Author: admin

To what extent can researchers plan for ethical issues when working with children and young people? People often think of ethics or morals, as a rule for distinguishing between what is right and wrong. Something that springs to mind, is the saying; ‘Do unto others as you would have them do unto you’ or the religious creed of the Ten Commandments, ‘Thou Shalt not kill’. This is a common way of defining “ethics” and the norms for conduct that distinguish between unacceptable and acceptable behaviour.

Most people learn ethical norms within the home, at school or in other educational settings. Majority of people acquire their sense of right and wrong during their childhood as moral development occurs throughout life. Simply because as human beings, we pass through different stages of growth as we mature. Ethical norms can be classed as ubiquitous, simply because one might be tempted to regard them as simple ‘commonsense’.

A plausible explanation of these disagreements is that as humans, we can recognise some common ethical norms, but majority of individuals may apply and interpret these norms in different ways in respect of their own life experiences and own values.

Our society has legal rules that govern behaviour, but ethical norms can be broader and more informal than laws. However, most societies use laws to enforce moral standards and ethical and legal rules use similar concepts, it is however crucial to point out that law and ethics are not the same. For example, an action could be classed as legal, but illegal or unethical, but ethical. Society also uses ethical concepts and principles to interpret laws, evaluate and criticise. Within the last century, citizens were urged to disobey laws in order to protest what they classed as unjust laws that were immoral.

Within research with children and young people there are several reasons why it is important to adhere to ethical norms. Firstly, it promotes the aims of research and examples include, truth, avoidance and knowledge such as misrepresenting research data promote the truth, prohibitions against fabricating, falsifying and avoid error. Second, is that research often involves a great deal of cooperation and coordination amongst different people in different institutions and disciplines. Ethical standards promote the values that are essential to collaborative work, which include fairness, trust, accountability and mutual respect. For example, many ethical norms in research, such as guidelines for authorship, data protection policies, and confidentiality rules are designed to protect intellectual property interests, but still encouraging collaboration amongst the institutions. Therefore, researchers want to receive credit for their work and contributions to be disclosed prematurely and do not want to have their ideas stolen. Third and the main standard is that many of the ethical norms help to ensure that researchers can be held accountable to the public. Many of the norms with research are that it promotes a variety of other important moral and social values, for example social responsibility, human rights, compliance with the law, and health and safety. Critically, ethical lapses in research can significantly harm humans, students and the public. A researcher who may fabricate data in a clinical trial could harm patients and a researcher who fails to abide by regulations and guidelines, as set out in the ethical standards, could jeopardise his health and safety or the health and safety of staff and students in relation to radiation or biological safety. Consequently, ethics are often a matter of trying to find a balance between opposite extremes.

Ethical research with children has changed significantly in the past 30 years and modern standards of research ethic may considerably depend on modern transparent research methods and a respectful relationship between children and researchers. During the 1947s lawyers stressed the dangers of research and insisted that willing consent should be obtained, although it was presumed that children were too young to give consent and consequently banned from participating from research. Traditionally, children were not allowed to consent for themselves for medical

Children traditionally were not allowed to consent for themselves in terms of medical procedures and even for the simplest procedures. Today, there are three approved models of consent for children. First, children who are classed as competent, which are sometimes called ‘minors’ may provide consent on their own. Second, children may provide an assent with parental consent and third, some children, due to their developmental stage or age cannot provide consent until parental consent is sought. Critically, this can raise serious ongoing challenges and some of the difficulties can arise from assessing competence, best interests as well as, motivations. As well as dealing with conflict between children, parents and or with children and youth, many of which may be living on the street or in a crisis situation, to name just a few examples.

Children are traditionally considered more vulnerable than adults and this is because of their lack of competence to take part in making decisions. This could be especially around complex issues, such as health care and inclusion, in research. This vulnerability means that parents/ guardians, educators and health care professionals must be trusted to act in their best interests and make decisions for them. Moreover, this vulnerability has often meant that some children are simply excluded from research which is often in short-sighted attempts to protect them from harm. Consequently, this has resulted in excluding children from research and in research, failed to learn about children and to develop better and new ways to treat, approach and protect them.

Alderson (2004) states that ‘Ethicists teach the rules for ethical research are based on three main ways of thinking about what is ‘good’ research: the principles – of doing good research because it is right and correct thing to do. Rights based research – involves respect and children’s rights, such as providing for basic needs for example, healthcare and education. Protection – from child abuse and discrimination and participation – is vital during ethical research in having their own views listened to and respected by adults. This is based on good research, rather then relying wholly on adult’ principles and values. The best outcomes based ethics basically means, working out how to avoid or reduce harm and costs’.

Researchers may produce very misleading results that are produced in policies that could damage children’s lives. Researchers may upset children by worrying them by making false promises or betray them. Critically, moral questions about power, honesty and respecting people can arise throughout the research process. Although a problem, often seldom mentioned by ethicists, is a risk on published research reports that increase stigma and disadvantage children and young adults. However, these reports can help researchers address such risks and problems and learn how to deal with them.

An actual research that wasn’t properly planned and a particular ethical issue uncovered was when, as stated by Dennis, 2009 ‘A Japanese graduate student, was translating at a parent/teacher conference and the teacher asked her to pass along comments to the parents that Hanako’s thought were rude. She did not want to do it. She intervened covertly because she did not pass along the comments as they had been expressed by the teacher, but she pretended to do so. She tried to make the point the teacher was making, but in a much more polite, positive, and from Hanako’s perspective, acceptable way’. Critically, this issue would have failed to demonstrate the teacher’s irritation and pose an ethical risk, as this interpersonal intervention was not inclusive. It could pose a potential harm, as it failed to promote moral and social values and follow ethical standards that promote the values that are crucial to collaborative work, such as mutual respect and trust, especially when working with children and young people.

Another actual research that the researcher planned well for ethical issues was that off, Naz Rassool. Rassool (2004) was interested in working with a group of 14 and 15 year olds that raised several ethical and practical issues. Rassool felt that the pupils should not be exploited emotionally due to the nature of the work as the pupils were in a critical phase of their development. The research had to be very sensitive through its investigations of identity formation. Therefore, the ethical issues were paramount and persisted throughout the research. Rassool found the most effective way to address the theoretical research question to the pupils, incorporating the concepts of religion, knowledgeability, social change and individual reflexivity, all provided Rassool the theoretical framework. To generate a common understanding of the purpose of the research, Rossool conducted a seminar with staff involved, which addressed the aims of the research, ethical issues and the purpose of the activities. Other ethical issues, revolved in receiving parental consent and whether this as absolutely necessary, if the activities formed a part of the teaching programme. However, since the ultimate aim is to answer research questions it is crucial that all ethical issues are applied throughout. Critically, however when working with children and young people, it is normal protocol to seek parental consent, especially when conducting research. Rossool’s research promoted the aims of research; followed ethical standards and promote the values, which are essential for collaborative work, such as mutual respect, trust and fairness. It promoted moral and social values.

Research heavily relies on the public to take part in the research and if this cooperation is to continue, then researchers have to keep high ethical standards. Alderson (2004) states ‘public anxiety about the removal of children’s organs without consent, partly for research shows how research ethics, consent and rights may change, especially when children are involved’. Similar changes may occur in social research and therefore, it is crucial to gain foresight about social research from the hindsight of medical research. Critically many medical journals refuse to publish these reports that may not have the backing of ethical committee approval and therefore, researchers need to keep abreast of the ethical standards. Gaining ethics committee approval can take time and can protect people who take part in the research and protect them from litigation and criticism.

The extent researchers can plan for ethical issue is by involving children and young people and should only be conducted when the research question posed is crucial to the well-being and health of children. Ethics help researchers to be more aware of hidden problems, but do not always provide the right and easy answers. However, a research procedure which is not intended directly to benefit the child subject is not necessarily either unethical or illegal. Such research includes observing and measuring normal development and the use of ‘healthy volunteers’ in controlled experiments. The participation of children is indispensable and this is because the information available from research on other individuals cannot answer the question posed in relation to the children. Therefore, the study method is appropriate for children and the circumstances in which the research is conducted, provides for the emotional, physical, emotional and safety of the child.

The challenges relating to ethical and consent issues involving children and young people in research are numerous and require careful consideration and yet are not insurmountable. Critically, as a priority, researchers must engage with the legal, moral and ethical imperatives offered by UNICEF. As Alderson quoted, that Rights based research – involves respect and children’s rights and as part of the UN Convention on the Rights of the Child in particular. The researcher needs to give diligence to Article 12, and the article due and diligent consideration in its entirety, by respecting the views of the child. Researchers must not only commit to inclusive practices, but also maintain assiduousness in ensuring that children and young people are respected participants in the research process, from selection of methodologies to the dissemination and reporting of results. With these guidelines in mind, children should be offered opportunities to genuinely participate in research. When adults are making decisions that affect children, children have the right to say what they think should happen and have their opinions taken into account.

Ethical considerations are paramount in children’s research and management of these considerations can be very influential on the research that is ultimately completed with children and young people. The major issues discussed include, protection and safety versus participation, the role of ethics committees and the impact of consent processes.

In summary, negotiating ethics approval and access to children and young people remains a major challenge. More attention needs to be given to facilitating information and understanding participatory research across all groups involved to minimise culture clashes and increase the understanding of the nature of participatory research. As Dennis, 2009 quotes ‘There is one ethical principle that worked differently: all people’s voices should be included in decision making thus those who oppose egalitarianism should not be allowed to make decisions that limit the inclusion of others’ voices. In this case, there is no way to achieve egalitarian inclusivity with people who would limit the egalitarian and inclusive treatment of others. Thus, the two aspects of this ethical principle do not contradict each other and do not need to be criticised on these grounds’.

The extent researchers can plan for ethical issue is by ensuring the adoption of methods which are respectful to the children and is also crucial that researchers take ethics seriously. This may mean researchers moving away from traditions that in the past may have considered children as ‘unthinking human beings’. Instead, it places the emphasis on respecting children as dynamic people, which makes this method more realistic and productive. This is consequently classed as ethical, as most ethics encourage research methods with children participants.

Word Count: /2,500

Group Therapy has a variety of ethical issues one of the main issues that maybe encountered is involuntary group members. Corey, Williams, and Moline (1995) explained that ethically a counselor should advise clienteles of theirs privileges and duties and advise them of any probable concerns they face if they choose to follow treatment. Informed consent is extremely important when participation is mandatory. Informed consent is something that all psychologist, counselor, and therapist have to obtain from clients. The consent is important because certain guidelines have to be followed by the counselor during the sessions. When a client becomes involuntary this puts the counselor in a comprising position. The counselor becomes comprised because the incorporation of the client places limits on the direction of the sessions in the group.

The following is an example of legal issue where a patient refuses medical care. Website Merck (2007), stated “People who have legal and clinical capacity may refuse any medical care. They may refuse care even if it is something almost everyone else would accept or something that is clearly life-saving”. With that being said there is also a variety of issues related to right of refusal.

The following is a list of some legal issues related to refusal of consent. American Bar Association (n.d.), stated “religiously sponsored HMOs often do not cover prohibited services or provide information, counseling, or referrals to plan members who may want or need these services. Women in Medicaid managed care plans face particular challenges” (Susan, Lourdes). Because of the risk of misdiagnosis financial factors have become an issue. Psychologist and therapist are avoiding working with some clients because of what insurance they have. The reason for this is because some insurance companies cannot be reimbursed for certain diagnosis. In addition insurance companies are starting to take practitioners to civil court for incompetence.

Ethical Issues Unique to Individual Counseling

Some of the ethical issues a counselor may encounter in individual counseling may range from dual relationships, involuntary client, moral dilemmas, breach of confidentiality, and other significant factors. Ethics in psychotherapy and counseling (2007), stated “In the mid-1970s, New York Supreme Court Presiding Justice Markowitz recognized evidence that from the time of Freud to the present, the health care professions had agreed that therapist-patient sex harms patients” (Pope, Vasquez, p. 174). The extent of sexual relationships has not been fully understood until recently. Within the past quarter century a diverse series of investigations have broaden the meaning of therapist – client relationships in individual psychotherapy. Certain issues that were addressed in the investigation included how clients can be injured, physical contact with clients, and sexual attraction to patients. Studies that were conducted have concluded that certain outcomes for sexually abused clients. Clients who have been sexually involved with individual counselors produce negative outcomes.

