeed likely, that some adolescents engage in risky behaviours because of a perception of invulnerability-the current conventional wisdom of adults’ views of adolescent behaviour. Others, however, take risks because they feel vulnerable to a point approaching hopelessness (Fischhoff et al., 2000). In either case, these perceptions can prompt adults to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability.

Learning Disabilities:
Risk Assessment Decision Making Process/ Practice Tools:

Every day a lot of risk situation changes rapidly and what applied yesterday but may not today. Those service users who are identified as “at risk” would be provided highly effective instruction to reduce their risk in the identified area (e.g., language, reading, numeracy/ math, behaviour). Service users whose response to instruction moved them out of risk status would receive no further supplemental intervention. Service users whose response to well-documented, effective, and well-implemented instruction was low or who remained at risk would be considered for placement in special education. Thus, potentially, many Users could benefit from this type of an identification procedure. (S.Vaughn and Lynn S. Fuchs, 2003). For minimize risk and make it useful and meaningful, may risk situations need to be reassessed regularly perhaps daily basis according service users daily need. People with learning disabilities are subject to risk all time due to their vulnerability they sometimes abused by those who have control over them or by those who realize that they are vulnerable because of their disabilities they often find it very much more difficult to assess risk the way most of us do. While most of carer don don’t asses risk very efficiently they generally make some attempt to do so. It’s not easy at all to do risk assessment as it is a complex task and most of the time carer or support worker they do adequately but not very thoroughly. Adult with learning disabilities they always find this difficult and also fail to recognize any risk at all as they can’t explain due to lack of communication. In spite of some difficulties, there is an increasing awareness that people with learning disabilities can make choices, moreover they want to do so. However it’s often fail to consider is that, the amount of risk that these choices carry and most of us have grown up accustomed to risk-taking. Life is full risks we all take risk all the time and the more familiar they are the less we tend to recognize the real level of risk involved.(Refe………). Many problems about assessing risk that different services user may perceive the different risk. What is acceptable to one person may not be acceptable to another. Main objective of the risk assessment when it’s possible may sometimes affect decision making in number of different ways.

Its true many people with learning disabilities who are always facing risk in their everyday life. Significantly about choice decision sometimes it’s difficult for adult as well carer to make right choice how could be at risk. The difficulty for people with learning disabilities is that carers often do feel often they are expected to make these choices for them. The law of negligence can appear to inhibit decision making ‘personal freedom and choice sit uncomfortably next to the concepts of duty of care and professional liability (Ref……….).’ people with learning disabilities may not have done perhaps carers need to be encourage to help their service users how to make choices with and appreciation of the risk involved. This is more challenging task than just encouraging choice alone it seems that not only should people with learning be allowed to make choices and take risk ‘they should actively be encourage to do.’

Multidisciplinary Risk Assessment:

The problem with the right to make choices is that it assumes that adult with learning disabilities are able to make choice about risk in the same way every one does(Refe….). we have to acknowledge that adult with learning disabilities do have real difficulties with many cognitive takes. Most we have problems in assessing risk effectively because of the complexity of doing so it is likely that people with learning disabilities will find the particular difficult. The assessment of ability to consent and the ability to make real choice, especially in relation to understanding the likely consequences of the choices or decision made. It could be helpful when any risk assessment pan to do like-

If carer want to take any decision about the adult person, Is person are aware that about their decision at all? Are they communicating their choice decision making?

Giving people with learning disabilities more choice especially about taking risk, it’s mean that carer have to be alert to the extent to which the service users are able realistically to assess the level of risks involved(Ref………….). In order to decide when risk is acceptable, they need to consider a large number of pieces of information which is decision making become difficult for carer/support worker.

Many adult with learning disabled the most successful way to avoid and minimize risk to avoid further problem is by effective management. When the person concerned may have been living in a setting where the opportunities for such behaviour have been very limited or absent, carers and professionals are sometimes tempted to assume that because the recent past has been incident-free the problem has disappeared.

Risk Assessment:

Never take someone with a learning disability swimming without first reviewing their risk assessment plan. A risk assessment is in place to address issues of importance such as dangers, hazards, and known triggers and how best to avoid them. Make sure you are familiar with the particular risks that you could face with the person in your care and that you have put measures in place to reduce, or eliminate, them.

Assessment is a complex and time consuming task and it is a continuous process. Assessment of risk for adult with learning disabilities which should be evolutionary in nature constantly informed and shaped by changes of circumstances upon service users needs (M.Brown, 2003). The practice of risk assessment and management is the process of data collection, recording, interpretation, communication and implementation of risk reduction plan (Maden, 1996). For the risk of learning disability, clinical model of risk assessment have become the norm. There are two kinds of risk that are relevant to work people with learning disabilities, risk of unnecessary exposure to undesirable events or experience, and risk of negative consequences when possible benefits and desirable experiences are perused (Paul William, 2006). Above this it is clear that a strategy of prevention should implement, and management is required so that risk and benefit are balanced.

In social care and health care there are broadly two main context of risk which are not provided and everyday risk in their life. people with learning disability to have a history of formally documented offence.

Conclusion

People with learning disabilities are beginning to reclaim the lives they lost in the institutions, having choices, jobs, sex lives and even becoming parents – unthinkable until even quite recently. Slowly, perhaps far too slowly, the rest of the community is beginning to realize that the majority of people with learning disabilities are not so different from everyone else, and need the same things in their lives that all of us do: work, leisure, partners, and a sense of being part of a social group. They want to feel useful and valued, as we all do.

