Category: Free Essays

The problems that came about from industrialisation proved there was a severe lack of help for those who truly needed it. No profession already existed to help these people in society, and from that social care gradually came about, progressing into social work as it is today. Industrialisation meant that everyone left the country to move into the city, as it was a lot easier to find work, however with more people in the cities this meant more social problems could easily arise. Older people and younger children were given no help or education, as they were seen as no benefit to society, as they weren’t fit to work.

From the mid 1700s Britain began to change dramatically, those who had formerly lived in the country and worked on the land, moved to the cities and sought employment in the factories. Work conditions were harsh and many were working 12 hours days on very low wages, and without laws people were exploited. Home conditions were not much better, and the large urban populations led to poor sanitary and social conditions which went on the lead to very poor public health, and high numbers of those being effected by diseases such as cholera and typhoid. The governing social policy of the time was ‘laissez faire’, leaving the caring self less citizens of society to help those worse of than them, with the policy having its roots in religious benevolence.

However laissez faire had appeared to have failed and the effects included the poor living conditions of the time. In the fight against poverty and poor sanitation the Poor Law Amendment Act (1834) and The Public Health Act (1848) were created, and this was said to be ‘..the first example of the state taking direct responsibility for the poor’ (Sheldon & McDonald, 2009, p13). The Poor Law Amendment Act was put in place to make sure that those who truly deserved relief were receiving it. The poor were separated into two categories; the undeserving and the deserving. The deserving poor received practical and financial support from charities, and consisted of those who were not physically fit to work such as the elderly, sick, and disabled. The undeserving poor were those who were fit to work but chose not to for whatever reason; these people were turned down for support from charity and voluntary services. They were forced to turn to the workhouse or the state, conditions in the workhouse were deliberately harsh, to try and deter those who we able to work to seek work instead. Workhouses soon became home to those who were not well enough to work, but were eliminated in 1930.

The Public Health Act came as a result of Chadwick’s Sanitary Report, and the aim was to improve the sanitary conditions in towns and cities. The General Board of Health had responsibility over water supplies and drainage; the first main focuses were on public places, especially hospitals. Diseases slowly killed fewer and fewer people, due to the drainage systems and clean water put into place in London following the act.

‘At first sight the Poor Law and the workhouses it introduced may seem a far cry from social wok…’ (State Social Work, BJSW, p.665, John Harris 2008) Financial and practical support provided was and still is set below that of minimum wage which therefore dissuaded people from seeking help from state intervention and instead encourages them to find employment. Today the same values still hold.

The Charity Organisation Charity (COS) was founded in 1869, to help manage the relief that was given out to the poor. The system was designed to stop charitable relief being given out to those who didn’t require it as much as others, as they were seen to be taking advantage. Only the deserving poor could receive aid from charities. The COS introduced a case work practice, which meant that those who applied for support from charities could be thoroughly assessed as to whether they were legible for help or not. A caseworker would work closely with an applicant to build up a bigger picture of their personal background to determine what action plan would be put in place. Just as a social worker would today, the caseworker visited the client and built a relationship. A client would then be referred to a local charity or voluntary organisation which would best help provide for their needs. The COS was the first organisation to introduce the idea of casework, which was later developed and expanded due to the work of Mary Richmond. Richmond’s beliefs really conveyed the importance of casework, and her ideas focused on the social theory instead of a psychological theory. Her ideas are still recognised today and are said to be the root of social work education.

Post World War I, psychiatry in social work started to play a big part. Many men returned from war with what we now recognise as post traumatic stress disorder, however a hundred years ago little was known about it. Care centres employed psychiatrists to treat these men, and from this psychiatry became much more recognised and started to play a bigger part in treatment for mental health patients. Social workers and psychiatrists focused more on psychology for their answers and a more ‘head over heart’ (Sheldon & McDonald, 2009, p.21) approach was used more widely in practices. During World War 2, over 3 million children were removed from their homes in the cities and sent to live in the country for their own safety; however children experienced adverse effects due to their separation from their parents. It was from this psychologist John Bowlby produced his theory of attachment and effects of maternal separation.

1944 saw the beginning of the Education Act, ensuring that children were entitled to education, free of charge. In the following 5 years after the end of World War 2, towns and cities were rebuilt and following Sir William Beveridge’s suggestions, a welfare state was set up, as the former welfare system was not accepted anymore by those in society. In 1948 the Nation Health Service was founded, providing care to everyone who needed it. Even though voluntary organisations were still in place, the state had eventually become the biggest provider of care.