Therapist would choose Group Therapy

Essentially, Group Therapy is targeted on assisting clients with data about specific categories in order to give supplementary means or data. Counselors believe that group therapy is more structured; in group therapy counselors also believe that clients are provided with precise categories or modules to debate and learn about. The intent is to supply individuals with access data about the categories, which is frequently recognized in the label of the group. the process group therapy is favored by counselors too. a process group is best explained as a group that targets on the experience of belonging to a group, itself, this recognition is part of the healing opportunity given within the group. An example would be the process of a client showing their ideas, emotions, and in the group, “in the here and now” can become the essential vehicle that finds change in group therapy. Counselors often choose group therapy to supplement individual therapy. Counselors believe group therapy will supply clients with access support, or as the primary part of healing work. On no account substance what issues a client may want to address in therapy, group therapy give clients the opportunity to share their thought which is part of their healing journey. Counselors believes that clients attending group gain a sense from the experience as a way to know that they “are not alone” and that there others, with similar experiences, who are supportive of them.

Therapist would choose Individual Counseling

Ethical decision making in professional psychology is important to regulate the practice of psychology. Individual counselors believe that ethical decision making procedures can produce positive psychological outcomes. In addition ethical decision making places a certain degree of accountability on the psychologist in individual counseling. Ethical guidelines and educational requirements ensure that clients receive adequate professional assistance on a one on one basis. Ethical decision making in a sense also causes a power shift. Paste psychological practices were controlled by the therapist. In modern times clients have a say so of what treatments and practices they want to receive. This is due to current ethical guidelines. Psychologists give numerous reasons why Multicultural psychology has become a subspecialty. With a society that is diverse in culture psychology had no choose but to be aware of these circumstances. Because of this factor training had to be given to researchers and psychologist in the career field. These measures were done to raise awareness of culture differences and to clarify that these differences had to be handled different individually. Cultural competence is best explained by CEO Services (2007), as “the development of skills by individuals and systems to live and work with, educate and serve diverse individuals and communities”.

Having multicultural psychology as a subspecialty eradicates negative beliefs about other cultures. In addition categories of discrimination, prejudice, lack of education, and ethical values are learned. A major issue with research done with past experiments was they were not culturally equal. Things like the above issue and other factors lead to the requirement of multicultural psychology as a subspecialty. If a professional is culturally competent they should see and understand cultural, economic, gender, and physical differences that another individual may have in society. Culturally competent professional should not be prejudiced in thought while considering another human being feelings and cultural traditions. Social Phobia has a connection with the stability-change issue. The Life -Span Development (2007) text explains the stability-change dispute consists of the point to which early traits and characteristics persist through life or change. In the stability-change issue Developmental psychologists acknowledge the concept as broken into two separate issues. On the stability side of the issue psychologist argue that early experiences in life can affect a person’s stability or there heredity can cause change in stability. But on the change side of the spectrum psychologist are arguing that people’s later experiences can cause change. So in saying that the change concept is basically that people are is constantly being molded throughout their life span.

Distinctive Features

Some of the distinctive features that are associated with social phobia range in vary areas. “Person with social phobia experience excessive fear of being humiliated or judged negatively in social or performance situations” (Heimberg, G. R., Liebowitz, R. M., Hope, A. D., Schneier, R. F., 1995). Social anxiety and panic disorder are also qualified as features in the social phobia criterion. The different experiences an individual lives through and witness can mold their mind state. If an individual has had many experiences dealing with discrimination they may perceive the world as unfair. If an individual is or maybe was raised in poverty they may perceive the world as unfair and class based.

A prime example would be a minority individual born during the civil rights era or earlier. These individuals had witnessed the inequality of America and seen the horror that come from inequality. A majority of individuals who lived during those times have negative views on white America. I have seen this in my grandmother who is 83. She can get along with other races but she is still to a degree stuck in the past. Often stating how minorities should watch they do because of inequality.

Ethical Challenges I may Face

Being a counselor some of the many ethical challenges I believe I will face will be as followed. Being a counselor whether the setting is for a group or individual counseling Being mentally aware is important for individuals so they can understand their personal ethical perspectives in life. If individuals have an understanding of their ethical perspective other attributes can be understood. Personal ethical views can influence emotions and reactive behavior in some individuals. Personal ethical perspectives are essential in formulating who an individual is and what they stand for. In addition understanding personal ethical perspective is necessary when choosing a career field. Ethical dilemmas’ can be frequent if professional ethics are opposite of an employee’s personal ethics. If personal ethics are misunderstood stress can manifest in individuals. Ethics in psychotherapy and counseling (2007), stated “Uncertainty causes stress for some of us. We cannot find that magical book that will tell us what to do, especially in a crisis” (Pope, Vasquez, p. 2).

The argument about personal and professional ethics has been debated for a while. But each ethic is unique and essentially a necessity to function in society. The United States has become a nation were ethical perspectives are revered. The evolution the United States has made is amazing. Manifesting from a primitive culture to what is now known as the ethical nation. Work ethics involve such characteristics as honesty and accountability. Basically, work ethics break down to what one does or would do in a particular situation ethics as guidelines restrict the abrasive production low safety, employees non-companies, non-compliance with legal regulations and even lawsuits. Ethical regulations decline tension; makes the environment more beneficial by fostering a goal focused climate of cooperation that even boost business. Ethical regulations purely boost a positive site for the future.

Confidentiality

Better Morale

Worker safety

Organized work environment

All organizations have laws that they have to abide by, employees, board members, and those who work voluntarily must do the same. Regardless of personal feelings toward those laws, they are to obey all laws in the performance of their work on behalf of Community Services. Ethics

is the central part, the heart of leading and include private duties of service and public duties to the common good. Therefore, personal, professional, and practical ethics are included into a multidimensional perspective of ethical leadership in human service organizations

Development of Professional Ethics through Societal Norms

Ethical standards have a role in society’s developmental norms. Social norms are explained on Sociology Guide website. Sociology Guide (2006), stated “Sociologists have offered the following definition. Social norms are rules developed by a group of people that specify how people must, should, may, should not, and must not behave in various situations”. To better understand what ethical standards really mean, the Santa Clara University (2007), stated “Ethics has to do with what my feelings tell me is right or wrong; Ethics has to do with my religious beliefs. Being ethical is doing what the law requires; Ethics consists of the standards of behavior our society accepts” (Velasquez, Andre, Shanks, S.J., and Meyer).

Evolution of cultural factors and beliefs has impacted ethical standards also. Some of these factors are responsibility, malpractice, ethical dilemmas, ethical judgment, reasoning, language, and justifications. American 18 or 1900’s social norms seem barbaric compared to 21st century norms. A prime example of disturbing social norms and ethical codes are practices of psychology. Practices such as psychosurgery left permanent damage to areas of the brain. Other primitive methods used were insane asylums, electroconvulsive therapy, and Trepanation. Robert Todd Carroll (2007) states “Trepanation is the process of cutting a hole in the skull”. If those procedures were practiced today society would consider them cruel and legally incorrect.

Ethical standards and codes have helped the American nation become civilized. Civilized behavior is a progression compared to when individuals would react by emotions. In addition the codes have formed this nation into a more business oriented society. Ethical standards have made equal right obtainable to women. Because ethical standards and codes affect social norms woman can vote, and get equal pay. Equal bus seating, right to vote, and other factors African Americans gained because of ethical standards. Disabled individuals have also gotten opportunities to work. Through the development of new ethics standards societal norms have also changed and quality of life for all individuals has improved.

APA Ethics Code

The American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct consist of an introduction, a preamble, five general principles and specific ethical standards. The general principles and preamble are not enforceable rules. However, they should be considered by psychologists in arriving at a professional and ethical course of action. The Ethical Standards are set enforceable rules for conduct of psychologists/psychiatrists. Most of these standards are written so they apply to psychologists that have various roles within the field.

The American Psychological Association enforces members and student residents to comply with the standards of their ethics code and the procedures and rules that are used to enforce them. Misunderstanding or lack of awareness of the code is not considered a defense if a member and/or student resident is charged with unethical conduct.

The APA’s Ethics code ensures psychologies will protect the human and civil rights and the importance of freedom of inquiry and expression in teaching, research and publication. Psychologists perform many roles; such as educators, diagnosticians, researchers, supervisors, therapist, administrators, consultants, expert witnesses and social interventionists. The APA’s Ethics codes provide a common set of standards and principles, in which psychologist, researcher, therapist, etc. build their scientific and professional work.

APA Ethical Violations

The impact of the American Psychological Association’s (APA) ethical standards and codes on professional practice in the field of psychology includes how the ethical issues are resolved once one is accused. The ethical code deals with such matters as: misuse of psychologists’ work, conflicts between ethics and law, regulations, or other governing legal authority, informal resolution of ethical violations, reporting ethical violations, improper complaints, and unfair discrimination against complainants and respondents. (APA, 2002)

Psychologists who learn of misuse or misrepresentation of their work may take reasonable steps to correct or minimize the misuse or misrepresentation through the APA. When there is a conflict between ethics and law, regulations, or other governing legal authority and a psychologist’s responsibilities they make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict cannot be resolved via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority. (APA, 2002)

Sometimes situations may call for informal resolution of ethical violations. If a psychologist believes that there may have been an ethical violation by another psychologist, they may attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate and the intervention does not violate any confidentiality rights that may be involved. Reporting ethical violations may be necessary when an apparent ethical violation has substantially harmed or is likely to substantially harm a person or organization. Psychologists may take further action appropriate to the situation such as referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities. This standard does not apply when an intervention would violate confidentiality rights or when psychologists have been retained to review the work of another psychologist whose professional conduct is in question. (APA, 2002)

When a Psychologist does not file or encourage the filing of ethics complaints that are made with reckless disregard for or willful ignorance of facts that would disprove the allegation the ethics code allows for treatment of these improper complaints. Unfair discrimination against complainants and respondents in the APA ethics code demands that Psychologists do not deny persons employment, advancement, admissions to academic or other programs, tenure, or promotion, based solely upon their having made or their being the subject of an ethics complaint. This does not preclude taking action based upon the outcome of such proceedings or considering other appropriate information. (APA, 2002)

Psychology and Professional Ethics

Psychologists have an obligation to protect the people in which they counsel on a regular basis. Ethic codes have been created to protect the public and offer guidance to professionals in serving their clientele. Many different mental health organizations have their own set of ethical codes in which they follow on a day to day basis. Without these ethical codes, they would not be able to properly protect themselves or their clients in the unlikely event that they are accused or sued for malpractice.

There is believed to be three main reasons that these ethical standards and codes have been created for professional psychologists to follow. The three standards and codes are the general reason is to educate professionals about adequate ethical conduct; consultants that comprehend the standards may acknowledge prolonged alertness, ideals-interpretation, and difficult-answering abilities. Next, ethical standards encourage responsibility, also, counselors need to preserve ethical conduct encourage such from colleagues as well. Third the code of ethics helps support in cultivating preparation by proposing answers to challenging inquiries and circumstances (Herlihy & Corey, 1996).

“Ethical issues in mental-health are governed by professional codes and laws. Law defines the minimum standards of performance which society will tolerate and these standards are enforced by the government. Ethics illustrates maximum or ideal standards of performance set by the profession and are managed by professional associations, national certification boards, and government boards which regulate professions” (Remley, 1996). Ethical codes that are used in mental- health organizations are revised when new issues in the psychological community arise.

Providing a code of ethics to clients receiving psychological care has proven to be fundamental in the field of psychology. Not only to the psychologist providing treatment but also to the client who is receiving treatment on a daily, weekly, or even a monthly basis. Besides knowing these rules, a therapist must be able to think rationally and apply different ethical standards to each individual situation that may crop up while they are providing professional counseling services. Not every situation is covered under these individual codes and standards. Often a psychologist is forced to make their own decisions in regards to which way to best treat a client who is seeking help. Without these codes of ethics, a therapist would be unprotected should they provide the wrong type of treatment to one of the clients they are serving. This could often a therapist up to losing their license to practice and be sued which could end up costing them a fortune financially, professionally, and personally.

Conclusion

The APA ethics code systematically describes how psychologists and psychiatrists should behave in a professional environment. Societal norms have helped to define how professional ethics should be followed and has also contributed to how the APA’s ethics code has developed. Through communication of this ethics code among psychologists, they can hope to have greater success with clients and better relationships with colleagues.

Pashan DeShields

Introduction

Throughout the years of being a social worker, a person can come across many different ethical dilemmas. An ethical dilemma involves being faced with a situation where a decision must be made under circumstances where ethical principles are in conflict. Dealing with these types of things, there is really no perfect answer that can conform to all of the ethical principles in the professional codes. Due to the fact that social workers have established guide lines for difficult situations, we can do better decision making.