Life is full of risks. We all take risks all the time, and the more familiar they are the less we tend to recognize the real level of risk involved. We actually take the greatest risk in our lives every time that we step into a car, but few of us really consider that risk seriously. This is the other side of the coin; we are inclined to believe that ‘it won’t happen to me’, even when the objective statistics suggest otherwise.

The difficulty that now exists for people with learning disabilities, especially those with greater handicaps, and those who care for and support them, is that the law specifies that many such people are vulnerable, and not able to make this choice for themselves. They are considered to be unable to assess the risks involved and thus make an independent choice. The onus of assessing risk and making the decision therefore often rests with carers. Because it is such a difficult decision to make for someone else, carers often take the simple way out, and avoid letting situations arise where learning-disabled people in their care have the opportunity to develop sexual relationships: if a person cannot make an ‘informed choice’

then perhaps it is easier not to offer them that choice. This is the current dilemma for those who work in community care situations. The issue of sexual relationships is perhaps the most difficult and complex, but this problem of balancing risk and choice is a constant one for carers and professionals, in relation to many aspects of everyday life. In the background is the ogre of the law (and/or local management), ready to jump on the unwary, should they get it wrong. No wonder, perhaps that many are cautious about enabling such choices to be made.

Recommendation

Social services departments have seen a rise in the numbers of vulnerable adults referred to them because they are at risk of physical and sexual abuse, as well as financial fraud, a study has found.

The survey of directors of adult services suggests the fallout from the death of Baby Peter has influenced social workers’ attitudes to vulnerable adults – with more older people or those with a learning disability deemed to be at risk of abuse being referred for assessment.

Speaking ahead of the national children and adults conference that opens today in Harrogate, the Local Government Association (LGA) warned that adults’ services were coming under increasing strain and called for reform of the way adult social services are funded to meet the explosion in demand and escalating costs.

“In others – for example, in the increase in the number of adult safeguarding referrals – it might be that the higher profile of risk and vulnerability has led to a greater vigilance by our care staff and by members of the public alike.”

How to balance the rights and needs of older people is a complex and important issue as it is an occurrence that will inevitably affects us all at some stage of our lives. It is fundamental to ensure a balance of the rights and needs of the individuals by remaining aware of the current Anti-Discriminatory and Anti-Oppressive Practices especially in residential care environments. In order to protect and respect elderly people it is imperative to look at these units, ensure their effectiveness; encourage accountability and most importantly, their provision of safety. This paper explores the nature of the discipline of social work and to illustrate that perhaps its central and unique characteristic is the way theory and practice are closely interrelated in reference to an article written in The Guardian dated 22^nd January 2005, They didn’t have long anyway.

Society has moved from the traditional family set-up where grandparents usually lived with their family in the nineteen and twentieth centuries to where families are more divided, private and elderly people often live on their own or eventually move into residential units or nursing homes. For the relative making this decision, it can be a distressing time evoking feelings of guilt or worry that they may be letting their parent down at a time of their life when they particularly need them. It can be especially complex if the elderly person resists the move. This is where the help of the social sector can be needed, both for support and information. It is helpful to have an open discussion with the elderly person, reassure them that any decision is made with their best interests being the main concern and that they are also involved in the decision-making process, wherever possible. (Rudd 1967, pp.13-15; Banks 1984, pp. 85-8).

Social work’s context of care has changed significantly over the last few decades according to Ife (1997) and Banks (1995). As result of changes in politics, economic and ideologies, some gaps may exist until the social work sector has time to adapt, particularly as social work is not a single entity, rather it is made up of many components. Social work is at times ambiguous, complex and uncertain such that its major strengths are in terms of its ability to improve dialogue, understanding and interpretation, rather than simply be concerned with legislating and acting with authority. (Ife 1997, pp.1-5; Hugman, R 1995, pp 1-12).

In the article, They didn’t have long anyway published in the Guardian 22^nd January 2005, many vital issues are highlighted, namely the concerning deaths of thirteen elderly persons at the former Maypole that seemed to result in a low-key reaction by society. The article outlines that other sectors of society such as children at risk are protected by laws and rightfully so, yet the same does not adequately seem to apply to elderly people who may also be at risk in institutions. The main concern is that many nursing homes are sub-standard, the food is badly cooked, and hygiene standards questionable and often staff are not providing adequate care and safety for the residents. It is a difficult area of care to decipher definite statistics proving negligence as according to the article there is a lack of meaningful, national data that could provide reliable information. The situation is further complicated by the fact that there can be conflicts of interests with parties such as care providers, pharmacists and doctors and this may add to the concern regarding standards. Plus, the age-old dilemma of funding and lack of resources. The most concerning issue the article raises is that it is the staff member’s responsibility to report the death to a coroner, this could lead to those acting honourably to do so and conversely those that do not, will not report the death. (Muir, H & Taylor, D 2005).