During the 1950s the COS no longer had such a major impact upon the development of social work, as it had had previously. Times were changing for social work as a profession, and psychological theories became one of the main influences of social work practice. The COS identified individuals social problems and sought the best way to deal with them, however they stuck too strongly to their social theory that in the end it began to have less and less relevance to the real problems the poor were experiencing. An in depth understanding of the individual was the basis to good social work, according to Younghusband. She wrote that the social worker needs to understand their client as a person, their individual’s needs and relationships but must not forget the reality of the situation they are in. Before the 1950s, social work training had always been specialised in a specific area of practice, so the social worker would be specifically trained to do the job they were doing. However the 1950s saw the first general social work training scheme being set up.

The Seebohm Committee was set up in 1965 to assess the social services, in reaction to the growing pressure for a reform. The Seebohm report was finally published in 1968 stating their recommendations and beliefs of improving the social work profession. To start with the committee set up area teams, where social workers worked within one community. It stated the profession needed to ‘provide a more coordinated and comprehensive approach to the problems of individuals, families and communities’. (Seebohm Report, cited in Social Work: An Introduction to Contemporary Practice, p.58) The report is said to be ‘a major landmark in social policy’ (State Social Work, p.670, BJSW, 2008). Social work was given more status as a profession and the Local Authority Social Services Bill was passed in Parliament in May of 1970. The conservative government came into power in June 1970, from then on social work saw a massive growth.

To begin with there was a huge increase in qualified social workers, however this stirred conflict between those who had qualified before 1970, and those who qualified after, due to the difference in their training, and there failed to be an established understanding of the social work role in society. The 1970s saw the formation of the Radical Social Work Movement, which start when a magazine named ‘Case Con’ was published, which passed judgment upon social work practices, in hope to come up with a new theory of Social Work. This theory was built on the need for Social workers and clients working together to bring about social change. Rather than offering suggestions on what needed to be changed, radical social work instead just summarised the faults within social work. Consequently the movement did not change policy and practices within social work, yet the writings of the movement still played a big part in the growth of Social Work throughout the 80s.

The Barclay Committee report published in 1982 recognised three approaches to relationships between the state and those in need. The first was known as the ‘safety net approach’, with the main principle that help from the state should only be given to those who really need it, as a last resort, once again with a focus on who are the deserving and undeserving poor. With the welfare state approach it was a responsibility of the state’s to offer services to everyone. The third approached focused upon the community’s responsibility to look after each other, and this was the most popular approach to the committee. Social workers main focus should be on a certain community and having an in depth knowledge of that community. With helping those in that community they encourage citizens to care more for one another. Overall the Barclay report did not make much change to community social work.

In social works reform as a profession, marketisation and managerialism became very important, introducing new techniques such as audits and inspections. With following wider market trends and models, social work became more cost effective and sustainable, focusing on the outcome rather than the quality in which the work gets done. ‘In recent times procedures and bureaucratic practices have become the main framework around which social work practice is structured, at the expense of the professional relationship’, (Gupta and Blewitt, 2007, cited in Social Work: An Introduction to Contemporary Practice, p.5). With growing advances in technology it meant that social workers could pursue more office base practices, which had its advantages in storing, accessing and organising files and data, however it can be argued that it has had a negative effect on the client/social worker relationship.

In 2003 the Laming Report was published, after the well known case of Victoria Climbie and how she eventually died. The safeguarding of children became a priority, and it was questioned how effectively social work was doing its job. More emphasis was put onto the importance of inter professional working and communication, as it was due to the lack of communication between services that Climbie was not saved. The Children Act of 1989 was modified and The Children Act of 2004 was put into place to help protect and safeguard children.

Social work has its beginnings in voluntary based services which were mainly based on religious principles and over the last 150 years the profession has grown to what we know it as today. Although laws and policies have changed and developed over the years, social work is still based upon the same values as it was all those years ago. Social workers still do the same service, in helping clients improve their lifestyle, however due to all the laws and legislation that have been put into over the years, the way in which social workers have to do their job has changed. Today the job is less hands on as it used to be, more paper work based, and more time is spent in the office, due to technological advances and managerial direction. The relationship with the client has always been at the heart of good social work practice, and social workers strive to do their best in improving their client’s situation, no matter what their problems may be. There is still a focus on who is deserving and undeserving, and there are limitations on who can receive what services. For example the benefits the unemployed can receive are lower than minimum wage, encouraging the unemployed to seek jobs rather than rely on the state. In social work assessments always have to be carried out on the client to determine whether they are eligible for the services on offer.