Ethical Dilemma. Jennifer, 23, is a student working at a halfway house for men on parole, who are also substance abusers. This is part of her final 480 hour field internship. Jennifer is very attracted to Sly, a 26-year-old, handsome client who is also quite charming. She finds it very difficult to avoid responding to his flattering, flirtatious advances. She is halfway through her placement and is finding it extremely difficult not to respond to Sly and secretly date him. The agency has a strict policy that no worker should date a client within six months after either have left the agency. Jennifer finds herself preoccupied thinking about him much of the time. She feels that she’s losing control.

Professional values that apply to the dilemma. A professional value cited in the NASW Code of Ethics that was used in this case in “Integrity”. It tells us how social worker’s should continuously be aware of their mission, values, as well as ethical standards. (p.6) Jennifer forgets her mission and the standards required to obtain this career. She was there on her internship and allowed herself to get caught up in a conflict of interest. In the code, it describes the precautions needed when facing this kind of dilemma. At all times, social workers should be alert and try to avoid having conflicts of interest.

Worker’s professional role and boundary issues involved. Jennifer is taking on the role as an intern which means that she should be following the guide lines for the “Social workers’ ethical responsibilities to the client”. One of the boundaries that have been crossed is Conflicts of Interest. According to the code, social workers should not engage in any dual relationships with clients or former clients (p.9). They should establish appropriate boundaries. This applies to Jennifer and Sly’s situation since they both cannot resist the flirting and are hiding their dating life. They are involved in a dual relationship. She is already in violation with site of where she is interning, who gave a strict rule of no dating clients within six months of leaving the agency.

Another boundary that has been broken is Sexual Relationships. This tells us that for no reason should a social worker participate in any type of sexual contact with a client, whether it was consented or forced. (p.13) Jennifer and Sly may not have had a moment of intimacy, but according to the dilemma, they are close to doing so. She can’t resist his advances and is finding it hard to control herself in secretly dating him. They are young, optimistic, and flirtatious; it is very possible that a mishap can occur.

What emotions, wants, and needs might characterize the worker involved in the scenario? It could appear that she is looking for an outlet herself and has found it in this relationship. Sometimes we search for answers through things, hoping that we will find our help as well. It is very important that a social worker is healthy and whole in every aspect of their life. As a social worker, you have been given trust by your patients that you will help them receive what they need and live a fulfilled life.

Alternatives available for the worker to take. Although Jennifer feels that her situation is becoming too much, there is alternatives that she can take to lessen the stress of the situation. Since she is attracted to him and is very tempted by him, she should address her feelings, sooner than later. She is halfway through with her internship and to not look bad, she should tell the site director. There, the supervisor or her educator can tell her what may be the best route for her to take in regards to her maybe later being employed at which she is interning. Or perhaps there should be a termination of the professional relationship. She should let Sly know that she will no longer be professionally working with him and find him another practitioner where he could still get proficient help from. Or, she could even just keep what has already been going on a secret. She and Sly can secretly date and wait until the 6 month rule has expired that allows her to date a client.

Potential positive and negative consequences for each alternative. Weighing the pros and cons of each alternative is a common perspective in various aspects of social work practice. It is also useful in resolving ethical dilemmas. A pro in being upfront with her supervisor is that she will possibly gain respect. She could tell the truth about her and Sly and how now avoiding him is hard and she doesn’t want to go against the code. The supervisor will see that the intern is aware of her professional responsibilities and wants to maintain the upmost respect of her patient. She could keep her internship and the client could possibly be relocated. Or, the supervisor may not trust Jennifer still being at the site since she has acted unethically. He/she may have to report her which could lead to Jennifer missing out on a good job opportunity. This record may also follow her to future job employments.

Then, there is terminating the client. If they terminate Sly as a client, a positive would be that she won’t be distracted in her work place. She can be more focused in completing her internship. This is usually the approach that is used for those who have been involved in dual relationships. Also, Sly can really continue to get the help that he needs instead of being at the facility flirting with the newly, young worker. However, in a termination, the clients’ reaction to things can be very negative. Sly can go into a mode of denial or even rage. He may not believe that they are removing him or even get mad that Jennifer is allowing this to happen. By being enraged, this could also cause Sly to relapse back into his substance abuse.

Lastly, she could keep the romance between them a secret. The pro in this is that she can continue to work on landing a good job while establishing a relationship with someone she likes. Due to the fact that Jennifer has already stated the frustration in trying to be in a secretive relationship, this could very quickly turn into a negative. She could ultimately be looked down on and could lose respect and a job. Also, she and Sly’s relationship may not even be long lasting for her to be risking her career. She would be better off being upfront and showing concern with following the code and respecting what is asked of her by the job instead of keeping it a secret, possibly ending up with the same outcome. Professionally, it would look better for her to do so.

How might each alternative affect the client and the worker/client relationship? Ways in which the alternatives can affect the client and the worker/client relationship can come in a lot of forms.

Action that the worker should take that would be the most ethical and appropriate for both worker and client? Ethical choices must be made to allow people to survive and thrive, existing with their basic needs met. There must be a decision made in regards to what is best for the social worker to take. However, before that decision has been made, critical thinking has had to have taken place. It is imperative to use critical thinking and ethical decision making to achieve the optimal result. She should talk the issue over with her supervisor or get counseling help. Face and evaluate the serious negative consequences for both her and Sly. Ultimately, she should terminate their professional relationship, referring Sly to another practitioner so that his services will continue.

Extent to which individual professional discretion is required. It is very important that when dealing with a situation like this, nothing is said or done that causes offense or reveals any private information. You have taken an oath to the service of humanity and to social justice. As a professional, the welfare of your patient is your first priority and the main focus is to make sure the client receives what he/she needs.

Conclusion

Sadly, the pattern associated with Jennifer’s unethical involvement is noticed in a small percentage of social workers, who have been associated with inappropriate behavior with their clients. Although this behavior is known, many social workers have upheld their oath and maintain a high expectancy of the honor and tradition of the social work profession.

New Hanover County Senior Resource Center: Ethical Dilemma

What are values, ethics, ethical dilemmas and a code of ethics? Values relate to principles and attitudes that provide direction to everyday living. Values also refer to beliefs or standards considered desirable by a culture, group or individual (Merriam, 2003). On the other hand, ethics means a system of beliefs that constitutes moral judgment. In essence, ethics are moral principles (Barsky, 2010, p. 12). An ethical dilemma is when a person is faced with a choice between two equally conflicting moral principles, and it is not clear cut which choice will be the right one. (Barsky, 2010, p. 6). In other words, adhering particularly to one principal might result in the violation of the other. Finally, ‘a code of ethics’ is an explicit statement of the values, principles and rules of a profession, which acts as a guide for its members and their practice (Code, 2008). In every occupation, professionals are faced with ethical dilemmas. Dilemmas at workplaces can sometimes be the hardest decision to make in life; however, as a professional we must take the proper steps to move further and not jeopardize our license or career. As a Bachelor of Social Work intern at the New Hanover County Senior Resource Center, ethical dilemmas are easy to come by.

Description of Ethical Dilemma

An ethical dilemma occurred on November, 20^th of 2014. The client that this dilemma revolves around, is on the Senior Resource Centers Home Delivered Meals program. The program serves home-bound elderly citizens age 60 and over, and they receive a lunch Monday through Friday, prepared at the center nutrition site by a local catering company (Nutrition, 2015). This specific client has been receiving meals since 2006, and in November it was time for a reassessment to be done. Reassessments are done every six months to make sure the clients are still eligible to receive meals.

I and my field instructor, Jean Wall, visited this client at their home. I knocked on the door, and after a few seconds I could smell marijuana wayfaring in the air coming out of an open window beside the door. The grandson of the client opened the door, and said the client was not there. He looked to be older than 18. My field instructor asked where the client was, and the grandson changed the story to the client was in the bedroom taking a nap. The grandson had red eyes, and was slurring his words, which are symptoms of marijuana use. Added with the smell of marijuana coming from inside, it was clear he had been smoking it. After leaving the clients home, I was unsure how to proceed with what just happened. The drug use in the home could negatively affect the clients overall health and well-being, but is it within our jurisdiction, as social workers at the senior resource center, to make a report?

The Code of Ethics of the National Association of Social Workers, also known as NASW, expresses the values and principles of the profession. By having values and principles that guides our practice, this assists our work, and helps us to act in ethical ways. In short, values and principles provide a guide and standard for ethical practice in social work (Barsky, 2010). The ethical standards that conflict, in this ethical dilemma, are standards 1.01 and 1.07. 1.01 states that a social workers primary responsibility is to promote the wellbeing of clients. Standard 1.07 part ‘a’ states that social workers should respect clients’ rights to privacy (Code, 2008). Standard 1.07 is also in conflict with North Carolina possession laws. In North Carolina, Marijuana is classified as a Schedule VI Controlled Substance, and possessing marijuana in North Carolina is considered a Class 1 misdemeanor under N.C. Gen. Stat. 90-95(d)(4).

Stakeholders

Every decision we make affects other people. Social workers have a moral obligation to consider the ethical implications of their decisions on others. Each person, group, or institution likely to be affected by a decision is a stakeholder with a moral claim on the decision maker (Barsky, 2010). There are individuals, groups, and organizations that can be affected by the ethical decision made concerning this client who lets their drug using grandson live with them. First of all, the client is most likely to be affected by the decision because this ethical dilemma revolves around the client and questions what is best for the client. The grandson is also a stakeholder. More individuals that are stakeholders are Jean Wall and myself, because we are the social workers involved with the case. The organizations that are also stakeholders are the New Hanover County Senior Resource Center, the Apartments where the client lives, The Department of Social Services, and The Wilmington Police Department.

Possible Courses of Action

Identifying all possible courses of action and the participants involved in each, along with possible benefits and risks for each, is important for making the best decision when it comes to ethical dilemmas. In this case, there are three possible courses of action; doing nothing, reporting the drug use, and discussing it with the client.

The first course of action, doing nothing, entails not reporting the drug use or confronting the grandson or client with the matter. Essentially, the participants with this option are the social workers involved with the case, which are Jean Wall and myself. We would document the home visit like we are required to, but no further investigation would take place concerning the drug using grandson living with the client. The benefit to this option is that the client gets to have the grandson continue to live there, which may help if she has an accident or medical emergency, where she would need help calling 911 or getting to the hospital. The risks of this option are that the grandson may become abusive as an effect of the marijuana use, and that the client’s health could be negatively affected from inhaling the smoke.

The second course of action, reporting it, entails making a report of the drug use to the police department, or to Adult Protective Services. The participants in this option are, myself, my field instructor, the client, the client’s grandson, the Wilmington Police Department, and the Department of Social Services. The benefits for this option are that the client is no longer living in an unhealthy environment, and that, if the police reprehend the grandson for possession, then drugs have been taken off the street. The possible risks are that the client is displeased and makes complaints to the agency, and another risk is that the police can do nothing about the drugs being in the home, and in retaliation, the client may want nothing to do with the senior resource center anymore.

The third course of action is discussing the issue with the client, and letting the client decide what they want to happen. Participants is this option would be the client, the grandson, myself, and my field instructor. The benefits are that the client becomes aware that there is an issue, and starts to take steps to get the grandson out of the house, and that the grandson will be aware that this could lead to a bad environment for his grandmother. The possible risks are that the client may get angry with us trying to get involved, the grandson may get violent and defensive, and that the agency may lose the client.

Analysis of Courses of Action

The courses of action mentioned previously need to be thoroughly examined. Doing this entails going over the reasons in favor of and opposed to each possible course of action. Option number one of doing nothing, entails not reporting the drug use or confronting the grandson or client with the matter. Reasons in favor of this option include the Code of Ethics ethical standard 1.07. That standard prohibits social workers from sharing client’s personal information (Barsky, 2010, p. 98). Social workers should respect the client’s rights to privacy, and this applies to this option because we would be protecting the clients privacy by not reporting the drug use. Another reason in favor of this option is that it’s not in our jurisdiction to do, or say anything, about the apparent drug use because there was no evidence of elder abuse, and we could see no actual drugs. The reasons opposed to doing nothing revolves around the Code of Ethics standard 1.01. It is a social workers responsibility to promote the wellbeing of clients. In this case, doing nothing would not adhere to following that standard.

Option number two, of reporting it, entails making a report of the drug use to the police department, or Adult Protective Services. One reason in favor of this option is that it would adhere to the ethical standard 1.01 of promoting the clients wellbeing. Another reason in favor of this option is because it would follow with my own personal value about being against drug use. Additionally, possession of marijuana is against the law in North Carolina. Reasons opposed to reporting is that it would compete with ethical standard 1.07 where it states that social workers have to respect client’s rights to privacy. Also, reporting this issue to police would go against the ethical principle of dignity and worth of the person. The NASW Code of Ethics (2008) states that, “Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs”.