There has been a long history of research into living conditions and potential abuse in institutional settings by theorists such as Goffman (1961) and Townsend (1962) culminating into a more significant scale in the 1970s and 1980s. Twenty years of campaigning resulted in the launch of two codes of conduct for the social care sector in 2002 in Britain. One code aims to identify social care workers’ conduct making them more accountable for the care they provide as well as informing service users of the standards they can expect. They are responsible for ensuring that they adhere to such standards and they protect the well-being of service users which in this case are elderly people in institutions. They work to a code of ethics including the concern for the well-being of others, respect for the autonomy of others, trustworthiness and honesty, willing compliance with the law (with the exception of civil disobedience), basic justice, refusing to take unfair advantage, duty of care, confidentiality, commitment to professional responsibilities and preventing harm. The second code for employers of social care workers, ensuring their regulation in order to safeguard and promote the interests of both service users and carers. The code is part of the wider component of existing legislation, requirements and guidance relating to staff employment. (Excellence in caring, 2002).

So this leads us to the question of what is going wrong? It is clear that elderly people are particularly at risk as they have are generally voiceless and marginalised as the move from their homes into an institution is usually fast and their families may have no idea of the potential dangers in the system. Often homes do not have regular legislative inspections, thus they can deteriorate with less questions being asked. A continued commitment to safeguarding this sector of our community needs to occur to prevent neglect and abuse. As the article They didn’t have long anyway concludes, it is often those with the loudest voices who are heard. Elderly people do not fit this description, thus it is important that a combination of steps are taken to ensure a balance of the rights and needs of the individuals by remaining aware of the current Anti-Discriminatory and Anti-Oppressive Practices especially in residential care environments.

Bibliography
Banks, G 1984. Options. A handbook for the elderly and those who care for them. Dove Communications, Victoria.
Goffman, E 1961. Asylums. Essays on the social situation of mental patients and other inmates. Penguin Books, Great Britain.
Hugman, R 1995. Ethical Issues in Social Work. Routledge, Great Britain.
Ife, J 1997. Rethinking Social Work. Towards critical practice. Longman, Australia.
Rudd, T.N 1967. Human Relations in Old Age. Faber and Faber, London.
Townsend (1962) The Last Refuge, Routledge and Kegan Paul, London.
Internet Sites
Colero, L A Framework For Universal Principles of Ethics, Crossroads Programs Inc, retrieved 5th May 2006, from: http://www.ethics.ubc.ca/papers/invited/colero.html
Excellence in caring, 2002 Guardian Unlimited, retrieved 5th May 2006, from: http://society.guardian.co.uk/scperformance/story/0,11025,629574,00.html.
Ethics Update, 2006 University of San Diego, retrieved 5th May 2006, from: http://ethics.sandiego.edu/index.asp#PageCite.
Muir, H & Taylor, D, 22^nd January, 2005, They didn’t have long anyway, viewed 6th April 2006: http://www.guardian.co.uk/
No secrets: guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse, 2000 Department of Health and Home Office, retrieved 5th May 2006, from: http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4008486&chk=7Wogjo

This essay is a review of a research article of how Local Authority Social workers make decisions when they are considering referrals of children. The title of the study is “Threshold Decisions: How Social Workers Prioritize Referrals of Child Concern” by Dendy Platt (2008). I would attempt to critically appraise this Qualitative journal article based on essential elements of the research which include the Title, Abstract, Introduction, Method, Findings and Conclusion. The study examined how social workers make choices on individual cases of children concern referrals, if to carry out a an initial Assessment i.e. Sect 17 of the Children Act 1989 or if to undertake the Child Protection Procedure under the Sect. 47 of the Children Act 1989. The major finding suggests that Social workers prioritize their referrals based on five key areas, “Specificity, Severity, risk, parental responsibility and corroboration. It was refreshing to know that data were collected from Social workers and that Parents were also involved.

Title

It is worth noting that the title adequately prepares the reader as it gives good insight into what the study is about. The title of an article is very important as it exposes the reader to an article. The key words were appropriate and sufficient as they did retrieve the article upon typing the key words in the search engine. (According to Descombe 2008 p.88), a topic needs to be a very much more narrowly defined area of its study.

Abstract

The major finding in this article suggests that social workers evaluate referrals based on five key factors, “specificity, severity, risk, parental responsibility and corroboration”. It is worth noting the abstract did prepare a reader for this study. The abstract clearly highlights that the aim of the study is to find out how social workers reach decision when to carry out an initial assessment (Sect 17 of children act 1989) or a core assessment, (Sect 47 of children Act 1989) when considering referrals about child concerns.

The abstract clearly stated that the study chose a qualitative approach. According to (Punch 2000 p. 243), qualitative approach is “often sensitive to context and process to lived experience and local groundedness, where the researcher tries to get closer to what is being studied”. Using qualitative method allows the researcher to find out a lot about the study. He went further to explain that”qualitative research methods are the best way we have of getting the insider’s perspective” (Ibid)

Qualitative method allows the researcher to generate new theoretical ideas. This happens because they are able to observe and speak to the people (person) being studied and allows them to come up with new ideas through out the study. Being bias is one of the limitations of qualitative research method because researchers can write their own view or even opinion on the matter. But as we can see that reaching difficult area is a great advantage to qualitative research method.)

Introduction

Looking at the introduction, it seems clear that the problem that led to the research was that the interpretation of the developments of the refocusing initiative has contributed to a climate where social workers work often feel “pulled and pushed in different directions by political and popular opinion.

The introduction touched on relevant government policies and initiatives such as “refocusing initiative which was initiated by the government in 1990 and the framework for Assessment of children in need.

In my view, the author attempted to appraise the refocusing initiative policy which attempts to refocus social work practice and to initiate any necessary changes. I partly agree with this notion as the study may bring about positive changes in the child protection climate. But also the author needs to acknowledge where he points on that the climate of child protection is one of uncertainty, that social work itself is a profession full of uncertainty….