In the last 10 years we have seen the development of the GSCC (General Social Care Council) which was set up in 2001, in reaction to criticisms, mainly stemming from the death of Victoria Climbie. As of April 2005 it became policy that all trainee and qualified social workers had to be registered with the GSCC. When registered with the GSCC, social workers must oblige by the codes of practice. The codes of practice are in place to show practitioners what is expected of them, and to ensure that clients are receiving the best care possible. The codes of practice of the GSCC are based on social work values developed over the years, giving us the underpinning beliefs of contemporary social work.

The development of social work practice within Britain since the Second World War and influencing welfare movements that have changed role of the social worker.

When looking at government policy within Britain since the Second World War it is possible to look at the development of the welfare state and how those governing the country have influenced and shaped the welfare state of today. Pluralism represented majority wide spread values within post war Britain having substantial historical legitimacy explaining contemporary decisions, supplying the most satisfactory foundation on which to examine the post war British welfare state.

Reluctant collectivism was the main overriding political ideology of the time period influencing strategy within post war Britain resulting in the recommendations of the Beveridge Report 1942. (Timmins, 1996)

1941 saw the government commissioning Sir William Beveridge to produce a report into the ways that Britain should be rebuilt after WW2, published in 1942 with recommendations to fight the five giant evils of Want, Disease, Ignorance, Squalor and Idleness. (Timmins, 1996)

Key points, despite later changes were that in organising social security the state shouldn’t suppress encouragement, opportunity and responsibility. The states position to Social Insurance and Assistance System should be rigorously limited to guaranteeing citizens a subsistence income. Anything above that minimum should be determined by personnel effort and voluntary contributions to private insurance, not the state. (Lowe, 2005)

Beveridge had strong commitments to the free market believing that the state intervention should be kept to a minimum promoting maximum freedom of the individual and therefore political autonomy, economic effectiveness and social diversity. Beveridge also indicated a need for greater state regulation acknowledging that politically it was crucial. He was concerned that should economic waste and social inequalities persist parliamentary democracy could damage and discredit political stability. (Lowe, 2009)

Beveridge was a reluctant collectivist intending his recommendations for the welfare state to be a safety net for those who would need it the most believing in limiting the role of the government. Beveridge believed that the overall cost of medical care would decrease as people became healthier, hence needing less treatment (Batholomew, 2004).

1945 saw the appointment of Clement Atlee of the labour party as the new prime minister. He went on to introduce the welfare state as outlined in the 1942 Beveridge Report. By 1948 the National Health Service was created introducing free medical treatment for all, reformist socialist looked upon it as a framework for development shifting towards an egalitarian society, whilst those such as Hayek had never been convinced of a need for the welfare state in the first place.

A national system of benefits was introduced to provide social security to protect from “cradle to the grave” Partly built on National Insurance Scheme set up by David Lloyd George 1911. People in work had to make contributions each week as did employers but the benefits provided were now much greater.

Social work was first recognised in 1898 with classes being offered at Columbia University. Social work and the “five giants of want, disease, ignorance, squalor and idleness” were deep rooted and radical welfare reformers often saw violence, alcohol misuse, child abuse being mainly caused through the absence of welfare and that the introduction of the welfare state as a way of solving these. (Lowe, 2005)

The provision of services following the Beveridge Report saw the introduction of many Acts, policies, reports and events that brought about changes to services and the law. In 1945 the death of Dennis O’Neil highlighted the plight of foster children. The Mockington Report 1945 found the poor supervision, coordination and overdue action being key contributing factors in the death of Dennis O’Neil. The Monckton’s committee Report and Curtis Committee Report 1946 brought about changes in relation to children in foster care. Stipulating that a fit person be it an individual or the local authority must care for the child as their own. (Horner, 2009, Jordan, 2007)

The Curtis Committee Report focused on children in care in particular those in residential care settings and directly resulted in the Children Act 1948 with local authorities becoming more responsible in the professional recognised service and recognised the need for a more personal approach within the care of children.