Finally, option number three, of discussing the issue with the client, and letting the client decide what they want to happen, has reasons in favor of and against it. Reasons in favor of talking it over with the client includes the ethical theory that the client is the expert on their own life, and the ethical principal of dignity and worth of the person. Option three adheres to this theory and principal because we would be giving the client the opportunity to change and to address their own needs instead of making the decision for the client, without the clients consent. A reason opposed to this option is the legalities involved with North Carolina law. Drug possession is against the law, so just discussing the issue with the client may not be enough.

Consultation

Consulting with colleagues and appropriate experts about ethical dilemmas can aide in the decision making process. With this case, I consulted with Jean Wall, who is my field instructor, and then I consulted with another intern at the New Hanover County Senior Resource Center. The reason I consulted with the other intern was to try and get a sense of what her opinions on the case are, and to see what her decision would have been. The outcome of that consultation was that she was stumped on what to do also, but that she agreed with me on that it was an issue. She was not sure what should be done about it either. Next, I consulted with my field instructor about the home visit in general, then asked what should be done with the issue. Jean stated that, first, it was not part of our job to advise our clients on what should be done. We are to only give them the resources and tools they ask for. Second, that since there was no sign of abuse or neglect we could not make a report.

Determining a Course of Action and Documentation

The course of action that was chosen was to do nothing about the issue. This option was chosen because there was no sign of abuse or neglect, so we could not make a report to Adult Protective Services, and because we did not actually see any drugs while we made the home visit. The Senior Resource Center does not have a particular method of documenting ethical dilemmas. Documentation is done for all client interaction with the agency and staff. I documented the reassessment, like I would any other reassessment, once we could get in touch with the client and do the full reassessment.

Ongoing Evaluation and Documentation

After making the decision, monitoring, evaluating, and documenting the decision comes next. After documenting the first home visit we did to see the client, my field instructor set up another appointment with the client, and did the full reassessment for Home Delivered Meals. After the assessment, my field instructor and I debriefed on how the second home visit went. My field instructor stated that the house was very cluttered and smelled of smoke. The grandson was still living with the client, but he was out of the room for the visit. The client was found to still be eligible for Home Delivered Meals, and in six months, my field instructor will conduct another reassessment.

Conclusion

In conclusion, an ethical dilemma is a conflict of moral principles, occurring when a person is faced with a certain situation where adhering particularly to one principal might result in the violation of the other. Over the course of this internship, I have found that dilemmas at workplaces can sometimes be the hardest decisions to make in life; however, as an aspiring professional I must take the proper steps to move further. While interning at the New Hanover Senior Resource Center, this ethical dilemma occurred during a home visit. The client’s grandson had been smoking marijuana within the client’s home. The reason this was an ethical dilemma was because two standards in the NASW Code of Ethics were in conflict, specifically 1.01, and part ‘a’ of 1.07. In the end, my field instructor and I were not able to do anything about the smoking of marijuana in the client’s home. We could not report it to Adult Protective Services because there was no sign of neglect or abuse to the client. However, there will be further monitoring of the situation due to the client still being on the Home Delivered Meals program, and having to do reassessments every six months.

References

Barsky, A. E. (2010). Ethics and values in social work: An integrated approach for a comprehensive curriculum. Oxford: Oxford University Press.

Code of Ethics of the National Association of Social Workers. (2008). Retrieved February 7, 2015, from https://www.socialworkers.org/pubs/code/code.asp

G.S. 90-95. (2015). Retrieved February 7, 2015, from http://www.ncleg.net/EnactedLegislation/Statutes/HTML/BySection/Chapter_90/GS_90-95.html

Merriam-Webster, Inc. (2003). Merriam-Webster’s collegiate dictionary. Springfield, Mass: Merriam-Webster, Inc.

Nutrition. (2015). Retrieved February 7, 2015, from http://src.nhcgov.com/services/nutrition/

Selecting an appropriate method of intervention is central to ethical and effective practice with service users. The aim of this essay is to define what is meant my method of intervention, explore the main factors which influence the worker when selecting a method and critically consider the role of partnership working and empowerment.

‘Intervention is rarely defined. It originates from the Latin inter (between) and venire (to come) and means ‘coming between’ (Trevithick, 2005: 66). Interventions are at the heart of everyday social interactions and make ‘inevitably make up a substantial majority of human behaviour and are made by those who desire and intend to influence some part of the world and the beings within it’ (Kennard et al. 1993:3). Social work interventions are purposeful actions we undertake as workers which are based on knowledge and understanding acquired, skills learnt and values adopted. Therefore, interventions are knowledge, skills, understanding and values in action. Intervention may focus on individuals, families, communities, or groups and be in different forms depending on their purpose and whether directive or non-directive.

Generally, interventions that are directive aim to purposefully change the course of events and can be highly influenced by agency policy and practice or by the practitioner’s perspective on how to move events forward. This may involve offering advice, providing information and suggestions about what to do, or how to behave and can be important and a professional requirement where immediate danger or risk is involved.

In non-directive interventions ‘the worker does not attempt to decide for people, or to lead, guide or persuade them to accept his/her specific conclusions’ (Coulshed and Orme, 1998: 216). Work is done in a way to enable individuals to decide for themselves and involves helping people to problem solve or talk about their thoughts, feelings and the different courses of action they may take (Lishman, 1994). Counselling skills can be beneficial or important in this regard (Thompson 2000b).

Work with service users can therefore involve both directive and non-directive elements and both types have advantages and disadvantages (Mayo, 1994). Behaviourist, cognitive and psychosocial approaches tend to be directive but this depends on perspective adopted and the practitioner’s character. In contrast, community work is generally non-directive and person-centred.

Interventions have different time periods and levels of intensity which are dependent on several factors such as setting where the work is located, problem presented, individuals involved and agency policy and practice. Several practice approaches have a time limited factor such as task-centred work, crisis intervention and some behavioural approaches and are often preferred by agencies for this reason. In addition, practice approaches that are designed to be used for a considerable time such as psychosocial are often geared towards more planned short-term, time limited and focused work (Fanger 1995).

Although negotiation should take place with service users to ensure their needs and expectations are taken into account, it is not common practice for practitioners to offer choice on whether they would prefer a directive or non-directive approach or the practice approach adopted (Lishman, 1994). However, this lack of choice is now being recognised and addressed with the involvement of service users and others in the decision-making process in relation to agency policy, practice and service delivery (Barton, 2002; Croft and Beresford, 2000).

The purpose and use of different interventions is contentious. Payne (1996: 43) argues that ‘the term intervention is oppressive as it indicates the moral and political authority of the social worker’. This concern is also shared by others with Langan and Lee (1989:83) describing the potentially ‘invasive’ nature of interventions and how they can be used to control others. Jones suggests that in relation to power differences and the attitude of social workers especially with regards to people living in poverty: ‘the working class poor have been generally antagonistic toward social work intervention and have rejected social work’s downward gaze and highly interventionist and moralistic approach to their poverty and associated difficulties’ (Jones, 2002a: 12). It is recognised that intervention can be oppressive, delivered with no clear purpose or in-depth experience however, some seek and find interventions that are empathic, caring and non-judgemental due to practitioners demonstrating ‘relevant experience and show appropriate knowledge’ (Lishman, 1994:14). For many practitioners, these attributes are essential in any intervention and are demonstrated through commitment, concern and respect for others which are qualities that are valued by service users (Cheetham et al. 1992; Wilson, 2000).

Dependent on the nature of help sought there are different opinions on whether interventions should be targeted on personal change or wider societal, environmental or political change. Some may want assistance in accessing a particular service or other forms of help and not embrace interventions that may take them in a particular direction i.e. social action (Payne et al. 2002). In contrast, problems may recur or become worse if no collective action is taken.

Importance has reduced in relation to methods of intervention over recent years as social work agencies have given more focus to assessment and immediate or short-term solutions (Howe, 1996; Lymbery 2001). This is strengthened by the reactive nature of service provision which is more concerned with practical results than with theories and principles. This has a reduced effect on workers knowledge of a range of methods resulting in workers using a preferred method which is not evidenced in their practice (Thompson, 2000). Methods of intervention should be the basis of ongoing intervention with service users, but often lacks structured planning and is reactive to crisis. This reactive response with emphasis on assessment frameworks is concerning, as workers are still managing high caseloads and if not supervised and supported appropriately, workers are at risk of stress and eventual burn-out (Jones, 2001; Charles and Butler, 2004).

Effective use of methods of intervention allows work to be planned, structured and prioritised depending on service users’ needs. Methods can be complicated as they are underpinned by a wide range of skills and influenced by the approach of the worker. Most methods tend to follow similar processes of application: assessment, planning of goals, implementation, termination, evaluation and review. Although the process of some methods is completed in three/four interactions others take longer. This difference shows how some methods place more or less importance on factors such as personality or society, which then informs the type of intervention required to resolve issues in the service user’s situation (Watson and West, 2006).

More than one method can be used in conjunction with another, depending on how comprehensive work with service users needs to be (Milner and O’Byrne, 1998). However, each method has different assessment and an implementation process which looks for different types of information about the service user’s situation for example, task centred looks for causes and solutions in the present situation and psychosocial explores past experiences. Additionally, the method of assessment may require that at least two assessments be undertaken: the first to explore the necessity of involvement and secondly, to negotiate the method of intervention with the service user.

An effective assessment framework that is flexible and has various options is beneficial but should not awkward or time consuming to either the worker or the service user. As Dalrymple and Burke (1995) suggest, a biography framework is an ideal way as it enables service users to locate present issues in the context of their life both past and present.

Workers should aim to practice in a way which is empowering and the process of information gathering should attempt to fit into the exchange model of assessment, irrespective of the method of intervention and should be the basis of a working relationship which moves towards partnership (Watson and West, 2006). As part of the engagement and assessment process, the worker needs to negotiate with the service user to understand the issue(s) that need to be addressed and method(s) employed and take into account not only the nature of the problem but also the urgency and potential consequences of not intervening (Doel and Marsh, 1992).

Importance should be placed on presenting and underlying issues early in the assessment process as it enables the worker to look at an assessment framework and approach that assists short or long-term methods of intervention. An inclusive and holistic assessment enables the service user to have a direct influence on the method of intervention selected and be at the heart of the process. The process of assessment must be shared with and understood by the service user for any method of intervention to be successful (Watson and West, 2006).

The worker’s approach also has an influence on method selection as this will affect how they perceive and adapt to specific situations. The implementation of methods is affected by both the values of the method and value base of the individual worker. The worker will also influence how the method is applied in practice through implementation, evaluation, perceived expertise and attitude to empowerment and partnership.

Methods such as task centred are seen to be empowering with ethnic minority and other oppressed groups as service users are seen to be able to define their own problems (Ahmad, 1990). However, when an approach is used which is worker or agency focused the service user may not be fully enabled to define the problem and results in informing but not engaging them in determining priorities.

Empowerment and partnership involves sharing and involving service users in method selection, application of the method, allocation of tasks, responsibilities, evaluation and review and is crucial in enabling facing challenges in their situations and lives. However, service users can have difficulty with this level of information-sharing and may prefer that the worker take the lead role rather than negotiating something different and not wish to acquire new skills to have full advantage of the partnership offered.

Selecting a method of intervention should not be a technical process of information gathering and a tick box process to achieve a desired outcome. Milner and O’Byrne (2002) suggest it requires combining various components such as analysis and understanding of the service user, worker and the mandate of the agency providing the service otherwise intervention could be is restrictive and limit available options. However, negotiation and the competing demands of all involved parties must be considered and the basis of anti-oppresive practice established.

Methods of intervention can be a complex and demanding activity especially in terms of time and energy and therefore, short-term term methods are seen as less intensive and demanding of the worker as well as more successful in practice. However, Watson and West (2006: 62) see this as ‘a misconception, as the popular more short-term methods often make extensive demands on the workers’ time and energy’.

Workers are often dealing with uncertainty as each service user have different capabilities, levels of confidence and support networks. Therefore, there is no one ideal method for any given situation but a range of methods that have both advantages and disadvantages and as Trethivick (2005: 1) suggests workers need to have ‘a toolkit to begin to understand people’ and need to widen the range of options available in order for them to respond flexibly and appropriately to each new situation (Parker and Bradley, 2003).

When using methods of intervention, workers have to be organised to ensure that the task is proactively carried out and often attempt to prioritise involvement with service users against both local and national contexts and provide an appropriate level of service within managerial constraints. This prioritisation means in practice that, given the extensive demands, work using methods can only be with four or five service users at any one time and with the additional pressure of monitoring and supervising service users and reports, risk response is often responsive and crisis driven (Watson and West, 2006).