The researcher explained that the implication of the “refocusing initiative” is the rise in the threshold for acceptance of a child protection referral as it was thought that the cost to family of child protection procedures were not acceptable in the cases where allegations are minor.

In my view, the identification of gap of knowledge shows that the problem has significance for social work practice and the research may positively inform practice. Interestingly, the researcher acknowledges and analyses previous work on the child protection field ( what is known) but also points out the knowledge gap as it demonstrates how application of these factors differs between cases of child concern and cases of child protection (What is desired to be known). I would argue that these reasons amount to sufficiently justification of this study.

Literature Review

Knowledge gap was identified but author did not explain how his work would attempt to close the gap. Author made an effort to critically review the work of others and points out inconsistencies. The purpose of the research is to examine ways social workers in England made decisions at the initial referral stage. It is my believe that since the author decided to collect information form social workers and families suggest that research is from a grounded theory approach.

According to Punch (2000 p.163) Grounded theory is best defined as a research strategy whose purpose is to generate theory from data, To be grounded means basically the theory is generated from data. (ibid)

My rational for asserting that a grounded theory approach was implemented is that the author made sense of the data through concepts primarily informed by social workers and the discovery of these concepts begins from the interviews with the social workers. (Somekh and Lewin 2006p.49) point out that grounded theory is best described as an “integrated theoretical formulation that gives understanding about how organization experience and respond to events that occur”. From this definition, it could be argued that grounded theory was the most effective way to approach this study.

“Researchers do bring perspective to the research, although these perspectives tend to guide the question and influence interpretation, but they don’t drive the research.” (ibid p.51).

However one of the drawbacks from this approach is that research may be influenced by the researcher’s personal experiences and previous studies which thus disable the research in approaching the study with an open mind.

Finding

In my view, the researcher study has a strong internal validity, the researcher made a good effort to eliminate the alternative explanations in his findings…. The result however cannot be applied beyond the sample. It would be clearly naive to believe that the findings reflect how social workers in the UK decision making.

Method

The Researcher implemented ethical principles. The social workers involved have to be made aware of what they were getting into before deciding to collaborate. I would argue that appropriate procedures were implemented; also the participant understood what the purpose of the research.

The researcher effectively anonymised participants’ identities, which protected participants’ privacy. The likely outcome the research aim to achieve include possible changes in policy, examine practice issues for social workers carrying out initial assessment, where in the past, it would have been a child abuse investigation ( Sect 47 of the children Act 1989)

“One of the strengths of case study is that multiple methods and data sources can be used to explore and interrogate case study thereby leading to a good description of a research from the perspective of the participant” (Someth and Lewin 2006 p.33). I do admire the fact that the research implemented the case study approach as this gives the reader a very rich description of the study and also gives a reader a good understanding on the issue.

Reliability of the finding was promoted by the data collection from two local authorities who have a very different procedures and practice, also All interviews were tape- recorded. According to (Silverman 2006p. 285), “working with the audio and video recordings eliminates at one stroke many of the problems that researchers have with the unspecified accuracy of field notes and limited public access to them”

However the generalization of the research may not be possible. “The weakness of case study is that it is not possible to generalize statistically from a small number of cases to a population as a whole” (Someth and Lewin 2006 p.34)

References
Punch, K.F. (2000) Introduction to Social Research Quantitative and Qualitative Approaches. London: Sage Publication.
Somekh, B. and Lewin, C. (2006) Research Methods in the Social Sciences. Sage Publication: London.
Silverman, D. (2006) 2nd Edition. Qualitative Research. Theory, Method and Practice. Sage Publication: London.
Denscombe, M. (2008) Ground Rules for Good Research, a 10 guide for social researchers. Open University: Buckingham.

The purpose of this paper is to review the recent literature on the recent state of theoretical and practical issues affecting the attainment of work-life balance within organizations. It also challenges some of the metaphorical assumptions associated with work/life balance. The balance between work and life is becoming an important strategic component in the Human Resource Management arena. Hence, to successfully maintain key human resource functions such as attracting and retaining talented staff within the organization, policies should be focused towards endorsing work-life balance.

Introduction

For the past ten years there has been increasing interest in work-life balance and has drafted innumerable attention from popular presses and scholarly journals. This increase in attention is in part ambitious by recent concerns stipulating that an imbalanced work/life relationship can reduce the health of individuals resulting in lower work performance and can have negative impacts on family life.

The concept of “work/life” balance began to emerge in the 1980’s and 1990’s where companies first started to offer work/life programs. While the first effect of these programs were mainly to sustain women with children. Theses included maternity leave, home-based work, flex-time, employee assistance programs (EAPs) and child-care referral. During the 1980s men also began voicing work-life concerns. However, today’s work/life programs are less gender-specific and recognize other commitments as well as those of the family.

The issue of work/life balance began to emerge to the forefront of research and organizations when Rosabeth Moss Kanter revealed the phenomena in her influential book “Work and Family in the United States: A Critical Review and Agenda for Research and Policy (1977).”. However, the term ‘work-life balance’ was first coined in 1986 in reaction to the unhealthy choices that many Americans were making in favor of the work place, as they opted to neglect family, friends and leisure activities in the pursuit of corporate goals. The articles published at that time suggested a sharp increase in the working hours of the Americans and this had started to affect their families and individual heath. Work life balance then slowly started gaining grounds in the various organizations. By the end of the decade, work-life balance was seen as more than just a women’s issue, affecting men, families, organizations and cultures. Since, then it has developed in to a multidimensional facet with factors affecting the both the individual and is critical for organizational success.