When looking at the knowledge and skills required for this role the Curtis Report noted the need for this position to be the responsibility of a graduate with experience of children:

Her essential qualifications, however, would be on the personal side. She should be genial and friendly in manner and able to set both children and adults at their ease

(Curtis, 1946 as in Jordan 2007)

The Origins of social work can be traced back to COS (The Charity Organisation Society founded in 1869) and the Settlement Movement both influential yet declined mid twentieth century. Younghusband’s report 1947 noted a wide variety of social work, family case work, settlement work, and work within physically and mental health, probation, youth work amongst others she also believed that both the COS and the settlement movements sought to integrate casework, group work and community work. Younghusband’s report went on to position social work into five specific settings, Children’s Departments, Welfare Departments, Health Departments linked to psychiatric services, Health Departments and medical social workers and Probation Departments ( Younghusband, 1981, Horner 2009)

In 1954 Younghusband played a key part in establishing the first generic training ensuring all social workers had a common base of knowledge for professional social work training. Further reports of Younghusband led to the founding of a Council for Training in Social Work and a social work certificate (Wilson et al, 2008). More recently through the Modernising Social Service Agenda and the Care Standards Act 2000 there have been huge developments within social work education with major changes ensuring that qualified Social Workers are educated to honours degree level ensuring common shared knowledge, skills and values (Department of Health, 1998)

Banks (1995) acknowledges the complex interaction of social work and how it involves interconnected complex issues, ethical, technical, legal and political. All of these are part of the shared knowledge, skills and values of the modern qualified social worker. These shared knowledge, skills and values are more important when considering as Parton (1997) argues the position of the social worker, between the rights of the individual and the states responsibilities.

The Department of Health (2002) states

Social work is a practical job and therefore the degree requires social workers to demonstrate their practical application of skills and knowledge ability to problem solve. Whilst providing hope for those people who rely on social services.

Some definitions such as Jones (2002) link more towards individual difficulties and raises questions of social control. When looking at different definitions it is possible to look at the different practice context. The department of health definition highlights skills and interventions this views social work as practical interactive activity which requires a set of beliefs, knowledge and interpersonal skills linking the ethics and values of social work (Oko, 2009)

Titmuss (1965) acknowledge the changing role of social work in relation to social problems stating that within the past two decades social problems brought about a call for more trained social workers. Focaults (1977) noted that government increased employment opportunities upon realising the capacity of social work to control populations those populations troublesome to social order. Foucault (1977) and Parker (1990) also acknowledged the importance of historical awareness and understanding of social work when reflecting upon the present to enable more productive and effective outcomes. The General Social Care Council (GSCC) views reflection as essential to high-quality social work and key to ongoing professional development and acknowledges this within the National Occupational Standards and General Social Care code of practice (GSCC, 2002). The BASW have recognised that the duty of the social worker being to assist with the solving of social problems and conflict at the personal level.(Oko, 2009)

National Occupational Standards define reflective practice as:

‘Reflective practice is grounded in the social workers repertoire of values, knowledge, theories and practice, which influence the judgements made about a particular situation. The characteristics of reflective judgments indicate that the practitioner has developed the ability to view situations from multiple perspectives, the ability to search for alternative explanations, and the ability to use evidence in supporting or evaluating a decision or position’

(Training Organisation for the Personal Social Services (TOPSS, 2002)

Learning through reflection is a life long process of development Lindeman (1926) viewed it as a process autonomous with life and revolves about non-vocational ideas noting adult education to be around situations putting the student needs first and acknowledges that it is the learner’s experience, if education is life, then life is education. Within the learning and qualification elements of social work training and qualification, anti oppressive and anti discriminatory practice is key.

Anti oppressive and anti discriminatory practice is fundamental to social work. This is clearly emphasized in the GSCC code of practice highlighting the need to respect diversity and promotion of equal opportunities. In order to undertake the role of a social worker it is essential to have some basic understanding of anti discrimination legislation. The Race Relations Act 1976 and Disability Discrimination Act 1995 make it illegal for authorities to discriminate as do elements of the Children Act 1989. Social work commitment to anti oppressive and anti discriminatory practice gained significance having recognised the lack of response to discriminatory and oppressive practice on the part of social workers in the 1980s towards the needs disabled people, women and ethnic minorities (Taylor, 1993). It is this fundamental practice that is recognised within the training and a major part of qualifying courses with in social work. (Wilson et al, 2008) It is this core commitment of the social worker to anti oppressive practice and anti discriminatory practice that encourages and supports active involvement on the part of the service users. Direct payments and individual budgets support individual choice and empowerment. Mullender (1997) stated that in order to understand the oppressions and discrimination people face it is essential perceive the way in which people are disadvantaged. With many forms of oppression and discrimination all of which impact upon social clients, it is important to recognise that negative use of power is at the heart. Thompson (2001) states that for social workers this power lies within their knowledge and expertise, access to resources, statutory powers and influence of individuals and other agencies. Historically this links back to the variety of social work as originally set out in Younghusbands Report 1947 as mentioned on page 4.