To work in an empowering and anti-oppressive perspective is to ensure that intervention focuses clearly on the needs of the service user, is appropriate to the situation than the needs of the service. An understanding of these competing demands and the worker’s ability to influence decision-making processes does impact on method selection however, this should not mean that the service is diluted and methods be partially implemented as this is not conducive to managerial or professional agendas on good practice. Thompson (2000:43) sees this as ‘the set of common patterns, assumptions, values and norms that become established within an organisation over time’ and a concern of workers is competitive workplace cultures where ability is based on the number of cases managed rather than the quality that is provided to service users which may result in use of less time-consuming methods.

For work to be effective, an ethical and a professional not just a bureaucratic response to pressures faced is required and is not about the service user fitting into the worker or agency’s preferred way of working but looking at what is best for the service user and finding creative ways to make this happen.

Workers need to be careful not to seen as the ‘expert’ who will resolve the situation as even the most established and experienced practitioners have skills gaps and often develop skills when working with the service users. This process of learning in practice requires good support and supervision, enabling the worker to reflect on assumptions about service users and their capabilities especially in relation to gender, race, age or disability to prevent internalised bias to impact on what the service user requires to work on to change the situation (Watson and West, 2006).

It is crucial to appreciate the situation from the service user’s perspective and see them as unique individuals as Taylor and Devine (1993: 4) state ‘the client’s perception of the situation has to be the basis of effective social work’. This concern is also shared by Howe (1987:3) describing ‘the client’s perception is an integral part of the practice of social work’. Service users often have their own assumptions about what social work is and what workers are able to provide which is generally based on past relationships and experiences for example, black service users experience may reflect a service which in the past was not appropriate to their needs (Milner and Byrne, 1998: 23) but to alleviate this practitioners need to work in an open, honest and empowering manner and recognise that although service users may be in negative situations they also have strengths and skills that need to be utilised in the social work relationship.

Workers should ensure that written agreements are developed that acknowledge all participants roles and responsibilities and avoid assumptions or issues (Lishman, 1994), this avoids breakdown in trust and encourages honesty and open shared responsibility between service user and worker. This involves negotiation on what should be achieved, by whom, including agency input. Agreements can provide the potential for empowering practice that involves partnership. However, cognisance has to be taken to ensure that the agreement does not become a set of non-negotiated tasks that service users have no possibility of achieving, combined with no reciprocal commitment or obligations by the worker as this does not address the issue of empowerment or oppression and can reinforce the power difference (Rojek and Collins, 1988).

The final stage of the process is termination which should be planned and allow both parties time and opportunity to prepare for the future however, it has to be carefully and sensitively constructed and is much easier to achieve if the work has been methodical with clear goals as it demonstrates what has been achieved. Evaluation is beneficial as it enables the service user and worker to be reminded of timescales and can acknowledge the service user’s increasing skills, empowerment, confidence and self-esteem which can be utilised after the intervention has ended. Endings can however, be difficult for both the worker and service user resulting from various factors such as complexity of service user’s situation, issues of dependency and lack of clarity about purpose and intervention. This lack of clarity can result in a situation of uncertainty for both worker and service user (Watson and West, 2006). Finally, termination as part of the change process creates opportunities but also fear, anxiety and loss (Coulshed and Orme, 1998).

It is important for workers to take a step back and reflect on their practice and review their experiences to ensure that they are providing the best possible service in the most ethical and effective manner. Reflective practice provides support and enables workers to not just meet the needs of the organisation but also develop their own knowledge and skills and increased understanding of their own approach and the situation experienced by service users. A good tool to facilitate this is the use of reflective diaries. Reflecting in action and on action both influences and enhances current and future practice. The use of effective supervision is another process where workload management, forum for learning and problem-solving should take place which should be supportive and enabling to the worker (Kadushin and Harkness, 2002). However, the worker’s role in supervision is often viewed as passive as the supervisor sets the agenda. This can lead to disempowerment of the worker in relation to the agency and is potentially oppressive and discriminatory and provides a poor role model for work with service users and therefore consideration must be given on how they can create a positive and empowering relationship (Thompson, 2002).

In conclusion, good practice requires workers to have knowledge to understand the ‘person in situation,’ (Hollis, 1972) understanding both sociological (society and community) and psychological (personality and life span) and the interrelation and impact on the service user (Howe, 1987). A critical skill for effective and ethical practice is empowerment which is based on knowledge and values and is the difference between informing and genuine partnership and the importance of active participation of service users throughout the process.

Social work is a value based activity and workers through reflection and supervision can all learn from experiences, adapt and enhance these to develop practice and gain self-awareness to understand how they themselves and their approach impacts on service users.

Haiyang Li

There are many kinds of relationships in the world, for instance, parents and children, husband and wife, boyfriend and girlfriend, friends, neighbors and etc. Normally, people think the relationship between supporters and clients is the same as doctor and clients. However, there are a lot of differences. In this essay, I will demonstrate what a supporting relationship should be, identifying the key theoretical principles to establish a supporting relationship. In between, I will connect the theoretical principles with the case study, and demonstrate how the principles work in the real situation. To build a supporting relationship, the supporter needs to put his heart in the support work using all the helping skills and Personal-Certred Approach as a guide in the real work.

The relationship between supporter and client was seen as someone who can talk to. It looks very simple. However, the supporter is the one who can be trust, the one who can understand the problems or the situation the clients in, the one can accept the fact of clients hold, and the one can be allowed to provide help for the client. In order to become that kind supporter, the helper need to prepare relevant knowledge to understand the situation, history, strength and worries the client has. the relationship is about building a rapport and trust with the supporter. The client may feel comfortable enough to open up and address their problems. This kind of relationship is built on confidentiality and reliability.

In this case, ‘Spider’, he is a 19 years old boy.

The situation of him is that he is sleeping in the nearby park. He is lack of education but he learned from street knowing how to survive on the street but poor living conditions.

The history of him is that he has family abuse history and has been lived in foster homes for a few years and change foster home frequently in those years. He was not good at school study left school when he was 14. After he turned to 18, he lost government support and then he had to live in the street in the poor living condition and use street drugs for himself.

The strength of him is that he identifies himself as a resourceful, determined and smart street dweller. He wants to start a new way of life which is moving out from the street, finding a job, requiring more knowledge and having his own living place. He hopes that he can have his own family. He has very strong desire to move on for his life to start working forward to his dream.

The worries of him are homelessness, unemployment and reuse street drugs.

From case study, I think the Person-Centred Approach is suitable and helpful for us to understand and care for him. The Person-Centred Approach developed from the work of Dr. Carl Rogers. The research (Richard, 1992) indicates that the Person-Centred Approach theory aim to develop or create a relationship that can allow the clients to be themselves. The relationship can be felt safe for the client and give them space to develop and grow. To achieve this goal, the supporter would be a person who was deeply understanding which is empathic in the theory; accepting which is having unconditional positive regard and genuine which is congruent in the principle.

Using Person-Centred Approach theory, the supporter needs to understand what has happened to him. Firstly, when he was young, he was suffering from neglect and abuse in his family. The research (Smith & Segal, 2012) shows that Negligence, on the part of parents or caretakers, can cause children both physical and mental health problems. Parents or caretakers carelessness can be seen as a kind of physicalabuse. Children’s fear is also from unpredictable environment change and behavior of their guardians. The guardians successfully manage to plunge fear in the hearts of the children. As a result children who suffered from family physical abuse always pay attention on the negative emotions of their caretakers or parents. So, when these children grow up, the childhood experience has impacted on their personalities and behavior as well. Research (Soomro, Abbasi & Lalani, 2014) shows that they may encounter physical problems such as asthma, high blood pressure, ulcer, allergies, etc; psychological problems such as personal disorders and aggressive demeanor and behavior problems such as felony, drug habits and poor academic performance. In this case, ‘Spider’ shows his behavior problems which are not successful in school and drug problems. And street drug problem still drag him back to the street.

Secondly, he had been into the foster home but change frequent between foster homes. The foster care system seems another ideal choice for them; however, it is not always helpful when these young people need help. These adolescents have been impacted by the homeless issue and cause their social and health problem (Joanne & Patricia, 2006). Children who have been put in the foster care home experienced about the relationship attached between them and their caretakers or their foster home parents. This link is very important for children’s development. Research (American Psychiatric Association, 1994) indicated that Disruptions in attachment relationships can lead to Reactive Attachment Disorder of infancy or early Childhood. In this case, ‘Spider’ has experienced the frequently changes in foster care homes. This impact may shows on him when he grows up. He may have difficulty trust or related with somebody else such as our supporters. So this may be a barrier in establishing supporting relationships.

So from this case, as a supporter, I understand that the most problems of him have not controlled by himself. He has no choices that born from a family where abuse him when he was young. For rescuing him, he has been put into foster care. The child abuse experience makes his misbehavior in the foster home and school. He does not prepare enough for his independent life before he had been abandoned from foster care home. He has to live in the street in a rough condition so that he has the opportunity to connect with street drugs. I am also glad that he is still holding his hope on his future. He wants to be employed, educated and to have a living place. The internal motivation is the most important helper for him to reach his goal because an important part of this theory is that in a particular psychological environment, the fulfillment of personal potential is a desire to know and be known by other people (British Association for the Person Centred Approach, 2015).

After understanding about the client, the supporter needs to preparing himself with communication skills, action skills, mind skills and using unconditional positive regard to start a conversation with the client. Richard (2012) indicates that the Communication and action skills are what people do and how they do it rather than what and how they feel and think. The skills include listening skills, questioning skills and challenging skills. Supporter and clients can use verbal messages, vocal messages, body messages, touch messages and taking action messages to communication with each other.

In the Person-Centred Approach theory, supporter needs to use positively acceptant response to the client. Use warm and appropriate expression to send messages to build a different kind of relationships so the client may feel free to talk and express himself. Also, in genuine part, the supporter need to show client that client has been heard. It is important to show that the supporter is paying attention in the conversation they have. The supporter may use verbal messages to reflecting what the client said; may use face expression to let client know the support was thinking about what client said; or the supporter, may use taking action messages to make a note to show his listening. That is the main difference of the relationship with doctor, nurse or social worker. John and Julia (2011) research shows that these professional people tend to provide advices response rather than listening. They are looking for the solution rather than the process of helping people finding their own problems the helping relationship is focus on people. It is the way for people to rescue themselves.

I understand of mind skills is the process to know yourself and your own experience in order to use your own experience to help the client. in this case, we can share the same experience when ourselves in the difficult situation. Out experience may difference with his abuse, foster care, homelessness history but we have our difficult time such as hard to find a job and do not know what to do next in life. The important that we share how we concur the difficulty, what effort we made and never lose the hope.

To sum up, the support work is how you treat someone who needs help and how to provide help. The first to start a relationship, as the Person-Certred Approach suggested, understanding what the client is, such as who he is, what the situation he is in, what the problem he has and what worries he may have. Then before start a conversation, the supporter needs to provide a comfortable and safe environment for the client. One meaning of the environment is physical environment that may include the nice place to sit, comfortable and no interrupting noise. The other meaning of the environment is between supporter and the client. The supporter need to prepare an environment that the client can open his heart and willing to share his story. In order to do so, the supporter need to use the communication and action skills, use his voice, use positive unconditional regards, use acceptance attitude and use congruent skills to show that the supporter is ready and willing to accept the client. Also, the supporter needs to keep the confidentially of the conversation. So the client feels trustworthy and safe to talk to the supporter.

References

British Association for the Person Centred Approach, 2015. What is the Person-Centred Approach? Retrieved fromhttp://www.bapca.org.uk/about/what-is-it.html

Joanne, O.,& Patricia, L. (2006). Adolescent Homelessness, Nursing, and Public Health Policy. Policy, Politics, & Nursing Practice, 7(1), 73-77. doi: 10.1177/1527154406286663

John, M., & Julia, M. (2011). Counseling Skills a practical guide for counselors and helping professionals. (2nd ed.). New York, USA: Open University Press

Richard, N. (1992). Lifeskills Helping A text book of practical counseling and helping skills. (3nd ed.). NSW, Australia: Harcourt Brace & Company.

Richard, N. (2012). Basic counseling skills a helper’s manual. (3rd ed.). London, UK. Sage publications Ltd.