It is formidable to note that the term ‘work/life balance’ is widely but an official definition of this term still remains indefinable. Even though there are many conceptualizations of work-family balance occurring in recent literature, a direct developed measure of the construct does not exist. This unreliable measure of work-family balance undermines the ability to fully explore the rudimentary facets of this phenomenon. However, this negatively impacts investigations into the policies with respect to individual and organizational outcome variables.

Within organizations and corporations there is increasing attention among organizational stakeholders (management, executive directors, owners etc.) for the introduction of work/life balance policies. This has become a predominant issue within the workplace. Many organizations have implemented proficient polices and programs with the objective of improving employee experiences of work-life balance. In the absence of a well developed measure of work-family balance, assessing impact of such interventions empirically becomes problematic. However, there is the need to fully understand and find an effective measure of work/life balance. This allows human resource practitioners to employ a proactive approach towards seeking innovative ways to augment their organization’s competitive advantage. It will also aid in finding a balance between challenges of the work/life dilemma and recommend complimentary solutions. In attempting to find an effective measure of balance, the organization would then be capable of assessing the impact of the policies created on employee discernment of balance. This can also promote inter-organizational assessment of the levels of perceived work-life balance which can provide useful information to organizational stakeholders for policy drafting.

Definition of Work Life Balance

Work/life balance can be defined as “the absence of unacceptable levels of conflict between work and non-work demands” Greenblatt(2002). It incorporates the achievement of a reasonable level of involvement among the various roles in the lives of individuals and assesses their ability to deal with simultaneously with the complex demands of life. There are various definitions of work/life balance that is commonly associated with an equilibrium or sustenance of a sense of harmony in life. However, the meaning can take on different characteristics as it can mean different things to different groups. For example, work/life balance is different within different stages of life every individual experiences. An individual who has recently graduated from university and is not married would have a different conception of work-life balance compared with an individual who may be married and has responsibility to their spouse and children. Johnson (2005) suggests that one’s perception of work-life balance is dependent on the individual’s environment, age and lifestyle. Another important consideration is the level of conflict between work and family spheres especially when there is role conflict (Kossek and Lambert 2005). Furthermore, the job requirements of the individual in the workplace would often hamper with their family life responsibilities. (Williams 2008).

The meaning is dependent on the circumstances of the discussion and the researcher’s viewpoint. There are some acceptable definitions regarding work/life balance and some definitions may overlap and some are evolving which are discussed further.

The Traditional view of work/life balance

The traditional view of work/life balance assumes that it involves the commitment of equivalent quantity of time to paid work and non-work roles. There are generally five major perspectives used to explain the correlation between work and life stipulated by Zedeck and Mosier (1990) and O’Driscoll (1996). The first perspective is the segmentation model which theorizes that work and non-work are both independent domains of life that are separate and have no influence on the other.A This appears to be offered as a theoretical possibility rather than a model with empirical support.A The spillover model is the complete opposite of the segmentation model hypothesizes that both spheres are interdependent on each other either in a positive or negative way.A The research into this sphere can support its proposition however it is deemed having little value as it is too general.A This standpoint needs a more meticulous proposal about the causes, nature and effects of spillover.A The other models examined are more detailed adaptations of the spillover model. The third model is the compensation model which states that the demands or satisfactions that is lacking in one sphere can be made up in the other.A For example, work may be routine and undemanding but this is compensated for by a major role in local community activities outside work.A The other model is an instrumental model whereby an activity in one sphere accentuates the other sphere.A The traditional example is the instrumental worker who will seek to maximize earnings, even at the price of undertaking a routine job and working long hours, to allow the purchase of a home or a car for a young family.A The final model is a conflict model which states that each sphere has multiple demands, thus requiring individuals to prioritize and make choices that can lead to conflict.

The contemporary view of work/life balance

The contemporary view stipulates that the concept is recognized to be more complex and a number of different issues are to be incorporate. Contemporary studies have explored and measured six aspects of work/life balance that can provide a valuable construct for theoretical advancement and practical human resource interventions. The framework consist of six conceptualizations of work-life balance found in recent literature are as follows multiple roles, equity across multiple roles, satisfaction between multiple roles, fulfillment of role salience between multiple roles, a relationship between conflict and facilitation and perceived control between multiple roles.

Work-life balance defined as multiple roles

This view is drawn from an individual’s multiple life roles which stipulate that the non work (personal/ family) demands are spilled over into the working day of the individual that negatively affects the health and work performance of the individual. This can be referred to as a multiple demand ‘carry over’ which is referred by Greenhaus and Beutell (1985) as bidirectional, denoting home-to-work and work-to-home spillover. It is now accepted that there are positive as well as negative carry over with recent research identifying the bidirectional constructs of work-family facilitation and enhancement, as well as conflict. Within recent works Greenhaus and contemporaries have defined the multiple role conflict of work/life balance generally as ‘Work-family balance reflects an individual’s orientation across different life roles, an inter-role phenomenon’ (Greenhaus, Collins & Shaw 2003).