As people became more satisfied with each of the welfare services this resulted in them becoming a better resourced service dispelling previous anxieties changing the climate of opinion. The personal social services in 1950’s had very little increase in expenditure although 1960 – 1968 expenditure doubled.

As social work continued to develop so did policy and legislation, 1963 saw the first lawful vital Act that enabled preventative developmental social work enabling early intervention, the Children and Young Persons Act of 1963. This enabled preventative and rehabilitative social work enabling social workers to work towards changing conditions, to prevent children entering local authority care or the juvenile court.

It was as a result of pressure from probation and children’s services which led directly to the establishment of the Seebohm Committee in 1965 and the passage of the social work (Scotland) Act in 1968.

In 1968 Fredric Seebohm led a committee appointed by the government (Committee on Local Authorities and Allied Personal Social Services) who’s task was

To review the organisation and responsibilities of the local authorities personal social services in England and Wales, and to consider what changes were desirable to secure an effective family service.

(Horner, 2009)

The Local Authority Social Services Act 1970 went on to see the enactment of the Seebohm Report in 1971. The report changed the delivery of the welfare Servcies into Social Services with a new generic social worker role.

The report recommended a generic integrated social care approach to social services, family orientated, and community based service available and accessible to all, as an integrated service rather than totally separate departments run independently. This new personal Social Services being one of five parts of the social security policy arena, the other four being Social Security, Health, Housing and Education in which Social workers and Social Care are as Walker (1984) says viewed as the safety net of the five.

This saw the appointment of a director of social services accountable to the Social Services Committee. Resulting in breaking down fragmented services between health and welfare committees and associated departments and leading onto the development of generic social work training developed through central council for education and training of social workers (CCETSW)

Claire (2000) post Seebohm, noted staff struggles to the new generic approach given that many had specialism’s within a now integrated service. Whilst Willmott (1975) acknowledged how social work reforms brought about change which meant the families would have one lead social worker as a means to one for each area of need, resulting in a more holistic approach to the need of the individual or family. Toronto (1993) held a collectivist view of this that in order for society to be judged as a morally admirable society it must, among other things, adequately provide care of its members. Thompson (2005) noted that in working within integrated approaches positive outcomes can come about for all concerned, but warns that it can also make some situations worse and the potential for these situations needs to be recognised in order to minimise harm and maximise the good. It could be argued that the recommendations of the Seebohm report 1968 was not wholly new as the Ingleby Report 1960 with a main focus upon juvenile delinquency, child neglect and the entry of children into care it noted the need for state intervention when families are seen to be failing. The Ingleby report commented upon a solution being to reorganise various services concerned with families into one unified family service in effect Ingleby was a forerunner to integrated social care. (Boss, 1971)

The Seebohm reforms created changes to management systems and coordination in children and welfare departments for many this was a high point of collectivism, state intervention of the state in social welfare and formal education with the state at the fore front. With major developments also taking place within education, council housing and urban regeneration. Jordan also noted how the collective institutions were not seen as reliable and able to resolve disagreements. This was demonstrated through trade union consciousness amongst those working within social services, coming together against many of the state’s strategies and policies. Freire (2003) would see this as people understanding of their social and political position within society, consciousness raising and critical thinking enabling people to challenge their position and start the process of change, viewing empowerment as conscientization education of the consciousness, in which communities become aware of issues affecting them. Freire used the term conscientization to refer to “learning to perceive social, political and economic contradictions and take actions against the oppressive elements of reality”.