Smith, M., & Segal, J. (2012, July).Child Abuse and Neglect. Retrieved July 25, 2012, from Helpguide:http://www.helpguide.org/mental/child%5Fabuse%5Fphysical%5Femotional%5Fsexual%5Fneglect.htm

Soomro, S., Abbasi,Z. & Lalani, F. (2014). An Indepth Insight intoChildAbuseand itsImpacton Personality of Victims. International Research Journal of Art & Humanities. 10 (40), 53-68. Retrieved from http://eds.a.ebscohost.com.ezproxy.massey.ac.nz/eds/detail/detail?vid=2&sid=3dbcd49c-02aa-456b-9c1e-d379c403696f%40sessionmgr4002&hid=4208&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#db=hlh&AN=99236148

Describe the Setting and the Work it does

This report is commissioned by the Local Authority and is the result of a review a Phase One Children’s Centre who currently adopt and integrated model of working. The scope of the review was to identify benefits and limitations of an integrated approach. Furthermore, a brief exploration of the economic implications is provided and recommendations regarding future strategic structure and planning are detailed.

Terminology

A primary issue with multi-agency working is the inter-changeability and misuse of associated terminology (Morris, 2008; Walker, 2008). This report offers two distinct definitions of multi-agency working and clarifies the use of terms. The first definition describes multi-agency work as ‘a range of different services which have some overlapping or shared interests and objectives, brought together to work collaboratively towards some common purpose’ (Wigfield & Moss, 2001). The second definition contends that multi-agency work is about ‘Bringing various professionals together to understand a particular problem or experience…In this sense they afford different perspectives on issues at hand, just as one sees different facets of a crystal by turning it’ (Clark, 1993). These definitions share the ideology of different professionals from separate agencies working with a common goal and attempting to resolve an issue.

It is essential to note the differences between multi-agency and multi-disciplinary work. Multi-agency work refers to two or more professionals from different agencies working together, whereas multi-disciplinary refers to the collaboration between different professionals from one agency. For example, (Walker, 2008) suggests that the professional working relationship between a teacher, nursery nurse and teaching assistant within a school is multidisciplinary because although their roles are different, they work within the education agency. However, the relationship between a Teacher, Social Worker and General Practitioner would be multi-agency because it encompasses different agencies (Education, Social Services and Health).

(Wilson & Pirrie, 2000) make further distinctions between multi-agency and inter-agency and argue the choice of terminology is determined by three factors- numerical, territorial and epistemological. This relates to the quantity of professionals involved, locations, and the amount of innovation in developing new ways of working which considers the philosophical foundations of each professional identity(Wilson & Pirrie, 2000). Inter-agency may involve two professionals from different agencies whereas multi-agency involves a minimum of three (Wilson & Pirrie, 2000). Furthermore, true multi-agency working requires professionals to enter each other’s professional environment, both physically and culturally, and establishing or re-establishing a novel and universal awareness and understanding (Coad, 2008; Walker, 2008; Wilson & Pirrie, 2000).

For the purpose of this report, the term multi-agency shall be adopted throughout and shall refer to two or more professionals from different agencies working collaboratively to address the needs of children and young people.

Rationale

The emphasis for multi-agency teamwork initiated following the death of Maria Colwell in 1973 (Walker, 2008) which resulted in significant changes to the structure of child services. However, the deaths of children with whom various agencies were involved continued. Such deaths include Jasmine Beckford (1984), Tyra Henry (1984), Heidi Koseda (1984) Kimberley Carlile (1986), Doreen Mason (1987), Leanne White (1992), Rikki Neave (1994), Chelsea Brown (1999), Victoria Climbie (2000), Lauren Wright (2000) and Ainlee Labonte (2002). Despite enquiries into these deaths only a minority led to negligible changes in policy or guidance and only one led to a radical change in children services (Walker,2008). (Laming) (2003) highlighted significant failings on the part of agencies to work collaboratively to ensure the well-being of children and young people. Laming’s (2003) recommendations were broadly adopted into the Every Child Matters agenda (DfES, 2003) which (Walker, 2008) suggests the government were already considering implementing which suggests the it was implemented because it mirrored the ideological perspective of the government. However, van Eyk and Baum (2002) suggest that inquests have provided h3 evidence that agencies should be working together in a collaborative manner to safeguard children and therefore it is unsurprising that the government have adopted this ideological stance.

Laming (2003) supports this by indicating the inseparability of the protection of children and wider support to families which has been widely accepted (Morris, 2008) and therefore the need for Local Authorities to have agencies working collaboratively is essential (Coad, 2008; Walker, 2008). Despite the development of legislation and policies, the death of Baby Peter in August 2007 was attributed to the failure of Social Workers and other professionals who had seen him approximately sixty times.

In November 2008 Lord Laming was commission by the government to conduct independent report on the progress being made by Local Authorities to work collaboratively to protect children. Key findings from Laming (2009) included:

Social Workers are under-pressure deliver but inadequate training.
The Day-to-day running of protection cases has significant problems.
Managers are failing to lead by example with an over-emphasis on targets and process.
The lack of a centralised Information Technology system is hampering progress.
Administration is too complex and lengthy with a tick-box recording system.
There is a lack of communication and joined-up working.
Data protection laws are not clear nor understood resulting in information not being shared.
There is a lack of funding in Social and Child Protection work.
There has been a reduction in Child Protection Police Officers.

Laming (2009) made the following recommendations:

Directors of Children’s Services with no experience with child protection issues should appoint an experienced social work manger.
All Local Authority Leads and Senior Managers should have child protection training.
Social Work students should get more child protection training.
Employers should face prosecution for failing to protect.
Court fees for Care Proceedings should be reviewed (currently ?4000 per case)
OFSTED inspectors must have experience of child protection
Explicit targets should be developed for all frontline services
A national agency should be developed to ensure the implementation of these recommendations.
Legislation

Under Section 17 of the Children Act 1989 the Local Authority has a duty to safeguard and promoted the welfare of children within their area and are in need. Section 22(3) extends this to include children within care. As the local authority is constructed of many agencies there is an implicit requirement for agencies to work collaboratively. This is stipulated within Section 10 of the (Children Act, 2004) Children which is a development of Section 27 of the Children Act 1989. This places a duty on agencies to pro-actively work with each other to support children and their families.

However, there also conflicting social policies and legislation which may act to limit the effectiveness of multi-agency working. An example may be a single-mother under the care of Social Services because she is over-crowded in her house. The assessment indicates this is the primary factor from concern and recommends better accommodation from the Housing Department. The Governments Every Child Matters vision demands that all children be placed at the centre of social action. However, other laws conflict this. Housing law does not need to consider the Children Act 1989 or 2004, nor does it force Local Authorities to consider the allocation of accommodation on a child-centred basis, but on the basis of ‘reasonable preference’ (Shelter, 2005, p.www). This leaves the potential for one law to stigmatise with the other to maintain stigmatisation and conflict between agencies arising.

Current Model of Inter-Agency Working

Integrated Service Model

The Integrated Service Model unites various agencies into one hub who deliver a range of services and integrated support children and families within a community. The team share a location, vision, agreed principles and philosophies in developing localised plans to improve outcomes for service-users. This is usually delivered from an early years setting such as a Children’s Centre. The facilities and services of the integrated team are funded by all agencies and out-sourcing funding from voluntary, community and government agencies is also available. Such services may include access to childcare, education, and counselling as well as advice on health, employment and benefits. Furthermore, practitioners actively and collaboratively engage in outreaching activities to identify and target ‘in need’ families.

Parents and children are given the opportunity to learn new skills, discuss their issues (formally and informally), and engage in communal activities. As services are localised it recognises each community is different and has unique needs. Therefore, activities will differ from hub to hub. Furthermore, there is a greater emphasis on co-working and co-training with skills between agencies being shared at a deeper level resulting in better practice and information sharing.

However, the benefits of this model can be limited by local factors such as poor management or failing to identify local needs. Furthermore, getting all agencies involved requires an initial financial and personnel investment along with a clear and agreed strategy on how to merge services. Managing the differences in pay between practitioners and the power each agency holds needs to be considered at a macro-level to ensure fairness and consistency. A failure in this may result in practitioners feeling devalued or threatened. Atkinson et al’s (2001) study found this model is most effective when there is a case lead/manager responsible for co-ordinating services for families which ensures services are aimed at the service-user rather than the organisation or professional.

A review into outcomes for families with disabled children indicates that a key worker integrated model promotes better outcomes (Liabo et al,2001). Although Liabo et al (2001) acknowledge a lack of large scale and robust studies, an integration of the current evidence indicates families enjoy a better quality of life, lower levels of stress and quicker access to services. However, from a critical perspective a systematic review is required to minimise any bias. Although Watson et al (2000,2002) concur, they argue these are opinions rather than fact and call for localised research aimed at measuring outcomes to enable a synthesis of results.

Alternative Models of Multi-agency Working

Multi-agency Team

The multi-agency team model is considerably more formal than the Multi-agency panel model currently employed. Practitioners are recruited as part of a singular team who share a common goal and a sense of team identity and are line managed by a team leader. However, links are maintained with home agencies through supervision and training.

This team would share a base, although some practitioners would be required to work in two settings. Such an example might include a School Attendance Officer who would be based within the Local Service Team and at the school which can lead to confusion between job roles. As collaborative working is at the foundation of the approach there is inevitably a sharing of skills and knowledge with communication being uncomplicated.

However, recruitment of staff is time-consuming and identification of people not only with the appropriate skills, but also to work collaboratively may be problematic. Also, as this will be new to the Local Authority, time and funding would need to be allocated for team building and development. There is also a reliance on agencies sharing a good relationship and be willing to partake in meetings, conferences and strategy meetings in addition to service-user discussions.

Measuring the Impact of Integrated Working

The above has highlighted the implications for failing to work in an integrated manner and there is an assumption that effective integrated working actively contributes to the positive outcomes of Every Child Matters. Therefore this section focuses on studies and literature aimed at measuring the efficacy of integrated working.

Cameron and Lart’s (2003) systematic review reaffirms the findings of Cameron et al (2000) that there is little evidence to confirm the benefits for service users of integrated working. Cameron and Lart (2003) are critical of the lack of evaluations aimed at measuring the effectiveness of multi-agency working and highlight the few that have are methodologically poor. Similarly, few studies have provided information regarding the effectiveness of different models. For example, Atkinson et al (2002) interviewed professionals to assess benefits of multi-agency working to service users. They identified quicker access to services leading to quicker diagnosis and treatment. Furthermore, they identified that professionals from different agencies communicated more effectively. However, this study collected the subjective views of professionals and failed to obtain the representative view of the service user.

Webb and Vuillamy’s (2001) study indicated a reduction in the exclusion of high risk pupils through the introduction of specialist support workers responsible for avoiding inter-agency disputes regarding responsibilities and resources. Webb and Vuillamy (2001) claim the support workers differentiated between school-focused agencies (such as educational social workers, educational psychologists and teachers) and external-agencies (such as Social Workers, Police and General Practitioners). This study reported a 25% reduction in exclusions. Webb and Vuillamy (2001) claim this has far-reaching consequences such as a reduction in crime, better educational and vocational attainment, however, this is broad assumptions based on the statistical link between exclusion and crime and is not proven within the study.

Challis et al (2004) conducted a Randomised Control Trial (RCT) of 256 older people at risk of care home entry. The objective of the RCT was to redesign the decision-making process by assessing the value of obtaining a specialist clinician assessment prior to placing individuals into care homes. Participants were randomly allocated into two groups, the first received the standardised assessment process and second (experimental group) received a clinical assessment from a geriatrician or psychiatrist. The collaboration between the clinician and social worker was at the heart of this RCT. The experimental group continued to experience reduced deterioration mental and physical, had minimal contact with emergency services and carers reported lower levels of stress. Furthermore, NHS costs were lower and social services and the NHS benefited from merging skills, developing communication; and improved outcomes for users and carers.

Despite the findings from these studies, the majority of studies focus on process rather than outcome, for example a Systematic Review by Cameron and Lart (2003) indicate factors which promote and hinder integrated working. This is supported by the Integrated Care Network (ICN) (2004) who contends that even when outcomes are considered this is narrowly focused and are difficult to measure in the short-term without evidence from a cohort study. The ICN (2004) believes emphasis needs to shift from structure and input to outcomes.

Benefits of Multi-agency Working

Inter-agency working is reported to improved the knowledge, skills and expertise of professionals (Sammons et al,2003) due to the increased opportunity for professionals development through working with other agencies (Atkinson et al, 2001,2002). This is supported by Townsley et al (2004) who indicate that the process of multi-agency working is having an effect on positive outcomes for families with disabled children. However, this incorporates the views of professionals rather than service users suggesting a subjective and biased view. The study by Atkinson et al (2002) also considers the views of professionals who suggested service users benefited from quicker access to services leading to quicker diagnosis and treatment. Furthermore, they identified that professionals from different agencies communicated more effectively.