Work-life balance defined as equity across multiple roles

The multiple roles definition of work-life balance as further examined by Greenhaus that explored with further focus on the fulfillment across an individual’s multiple life roles or the equality of time. Work-family balance was therefore defined as “the extent to which an individual is engaged in and equally satisfied with his or her work role and family role. There are three components of work family-balance that are time balance, involvement balance, and satisfaction balance” (Greenhaus, Collins & Shaw 2003). Time balance refers to an equal amount of time devoted to work and family roles and involvement balance refers to an equal level of psychological involvement in work and family roles. Satisfaction balance stipulates that there is an equal level of satisfaction with work and family roles. The individual components of work/life balance can represent either a positive balance or negative balance depending on the levels of time, involvement, or satisfaction which are equally high or equally low.

However, the work/life balance can be viewed a continuum anchored that is skewed to one end by disparities in favor of a certain role (family, personal roles). It can also be relatively balanced state to extensive imbalance in favor of the other role (work). Work/life balance can be conceptualized as an independent variable of an individual’s desires or values. Bielby and Bielby (1989) observed that married working women may emphasize their family ”in balancing work and family identities” and Lambert (1990) discussed ”maintaining a particular balance between work and home”. The term balance here is used to represent an array of diverse patterns of dedication, rather than parity of dedications across roles. It can be inferred that an individual who gives extra priority to one role than the other is relatively imbalanced even if the distribution of commitment to family and work is highly consistent with what the individual wants or values. This conjures the controversial question whether such imbalance in favor of one role is healthy or not.

Work-life balance defined as satisfaction between multiple roles

Kirchmeyer research have focused on the importance of individual satisfaction with multiple roles defined work-life balance as ‘achieving satisfying experiences in all life domains and to do so requires personal resources such as energy, time, and commitment to be well distributed across domains’ (Kirchmeyer 2000). Clark (2000) also focused on individual satisfaction within the description of ‘work/family border theory’ and defined work-life balance as ‘satisfaction and good functioning at work and at home with a minimum of role conflict’ (Clark 2000).

Work-life balance defined as a fulfillment between multiple roles

This aspect focuses on the individual satisfaction where there is an overlap with the acknowledgment an individual’s perspective the multiple roles in relation to its importance. This point of view recognizes that the salience of roles is also not a static evaluation but may change over time with diverse familiar life changes such as work promotion, new baby, sick spouse or parents etc. Greenhaus and Allen then defined work-life balance as ‘the extent to which an individual’s effectiveness and satisfaction in work and family roles are compatible with the individuals’ life role priorities at a given point in time’. Similarly, work and life balance research should focus on ‘whether one’s expectations about work and family roles are met or not’. Eby, Casper, Lockwood, Bordeaux and Brinley (2005).

Work/life balance defined as a relationship between conflict and facilitation

Recent research has revealed the psychosomatic constructs that map work-life balance, noticeably conflict and facilitation. Consequently, work-life balance is been defined as an absence of conflict and a presence of facilitation where “low levels of inter-role conflict and high levels of inter-role facilitation represent work-family balance” (Frone 2003). The assessment of the four bidirectional conflict and facilitation constructs can be used as a framework to test this definition: ‘Balance is a combined measure whereby work-family conflict was subtracted from work-family facilitation, and family- work conflict was subtracted from family-work facilitation’ (Grzywacz & Bass 2003).

Work-life balance defined as an apparent control among multiple roles

This aspect is the least supported within the research literature. It states that work-life balance can be interpreted as a degree of independence where an individual perceives themselves having control over their multiple role demands. Fleetwood states that “Work-life balance is about people having a measure of control over when, where and how they work” (Fleetwood 2007). Apparently, work-life balance can also be seen as a result of individual sovereignty over the roles most salient to the individual. Therefore, an individual could reduce their work hours to spend time with for example their children which can be perceived as effective work-life balance.

Finding a balanced work/life measure

The brief review of the literature denotes that there has been limited systematic effort to clearly develop one clear definition or one specific measure of work-life balance. It is important to work towards a consensus of the precise meaning of work-life balance. With the emergence of a specific definition of work-life balance, it would foster decisive outcome variables to authenticate the contemporary theoretical models that describe the relationship among common moderators, outcome variables and the background of work-life balance. This would ensure that a detailed measure of work-life balance could also be used to contrast the levels of perceived balance among the levels within an organization. This would be significant for comparisons among the levels of balance among organizations. It would incorporate questioning employees to rate their present discernment of work-life balance to avidly create an effective measure of balance. The development of a systematic scale would also be necessary to sufficiently authenticate such a measure.

The review of the literature reveals that is difficult in capturing a simple holistic measure of the meaning of work-life balance. A basis for recognizing the common threads of meaning can develop using the six definitions of work-life balance previously reviewed. Some definitions consist of the concept of ‘perceptions of good balance’ as imperative to the significance of work-life balance. The realization that levels of work-life balance can change over time according to the salience of specific life events is also important to note. This would acknowledge the repeated readjustment to several demands that most employees cope with over their period of employment.

An integration of the two core meanings or definition of work-life balance can equate the following definition, “Work-life balance is the individual perception that work and non-work activities are compatible and promote growth in accordance with an individual’s current life priorities” (Kalliath 2008). The literature proposed that any appraisal of work-life balance should include individual preferences of current roles. This definition further acknowledges that an effectual balance would lead to positive improvement within the work and non-work spheres. Consequently an individual’s work/life precedence can be voluntarily changed to incorporate the development of non-work activities (eg new baby, travel vacations) or growth at work (working harder to gain a promotion). This definition of work-life balance has to be operational within the context to measure validation and development across variant samples.