The Victoria Climbie inquiry overseen by Lord Laming saw the production of the green paper Every Child Matters (ECM), published along side Lord Laming’s report. The report had four key focus points, improving the way in which carers and families are supported and notes the critical influence upon the lives of children, preventative interventions prior to crisis point situations proactive action to stop children falling through the net, addressing underlying weak accountability and poor integration and make sure those people working with children and young people are appreciated, rewarded and trained. one of the outcomes of ECM was to set five outcomes for all children and young people, be healthy, stay safe, enjoy and achieve, make a positive contribution and achieve economic well being. In relation to social work there are many areas covered and given consideration, foster care, care matters, child trust funds, independent reviewing officers, health care, adoption, educational achievement of looked after children, secure children’s home, family and friends carers and social work practice pilots. Within this new Joint Area Reviews (JAR) inspections focused on communication and integrated care. In addition there is substantial coverage of issues around safeguarding. The ECM has seen a multi agency approach with integrated services, strategies and governance as a result of the depth and breadth for the ECM and subsequent ECM papers.

In conclusion social work mediates between the state and its members the roles and responsibilities therefore can vary significantly based upon the over riding views within society and the elected government. This in turn will affect responses to the “needs” of people in relation to individual rights and responsibilities verses collective responsibility.

Social workers often engage with those most in need, struggling to participate within society. Frequently caught somewhere in the middle of conflicting political ideologies of left/right wing policies, engaging and supporting those most marginalised yet often employed within the political, social and economic setting that may have gone some way to contribute to that marginalisation. Therefore it is essential for social workers to have a commitment to understanding their modern role and how that has developed through the range of different and often conflicting political thinking of government influencing power in relation to culture, thoughts, actions, attitudes, feelings and structural levels.

Social work will continue to evolve along with legislation, movements and unfortunately high profile incidents and therefore training will follow a parallel in line with the current discourse. Through looking back through time from the implementation of the state welfare the collectivist approach was dominant. That was until the Thatcher years which saw an anti collectivist approach to welfare services which viewed the welfare state as over developed creating dependency, irresponsibility and keeping people from using their initiative. Whilst New Labour believed in a limited role, reducing the role of the state and by supporting and promoting schemes such as sure start and new deal with the focus being upon social inclusion.

As governments and common ideologies change so will the roles of social workers as, administrators of social policies.

References

Banks, S (1995) Ethics and Values in social work. London: Macmillan

Bartholomew, J (2004) The welfare state we’re in. London: Politico Publishing.

Clare, B (2000) Becoming a social worker: learning, doing and being, in J Harris, I Paylor and L Frogget (Eds) Reclaiming social work: the south port papers. Birmingham: Venture Press.

Department of Health (1998) Modernizing Social Services: promoting independence, improving protection, raising standards. CM.1469. London: Stationary Office

Department of Health (2002) Requirements for social work training. London: Department of Health.

Foucault, M (1977) Discipline and Punishment. London: Allen Lane

General Social Care Council (2002) Code of Practice for Social Workers and employers. London: GSCC

Horner, N (2009) (3rd Ed) What is Social Work: Contexts and Perspectives, Exeter: Learning Matters Ltd

Jordan, B (2007) Social work and well-being. Dorset: Russell House Publishing Ltd

Lindeman (1926)

Lowe, R (2005) The Welfare State in Britain since 1945. Hampshire: Palgrave Macmillan

Oko, J (2009) Understanding and Using Theory in Social Work. Exeter: Leaning Matters Ltd

Parker, R (1990) Away from home: a history of childcare. Ilford, Essex: Barnardos

Parton, N (1997) Social Theory, Social Change and Social Work: an introduction. London: Routledge.

Taylor, G (1993) ‘Challenges from the margins’, in J, Clarke(ed) A Crisis in Care: Challenges to Social Work, London: Sage/Open University.

Thompson, N (2001) (3rd Ed) Anti-discriminatory Practice. New York: Palgrave

Thompson, N (2005) (2nd ed) Understanding Social Work. Basingstoke: Palgrave

Timmins, N (1996) The Five Giants: A Biography of the Welfare State. Glasgow: Fontana Press

Titmuss, R (1965) Goals of today’s Welfare State, in P Anderson and R Blackburn (eds) Towards socialism. London: Fontana.

Toronto, J (1993) Moral Boundaries: a political argument for an ethic of care. New York: Routledge.

Training Organisation for the Personal Social Services (2002) National occupational standards for social work. London: TOPPS.