Challis et al (2004) conducted a Randomised Control Trial (RCT) of 256 older people at risk of care home entry. The objective of the RCT was to redesign the decision-making process by assessing the value of obtaining a specialist clinician assessment prior to placing individuals into care homes. Participants were randomly allocated into two groups, the first received the standardised assessment process and second (experimental group) received a clinical assessment from a geriatrician or psychiatrist. The collaboration between the clinician and social worker was at the heart of this RCT. The experimental group continued to experience reduced deterioration mental and physical, had minimal contact with emergency services and carers reported lower levels of stress. Furthermore, NHS costs were lower and social services and the NHS benefited from merging skills, developing communication; and improved outcomes for users and carers.

Webb and Vuillamy’s (2001) study indicated a reduction in the exclusion of high risk pupils through the introduction of specialist support workers responsible for avoiding inter-agency disputes regarding responsibilities and resources. Webb and Vuillamy (2001) claim the support workers differentiated between school-focused agencies (such as educational social workers, educational psychologists and teachers) and external-agencies (such as Social Workers, Police and General Practitioners). This study reported a 25% reduction in exclusions. Webb and Vuillamy (2001) claim this has far-reaching consequences such as a reduction in crime, better educational and vocational attainment, however, this is broad assumptions based on the statistical link between exclusion and crime and is not proven within the study.

Counter-Evidence

Despite the findings from these studies, the majority of studies focus on process rather than outcome, for example a Systematic Review by Cameron and Lart (2003) indicate factors which promote and hinder integrated working. This is supported by the Integrated Care Network (ICN) (2004) who contends that even when outcomes are considered this is narrowly focused and are difficult to measure in the short-term without evidence from a cohort study. The ICN (2004) believes emphasis needs to shift from structure and input to outcomes.

Cameron and Lart’s (2003) systematic review reaffirms the findings of Cameron et al (2000) that there is little evidence to confirm the benefits for service users of integrated working. Cameron and Lart (2003) are critical of the lack of evaluations aimed at measuring the effectiveness of multi-agency working and highlight the few that have are methodologically poor. Similarly, few studies have provided information regarding the effectiveness of different models.

Facilitators to Multi-agency Working

Evidence on Removing Barriers

Barriers to Effective Multi-agency Work

There are apparent dangers to encouraging inter-agency and multi-agency working. As (Walker, 2008) stipulates, different professions are likely to have unique values at their foundation which they may want to protect. To provide an example of different values, cultures and practices consider a social worker partaking in an interview with a police officer. The child who they are interviewing breaks down. The role of the social worker is to consider the well-being of the child (from a child-centred perspective), however, for the police officer it is to provide evidence to consider prosecution. Obvious barriers, conflicts and confusion can arise. (Coad, 2008) offers support to (Walker, 2008) and suggests the primary trigger for such issues is the lack of clarity of roles and authority in decision making. The lack of clarity regarding roles may lead to work duplication or providing advice which conflicts with that of another professional. However, this can be overcome through effective communication between agencies and practitioners (Walker, 2008) and transparency regarding decision making processes (Coad, 2008).

In addition, each agency will have its own language, terminology, budgets, targets, assessments and measurement criteria to which other professions may not fully understand.

Overcoming the barriers presented is dynamic and complex. As expectations of politicians, academics and service users change so do the barriers which are presented. Therefore, in order to overcome such barriers a model of integrated thinking should be adopted with the development and deployment of a Children’s and Young Persons Strategy. This should be developed through the conduction of research to include all agencies, academic institutions training professionals, and the views of service users. This should be reviewed on a bi-annual basis to ensure it remains contemporary.

Recommendations

Conclusion

Seeking funding utilises large amounts of managerial time and resources.

The aim of this assignment is to focus on equal opportunities and the laws set up to protect people from discrimination on the basis of their gender, race, age and disability by providing a framework for the most vulnerable groups in society who, without legislation may feel their rights have been infringed. Prejudice and stereotyping is something we are all guilty of. From our own life experiences, beliefs and values we make assumptions about people from the way they look, speak and behave towards us. It is especially important in health care to be sensitive to the service user’s requirements. Negative language and labelling can make the service user feel unworthy, intimidated and deterred from accessing the very services they require. All care providers need to ensure that they view their patients as unique individuals, promoting their individual rights and supporting them in making decisions. Language is key, if the service user cannot communicate then an advocate or interpreter is required so they do not feel discriminated against. The use of positive language can be beneficial to the service user in empowering them to make choices and have greater control over the treatment they receive.

Society has changed considerably in the last 40 years and we have become much more multi-cultural. Our attitudes and beliefs have had to change too e.g. more women in the workplace etc… The Government has introduced equality legislation to protect vulnerable groups that may otherwise have no voice. By introducing acts that protect these groups from discrimination e.g. the disabled, mentally ill and other minority groups it ensures there is a set of legal guidelines in the way people are treated and that they have equal access to the same services and rights as everyone else.

Most caring roles are governed by legislation. Older people, people with a learning disability, physical disabilities or mental health problems have service provisions, rights and other requirements laid down by the law but no overall framework for protection of abuse, except for that of children.

This part of the assignment looks at The Mental Health Act, why it was conceived, who it aims to help and its limitations in practice. The basis of the act can be traced back to 1601 when The Poor Law was created but it has come a long way since then. In 1983 The Mental Health Act was put in place to protect those suffering from a disorder or disability of the mind. In previous times those with mental health issues may have found themselves locked away from society, with no proper treatment and no guidelines on how they should be treated. It wasn’t unusual for young unmarried mothers to find themselves institutionalised as society found them to be deviant and morally deficient. It wasn’t until the 1959 Mental Health Act reform that it was considered wrong to punish these women, however many had already been locked away and the damage done.

The 1980’s saw large-scale closures of psychiatric institutions in favour of the Governments care in the community policy, large numbers of long term patients were discharged into the community. By promoting the “least restrictive alternative” many were given freedom, the Reed Report stated “care arrangements for people with mental health problems should have proper regard to the quality of care and the needs of individuals; as far as possible, in the community, rather than in institutional settings; under conditions of no greater security than is justified by the degree of danger; so as to maximise rehabilitation and the chances of sustaining an independent life; as close as possible to their own homes and families.” (Mind.co.uk,2010)

The 1983 Mental Health Act focuses on the assessment and treatment of people with mental health issues. The legislation has several sections. Each section provides guidance on dealing with specific situations that may arrive when a person has significant mental health problems. The following are some of the sections of the Act that must be adhered to;

Section 1 gives definitions of mental disorder

Section 2 describes the situations in which people can be admitted to hospital compulsorily, providing specific timeframes in which assessment must be undertaken

Section 3 describes the provisions for admission for treatment, again there are specific guidelines regarding timescales

Section 4 is regarding emergency admissions

Section 5 is about detention of a voluntary patient for a period of assessment

There are sections which deal with taking people to a place of safety and also sections relating to admissions linked to criminal behaviour. Val Michie et al,2008,(p230-231)

Sectioning a person (detaining them against their will) is part of the act that needs to be done correctly as you are denying the person their right of freedom. This can only be done if the person shows significant harm to themselves or others.

The Mental Capacity Act 2005 provides a framework to empower and protect people who are unable to make decisions themselves. By the use of advocates and health professionals any decisions they make can be supported. It enables those with mental health issues to plan ahead of time in the event that they lose mental capacity and so their wishes can be considered.

The Mental Health Bill aims to bring together and simplify the Mental Health Act 1983 and the Mental Capacity Act 2005 by making it easier to understand the rules on detention and definitions of mental disorders. Supervised community support can be put in place using a variety of health professionals to ensure access to treatment. The Bill introduces safeguards to stop people being locked away for long periods of time without being reviewed at regular intervals and denying them the right to their liberty.

The Act however does have its limitations; lack of resources, funding, low staffing levels and poor communications between agencies, vulnerable people may escape the system and cause danger to themselves and others. There have been many high profile cases of mentally ill patients slipping through the net, being released from hospital too early and not receiving the support they need.

In August 2007 Vivian Gamor was detained indefinitely under the Mental Health Act 1983 after admitting to two counts of manslaughter at the Old Bailey. Vivian had been showing increasing signs of mental illness three years prior to this, her condition deteriorated to the point where she attacked her half-sister with a knife. This led to her being sectioned under the Mental Health Act and detained in hospital where she was diagnosed as suffering from schizophrenia. Doctors felt they could control her symptoms with drugs and 28 days later she was released. Her two children had been living with their father who was unaware of the reasons for Vivian’s sectioning. The children were killed on the third unsupervised visit to their mother. Antoine, 10, was beaten around the head with a hammer and then strangled while Kenniece, 3, was suffocated with cling film and her corpse stuffed into a black bin bag.

Lord laming who chaired the public inquiry into the death of Victoria Climbie said “It seems to me that had the whole range of services been directed to supporting that mother and thinking and bringing to bear all their different resources it may have been possible to prevent that mother doing what I don’t imagine she ever intended to do and the children paid the ultimate price for the failure of organisations to actually carry out their duty.” (BBC News, 2008)

A serious case review by the City and Hackney Local Safeguarding Children’s Board was launched with its results finding a lack of communication between agencies involved in the case. Guidelines under the Children’s Act obviously failed to provide the children safety and protection. Vivian had stopped taking her medication for up 10 days before the murders and was failed by the Mental Health Act as she posed a danger to herself and others. The children’s father was not married to Vivian, the law stated he had no parental rights at that time and could not stop her from having access to the children.

Alan Wood, director of children’s services at Hackney Council, said: “This case highlights how unpredictable mental illness can be, and the dreadful impact it can have on families. It also shows how child protection services and mental health services need to work ever more closely to successfully protect children in the future. (Communitycare.co.uk, 2008)

There have been many studies into murder associated with mental health. One published in the British Journal of Psychiatry2008 called “homicide due to mental disorder in England and Wales over 50- years”, which looked at murders from 1946-2004. The researchers found that the number of murders committed by people with mental health problems had risen until the 1970’s. Since then murder in the general population continued to grow, while those associated with mental health fell to very low levels. The researchers felt that the fall was due to better treatment and understanding within mental health. (The British Journal of Psychiatry, 2008)

With the introduction of the Mental Health Act 1983, figures have shown that the legislation on the whole is successful, providing more support and treatment for sufferers of mental illness. It is those cases where the system has failed that are sensationalised, creating a negative image that people with mental illness are dangerous and pose a threat to the rest of society when this has shown not to be the case.

The final part of the assignment shows how discrimination upon the individual in health care can greatly affect the way they feel about themselves and the treatment they receive. Prejudice is to prejudge, to already have an opinion or bias about a particular group of people. It is easy to assume and discriminate when an overweight person has type 2 diabetes that they have bought it on themselves, to label them as lazy and that they do not care about their own health needs. If the service user feels they are being treated this way then they can internalise those feelings and become depressed or angry. This can then lead to them feeling they are not worthy and unable to ask for or receive the help that they require. The service user is then marginalised, feeling that no-one cares leaving them isolated and vulnerable, their self-esteem suffers and the cycle of disadvantage sets in making them feel trapped in their own hopelessness, dealing with not only their medical problems but emotional ones too.

Word Count: 1444

References.

Michie,V.Baker,L.Boys,D. and McAleavy,J.,2008.BTEC National Health & Social Care. Book 2: Cheltenham:Nelson Thornes Ltd.

BBC News.co.uk, 2008.My two children should be alive. [Online] Available at: [Accessed 19.11.2010]

Community Care.Co.UK, 2008. Hackney criticised in Vivian Gamor serious case review. [Online] Available at:[Accessed 24.11.2010]

Mind.co.uk,2010. Dangerousness and mental health: the facts. [Online] Available at:[Accessed 19.11.2010]

The British Journal of Psychiatry, 2008. Homicide due to mental disorder in England and Wales over 50 years. [Online] Available at:[Accessed 24.11.2010]

Companies around the world are currently going through a period of transforming and changing. Some are expending their business globally and there are some who wonder how the changing will effect or give an impact on their organization. As we know, men and women are entering the labor force in equal numbers but the majority of top mangement positions is still belong to men. The failure of more women to break the upper levels of corporate management is due to the glass ceiling. In economics, the term glass ceiling refers to situations where the advancement of a qualified person within the hierarchy of an organization is stopped at a lower level because of some form of discrimination, most commonly sexism or racism. However, since the term was coined, “glass ceiling” has also come to describe the limited advancement of the deaf, gays and lesbians, blind, disabled, and aged based on the defination in Wikipedia.