Theoretical Framework: Work-Family Border Theory (Clark, 2000)

The theoretical framework employed to understand the balance between work and life is the Work-Family Border Theory. The work-family border theory (Clark, 2000) and boundary theory (Ashforth, 2000) each contribute to the study of work-family connection by depicting the circumstances under which changeable degrees of work-family integration are likely to positively or negatively affect an individual’s well-being. These theories deals with how people build, preserve, negotiate and cross boundaries. It shows how people depict the lines between work and family (Clark, 2000).

In both theories are similar by an incorporation or segmentation as indicated primarily by displaying characteristics of flexibility and permeability. It is suggested that both are integrate evident when two or more spheres are highly flexible and permeable with respect to one another. The Boundary theory and work-family border theory are common with respect to the extent of work-family integration depending on similarities among these domains with each other (Desrochers & Sargeant, 2004). However, the two theories diverge on the nature of the relationship and implications for work-family balance.

The difference among roles is the determination of the clarity of how substantial the boundary is between one domain and another that consequently influences the possibility of work-family conflict Ashforth (2000). (Desrochers 2005). This theory has a propensity to focus on transitions within an organizational context Matthews (2007). Even though, reference is made to conversion between organizational roles and non-organizational roles (conversion between work roles and family roles), Clark (2000) states that the transparency of the work-family border is distinguished from the correspondence of role domains in which these two factors interact to influence work-family balance. Matthews (2007) states that this theory is mainly focused on the approach of people transitions between the work and family domains.

The Work-family border theory denotes how individuals negotiate and control both the borders between work and family spheres and try to find a balance between them (Clark, 2000). The design of this theory is focused on finding a framework to undermine the criticism and gaps of previous theories on work and family (Akdere, 2006) by dividing the boundaries within the employees’ life. The theory seeks to deal with how the segmentation and incorporation, management and border creation and border crossers have on the relationships of work and home factors influence on work-family balance. The term “border-crossers” are referred to employees that are intending on making constant daily alterations between their work and family lives.

The distinguishing factor between Work-family border theory and boundary theory in that its definition of borders not only encompasses psychological categories but also the substantial boundaries that divide place, people and time that is associated with work versus family spheres (Desrochers 2005). However, Clark (2000) research tries to comprehend the progression of work-family conflict. The earlier approaches were inadequate as they lacked predictive ability and offered modest direction in either forecasting work-family conflict or solving problems that arise from trying to find a balance between work and family responsibilities (Clark, 2000).

Not all individuals are characterized engage in this transition of border-crossing as the language and customs are highly alike within both spheres. Within work domain the language and behavior that is expected are diverse from the expectation within the family domain and consequently a more extreme transition is required. The underlying concept of work-family balance theory refers to “satisfaction and good functioning at work and at home, with a minimum of role conflict” (Clark, 2000). The foundation of this theory is built upon the roles between spheres and has the possibility for further clarification on the work and family conflict processes between the family and the workplace (Bellavia & Frone, 2005). The fundamental concepts of the work-family border theory are the work and home domains, the borders between work and home, the border-crosser with other important domain members.

The Work and Home Domains

The work and home are regarded by Clark as being two different domains that has differential behavior rules, and thought patterns. The differentiation among the work and home domains can be classified in two distinct groups that are the differences in value ends and differences in value means (Rokeach, 1973 as cited in Clark, 2000). The Work primarily deals with satisfying the means and ends of providing an income and giving a sense of accomplishment, while home life satisfies the ends of attaining close personal relationships. Within the work sphere the desired ends of responsibility and capability were ranked as the most important whereas the life aspect the desired ends of loving and giving were ranked the most significant means in achieving happiness in the home (Clark 2000). Due to the differentiation in spheres, individuals often find a balance that assimilates both work and life to some degree (Clark, 2000). With respect to the way in which individuals deal with differences of the two domains can be explained on a continuum with one end being integration and segmentation on the other Nippert-Eng (1996).

The Borders between Work and Family

Within the context of the border theory, an individual’s role takes place in a detailed sphere of life and these domains are distinguished by borders that demarcate from either being psychological, chronological, or physical (Clark 2000). The physical borders define where domain or behavior takes place regarding to the workplace or within the home (Clark 2000). Within the research frameworks, the literature is geared towards more controlling and setting time schedules in examining the role conflict boundaries, however less consideration is given to space Ahrentzen (1990). The temporal border refers the time in which work is finished and when responsibilities of the family initiate (Hill 1998). The psychological borders refers to the rules an individual creates that dictate their emotions, behavior patterns and thinking patterns which are appropriate within a specific domain such as work but not family life (Clark, 2000). Psychological borders are used by individuals to identify the rules that create the physical and temporal borders. It is created as an endorsement which “a process in which individuals takes elements given in their environments and organizes them in a way that makes sense” (Clark 2000).

Work-Family Conflict

The various predictors of work/family conflict can be grouped into two general categories role environment and personality. The Role environment consist of several types of role related predictors of work/family conflict such as behavioral involvement, psychological involvement, role-related stressors and affect, and role related resources.

Behavioral involvement represents the amount of time devoted to work and family roles. As more time is devoted to one role, it would be expected that less time would be available to meet the demands of another role. Consistent with this notion, a number of studies have found that the time devoted to family activities and chores is positively related to levels of family to work conflict, whereas the time devoted to work is positively related to levels of work to family conflict.