There are many types of glass ceiling such as religious discrimination, different pay for comparable work, sexual, races, ethnics and even harrasment in the workplace. Other than that, exclusion from informal networks like preconceptions and stereotyping of women’s role and abilities is also one of them. Another types of glass ceiling are lack of family-friendly workplace policies and policies that discriminate against gay people, non-parents, or single parents.

There are many reasons that causes the glass ceiling. One of the reason is job segregation. Job segregation is the concentration of women and men in different types and levels of activity and employment. Normally, men tend to be highly concentrated in the upper levels of professions such as managers, supervisor, production supervisors and also executives. Women on the other hand, tend to be in the status of lower level and lower paid professions such as teachers, secretaries, receptionists and nurses. Women also measure success in the workplace differently than men because women place a higher value on their positive interpersonal relationships and feelings whereas men tend to measure success by high salaries, promotional opportunities and job titles.

There is also opinion that saying glass ceiling is voluntarily choose by some women. For example, men tend to work harder in order to get good pay and women tend to choose to work less hours or may not want to extend their work duration in order to organized their children and spend more quality time with their families. There are some organizations that provide their employees with family-friendly programs that offer options such as flex-time which employees can choose their own work hours, employee-assistance programs and child care nursery which allows their workers to have a better chance of balancing their work lives and home. Unfortunately, women may feel reluctant to take advantage of these programs as they feel it may lessen than chance for being success within the company.

Besides, part of the reason lies in leadership stereotypes. It is still a strong view that women are viewed by many others as weak and soft whereas good male leaders are mostly known as tough and powerful. More or less, this appears to affect career choices as the organization may have a perception that women is weak and not qualified for the positions especially the top management positions.

Women and men also differ in their career gaps. Men are not influence to take a leave of absence. For example, when one of their children is sick, women is most likely to have to take the leave because men seldom do that. Men also refuse to work on a part-time job in order to get additional or side income when compared to women. It is maybe because they are shy that people would know when they have two jobs as mentioned earlier that men tend to measure success by high salaries and job titles.

Other than that, most of the employers have the believe that women may quit the job when they want to begin a family and get married. Therefore, the organizations are less likely to invest in woman’s career by appointing them as the top management position. In order to let the organization hire a woman as one of upper levels of corporate management, they must show the dedication and willingness to take on new challenges and risks and be vocal about their personal ambitions.

SUMMARY AND DISCUSSION

Today, women represent more than 40 per cent of the global workforce as they have achieved higher levels of education than ever before. Unfortunately, their share of upper management positions remains unacceptably low, with just a little tiny ratio succeed in breaking through the glass ceiling.

According to the journal, the main topic that been highlight is about the impact and how gender diversity influence the career development of women being a director or one of the top position in the organization. There are three key areas that focus on women directors which are theoretical perspectives, characteristics and impact. Theoretical perspectives comprise of individual, board and firm. Individual consist of human capital, status characteristics and gender self-schema while board consist of social identity, social network and social cohesion, gendered trust, ingratiation and leadership. Firm level includes in resource dependency, institutional and agency theories.

Characteristic review in four levels which are individual, board, firm and also industry and environment such as demographics, social capital, role, size, commitment, shareholder distribution, performance and economic environment. Impact also focus on the same level such as role models, governance performance, decision making, glass cliff effect, talent and also recruitment and retention.

Glass ceiling exist because of few factors such as occupational sex discrimination, childcare responsibilities, stereotypes and gender discrimination. The perception of women can also lead to a problem because there are some belief that women are unqualified and they might have their own agenda. Organizations are very much concerned about hiring, retaining and promoting women to higher level but few are making the necassary changes to make a difference. Women hold less powerful corporate titles, fewer multiple directorships and earn considerably less than men. Men are more likely to have the collective trust whereas women believe in collective trust as well as relationship trust.

The impact of women as a top management postition dwell in different level. In areas where they are very much represented in the pool from which leadership is drawn, women still do not move into leadership positions in equal ratios. The reason is women typically hold up on too much share of the burden in balancing their job and family.

Sadly there are so much barriers that prevent women to become one of the top position in an organization. One of the barrier is the environment in a workplace. Organizational cultures, employees’ attitude, racial stereotype commonly limit women from completely participating in the organizations. Working parents, especially mothers, usually have to deal with family obligation which they often have to choose between their job and family. They actually require flexibility at work. Women often lack the “right” type of job experience to move foward. The experiences they have normally do not suit the promotion criteria.

Equal but different? As mentioned earlier, men and women are entering this labour force in equal numbers but why is that women is being treated as minority group and a weak person? In this paper, i have attempted to contribute to glass ceiling by exploring how glass ceiling affect the women in achieving their dreams. Women often to have less power or right to control, judge, or prohibit the actions of others than men in the organization. They face different challenges and most likely they should have a required skills to be successful in the organization compared to their male counterparts. This is due to glass ceiling that appear to have in every organizations directly or indirectly. Men and women are seen differently because men want to see and analyse if women have the capabilities and the qualification that fit to be in the upper level management.

The inflexibility of our culture builds an organizational resistance against the values that women and people with disabilities bring to the workplace. Women need to be guide and support through the challenge. The organization should revamped the assessment in order to exclude gender discrimination and conduct an exit interviews in order to determine the reason why women leave positions. Mostly, women will have less salary compared to men because the employers sometimes view women as they are not devoted to their work. In organizations, the progress of women and disable people appears to be affected by more than career choices and qualifications.

Today there are some organizations that appraise, measure and do changes to their organization’s policies and procedures in order to attract talented women to work in a diversifying work force. Doesn’t mean that when there are still difficulties in the working environment, women should stop trying to achieve their dreams. They should always think positive that one day women will no longer treated as a minority and a weak person instead they are being treated equally as men. It is important for them to strive and go for what they dream of because they might be able to break the glass ceiling.

SUGGESTION / RECOMMENDATION

Recently there have been many changes that organizations are trying to intergrate so that more women can be a part of the top management position and achieve their dream. Some of the examples are work from home, flexible timing and so on. There are few recommendations that i would like to suggest that may helps in changing the perception and mind-set of certain people towards glass ceiling. The recommendations are:

Women will have equal access to jobs if the government enforce the anti-discrimination legislation at the workplace.

Provide various training that emphasize on the workplace equality, values and their importance and the consequences of gender discrimination.

Part-time workers must have the same entitlements and benefits as full-time workers and make sure all employees’ conditions and benefits are equally distribute.

Providing education and enough informations about sexual harassment and directly implement no-sexual harrasment policies to create a note of respect in the workplace.

Creating a forums for women so that whenever they have issues affecting them in the workplace or jobs, they can always discuss it there.

Develope a programmes to help employers acknowledge the capabilities and the benefits that women can bring to their businesses.

Evaluation must not be rated based on employees gender, but it must be evaluated by their performance.

Implement a family-friendly policies that will help supporting women at work which include the flexible working hours, child care nursery and other facilities, parental leave for women and men and many more.

Organizational leaders should learn on how to enhance or upgrade the developmental and advancement opportunities for women and take responsibility for removing barriers.

CONCLUSION

In a nutshell, it seems that glass ceiling are still exsist in an organization and women have made a great tread in smashing on the glass ceiling but have not quite broken through it yet. In order to compete on a same level with men, having an access to line experience and management training it very important. Other than that, women must also have a good and effective communication skills that can give the opportunities for better interaction with others. Women also must have the ability to cope effectively and positively under pressure and willing to face of challenges, criticism and setbacks.

It is easy to jump to the conclusion that successful elimination of glass ceiling requires not just an effective enforcement strategy but also the involvement of employers, employees and others in identifying and reducing attitudinal and other forms of organizational barriers encountered by women in advancing to higher level management position in different workplace setting. Organization also need to embrace the concept of diversity and redefine leadership model in organizations so that this will let women bring value to and integrate into leadership structures.

Equality diversity and rights

I have done my presentation on equality diversity and rights I have chosen to do my presentation on a care home setting. I will be looking at the different aspects of care that is available at the care home and the possible barriers of care that may or may not be over come. I will also be looking at acts that are in place to protect the service user against abuse. I will also look closely at the safety measures they have in place to care for the service user and make sure that the service user is happy and is being cared for according to the care value base.

There are 3 ways that people can refer to care these are:

self referral – when the patient itself brings their self’s forward for care
third party referrals – this is when friends or family one someone else brings the patient forward to care as they may this he or she may be incapable of looking after their selves. There will be an assessment of the patient to see whether they are in need of help with the care of their selves. If they don’t want to go into care then things to consider will be their human rights (1998) and also other peoples human rights, so they have to either be a danger to their selves or the public (PUBLIC SAFETY ACT, 2002)
Professional referral- when a doctor or someone who is an expert in the line of work refers patients in to care for a variety of reasons, i.e. Dementia. Practice should be regulated by the ethics in patient referrals act of 1989.

Effective communication – this is important in making sure the service user is happy also taking in to account their opinions and letting them express their selves by verbal and non verbal communication, also to make sure that someone is there to listen to the service users issues. There might be some service users who might not feel comfortable talking so maybe there could suggestion boxes around the care home and also meeting with the service users every few weeks to see whether they are satisfied and to see if they have any thoughts about how to improve the care home, There could also be activities going on such as bingo and trips and events out for the service users. This would keep them occupied and meet their social needs; and also have a chance to communicate with the carers. There could also be a notice board with notices that allow news and up coming events to be known to the residences that may not be in a sociable mood that week this allows them to get involved in the activities that are going on, this stops them from being socially excluded.

Diversity (race, belief) and also equality –

Rights to individuality- everyone should have the right to express themselves in the way that they want to. Everyone should have the right to express their selves at the care home by maybe doing different activities that could take place each day such as bingo or arts and crafts this would give the service user the freedom to choose what they wanted to do .I think decision making should be left to the service user this should be down to what they eat what they ware their independence should be maintained unless it is no other way services user should also have the right to practice their religion without prejudice

Effects of discrimination (this can be a bad opinion or feeling formed in advance without any real reason thought, in the care home by a carer and it that can lead to unfair discrimination of a person making a difference in which way a person is treated) which can lead to abuse towards the client (This may affect the client badly by them being socially excluded from the group as they feel low on their self-esteem. This will just lead to oppression of the client.

Acts that protect the service user

Legalisation comes about by media, pressure groups and MP’s bringing up an idea like equality in care homes. Then people recognize that this becomes an issue of equal opportunity. The assembly discusses this and then the government research and write a report on this matter. Then the civil services make a suggestion such as: passing an act to protect people who are of different ethnicities. The government produces a green paper, which people have access to, they debate about the matter, the civil services passes on findings of the debate to the government who then produce a white paper which then creates further debates about the matter, the house of parliament debates proposals the proposals get the royal asset which then finally leads to legalisation of the matter.

The sources of equality in law are the British courts, British parliaments European Union and the European courts. The British court passes case law and the British parliament passes acts of parliament. The European Union passes directives ad regulations and the European courts passes case laws. These are all then become into one equality law. These laws are the put into care settings by charters organisational policies and codes of practice

There are 3 different European laws affecting individuals these are:

Regulations – this is the strongest law out of the three and must be carried out by all the members of the state straight away.

Directives – applied by members of the state to make their laws related to all the other members of the state. There are laws such as the race relations act 1976; this was amended in the year 2003 this protects the clients against unjust treatments due to their racial ethnicity. The act defines discrimination as “less favourable treatment according to racial ground” .This plans to promote racial individuality as a positive thing.

Section 3 on the 2006 act summarises:

people’s ability to achieve their potential is not stopped by prejudice or discrimination;
there is respect for and protection of each individual’s human rights;
there is respect for the dignity and worth of every individual;
every individual has an equal opportunity to participate in society; and
There is mutual respect between groups based on understanding and valuing diversity and on shared respect for equality and human rights.

There are also bodies such as the;Equality and Human Rights Commission who was established under the 2006 equality act.

Empowerment – residents have the choice to do what they want when they want they are given a choice of when to be woken up in the morning and what time they want to have breakfast and to be given a choice on what they want to eat also they should be able to have snacks at anytime throughout the day

Care value base- this is a mixture of:

Promoting anti discriminatory practice
Maintaining confidentiality ofinformation
Promoting and supporting individuals personal beliefs and identities
Promoting effective communication and relationships
Providing individuals care
Empowerment

The care value base came around 1992; and it can apply to any age group that is in a care environment.

Bibliography

Armstrong F and Barton L (1999) Disability Human Rights and Education Open University Press

Bagilhole B (1997) Equal Opportunities and Social Policy Addison Wesley Longman Limited

Moonie M (2004) Diversity and Rights in Care Heinemann Educational Publishers

Shakespeare T (2006) Disability Rights and Wrongs Routledge