Work and family stressors, dissatisfaction, and distress have been examined as potential causes of work-family conflict. It is generally hypothesized that role characteristics can produce role-related dissatisfaction or distress, which may lead to cognitive preoccupation with the source of the distress or to reduced levels of psychological and physical energy. The resulting increase in cognitive preoccupation or reduction in energy can undermine an individual’s ability or willingness to meet the obligations of other roles (Frone, Yardley, 1997). Consistent with this line of reasoning, past research has found that work demands, work-role conflict, work role ambiguity, and job distress or dissatisfaction are positively related to reports of work/life balance conflict.

Work and family social support have been explored as potential resources that reduced work-family conflict. For example, a supportive supervisor may not make excessive demands that would cause an employee to work at home. Likewise, a supportive spouse or other family member may provide direct assistance with demands at home, thereby reducing the likelihood that an individual is preoccupied with these problems at work. Past research has found that higher levels of social support at work are related to lower levels of work-to-family conflict, whereas higher levels of social support at home are related to lower levels of family-to-work conflict (Adams, 1996).

Personality. Although most research has explored role characteristics as potential causes of work-family conflict, a few studies have begun to examine personality dispositions as causes of work-family conflict. Various personality characteristics, such as mastery, hardiness, positive affectivity, and extraversion may be conceived of as individual resources in that they capture a tendency to actively cope with problems at work and home, thereby reducing the likelihood of work-family conflict. Other personality variables, such as negative affectivity and neuroticism, may be conceived of as individual deficits in that they capture a tendency to avoid problems at work and home, thereby increasing the likelihood of work-family conflict.

Several recent studies have found that high levels of hardiness, extraversion, and self-esteem were associated with lower levels of both work-tofamily and family-to-work conflict (Bernas & Major, 2000; Grandey & Cropanzano, 1999; Grzywacz & Marks, 2000). One study reported that high levels of neuroticism were associated with higher levels of both work-tofamily and family-to-work conflict (Grzywacz & Marks, 2000).

Managing the boundary between the work and family spheres

The review of the literature have show that little studies have examined an individual’s perception within the boundaries of work and family roles (Nippert-Eng 1996). The analysis of borders can elucidate the extent in which individuals can control the issues determining work and family balance (Guest 2002). This allows for the analysis of physical and psychological controls, an examination of the nature of border permeability and the extent in which they can be managed or moved. This is consistent with the centrality of the issue where individuals perceive the parameters of work and family activities, which create personal meaning and the management of relationships among families and work Zedeck (1992). Kirchmeyer (2000) views living a balanced life as reaching a level that satisfies experiences within all life domains and requires individual resources such as commitment, energy and time to be well distributed across domains. Similarly, Clark indicates that work and family balance is a satisfaction and good functioning of roles at work and at home with least role conflict (Clark, 2000). Furthermore, another definition of balance stipulates that a balanced life is productive, healthy and satisfying including facets of love, play and work (Kofodimos 1993).These definitions of balance share two important elements. There is the notion of equality, or near-equality, between experiences in the work role and experiences in the family role (Reiter, 2007). Clark (2000) and Kirchmeyer (2000) imply similarly high levels of satisfaction, health, functioning and efficiency across the various roles. Furthermore, the definitions of work and family balance implicitly consider two constructs of equality that are inputs and outcomes. The inputs are the personal resources (Kirchmeyer, 2000) that are applied to each role. Kirchmeyer (2000) states that balance within work and family requires that each role be approached with approximately an equal level of involvement, time, commitment or attention. The balance achieved can either be negative or positive. A positive balance refers to an equal amount of attention, time, involvement, or commitment, whereas negative balance refers to an equally low level among these inputs. These inputs determine an individual’s level of role commitment in accordance with the time dedicated or psychological involvement in each role. There is difficulty in determining an individual who is substantially balanced as being more betrothed in the work role than in the family role. The other component of balance is the resultant outcomes that are experienced in work and family roles. A frequent outcome included in definitions of balance is satisfaction (Kirchmeyer 2000; Clark2000).

The relationship between work/life balance and quality of life

The balance between work and life is denoted to promote well-being. It is suggested that an imbalance in work will stimulate high levels of stress, cause a reduction in the quality of life and diminish an individual’s job performance (Kofodimos 1993). Within an organization the promotion of work/life balance can be promoted by an organizational change approach proposed by Hall (1990). This organizational change can take effect, by companies and individuals considering the advice given by literary publications providing on how to promote a greater balance in life (Cummings 2001; Fisher 2001).

However, the question arises on how work/life balance can enhance an individual’s quality of life. With respect to individuals, multiple roles can protect and create a buffer from the effects of negative experiences in any one role in an individual’s life (Barnett & Hyde, 2001). Work/life balance not only produces this buffering effect but can directly promote well being. Marks and MacDermid (1996) states that individuals who are believed to have a balanced life are deemed ”primed to seize the moment” when they meet a role demand since one role is seen no less than the other. Within this way of thinking individuals who are perceived to have balance experience lower levels of stress when enacting roles due to the assumption that they are participating in role activities that are salient to them. It is evident that individuals that have a balance have experienced less role overload and less depression compared to individuals that were deemed imbalanced MacDermid (1996).

Furthermore, when an individual has a