Walker, A (1984) Social Planning: a strategy for socialist welfare. Oxford: Blackwell

Willmott, P (1975) (2nd Ed) Comsumer’s guide to the British social services. Harmondsworth: Penguin

Wilson K, Ruch G, Lymbery M, Cooper A, Becker S, Brammer A, Clawson R, Littlechild B, Paylor I, Smith R (2008) Social Work: An introduction to contemporary practice. Essex: Pearson Education Limited

Younghusband, E (1981) The Newest Profession. Community Care:/IPC

The following essay will identify and describe key takepu principles that are an integral part of social work and the development of relationships with all culturally diverse individuals within the social work practice. The main focus for my essay will lay around 6 main takepu which are Ahurutanga – Safe space, Kaitiakitanga – Responsible stewardship, Taukumekume – Positive and negative tension, Te Whakakoharangatiratanga – Respectful relationships, Mauri ora – Pursuit of well-being and Tino Rangatiratanga – Absolute integrity. (Pohatu, 2004:1). These takepu are guidelines that social workers should use to allow an open space that encourages and supports a healthy relationship between social worker and client and vice versa. When contextualized, and internalized, they assume a central place in how people should engage in kaupapa. (Pohatu, 2004:1). This essay will also discuss how I incorporate Nga Takepu into my social and professional life.

Nga Takepu principles are grounded in the social work professions philosophy, values, ethical prescriptions and an obvious way of living. They are not supported by empirical verification nor are they compiled in one single document supported by the government. Yet at Te Wananga o Aotearoa these principles are taught as if there is an agreed upon set of practice guidelines that all social workers should follow. To the contrary, social works practice principles are largely unwritten, learned life experiences and typically are passed on informally from seasoned workers to those who are entering the profession, or in my case from teacher to student. I feel that the takepu principles I have learned at Te Wananga o Aotearoa have enabled my conscious mind when it comes to forming and maintaining relationships with people. Social workers must be consciously aware of how their own beliefs, perceptions, and behaviors may have an impact on their professional relationships, as these personal attributes will surely affect the ability to be helpful to clients. (Sheafor, Horjsi & Horjsi, 2000).

Te Whakakoharangatiratanga (Respectful relationships) for me occurs in every aspect of our lives whether it is mother – daughter, brother – sister or student – teacher. There is always that acknowledgement of respect for each other and it is something that I have learned to appreciate throughout my life. In the Tongan culture Whaka’apa’apa (respect) takes on a lot of forms. Showing respect could be not looking your elders in the eyes, which in the European culture can be seen as disrespectful. Respect for me and Te Whakakoharangatiratanga go hand in hand. Respectful relationships cannot thrive without respect from all parties involved. All the positive outcomes that benefited Tongan people in the past were said to result from the acknowledgement, recognition and appreciation or faka’apa’apa for the roles played by deities in the people’s welfare and livelihood. (Havea, 2005).

Good helping relationships result from a conscious effort on the part of the worker. It is necessary for the social worker to make conscious use of what is naturally themselves – to use all of themselves and not just their analytical or technical skills – to achieve a purposive relationship with someone else. (O’Connor, Wilson and Setterland, 1998). A lot of what I am learning at Te Wananga is being consciously aware of my surroundings, being able to absorb all that I can from not only my kaiako but fellow peer’s also. I feel as though I’ve grown up with all these Takepu – I’ve just not known them by there Maori words, they are phrases and values I hold dearly. For me it was all to do with recognizing these principles and knowing when to apply them. My family created a safe space for me at home (ahurutanga), I care for my nephews and nieces when needed (kaitiakitanga), having faith in what I believe in and having the strength to back it up (tino rangatiratanga), I engage in respectful relationships with people I meet at Te Wananga o Aotearoa (Te Whakakoharangatiratanga), resolving disagreements within the family and acknowledging good behavior with younger members of my family (tau kumekume), and last but not least the constant need to better oneself, love more, give more, understand more and even further my knowledge base here at Te Wananga o Aotearoa is all in the pursuit of overall mauri-ora (wellbeing).

“Values are concerned with what is good and desirable whilst ethics deal with what is right and correct”.

(Loewenberg & Dolgoff, 1992)

While understanding when these principles should be used and being able to identify them we cannot steer away from the fact that there is always a deeper meaning to what we learn and what these principles mean to us. If we cannot control the definition we cannot control meanings and the theories which lie behind these meanings (Smith, 1995). This quote reminds us of the importance of Maori frameworks. The fact that I have been fortunate enough to learn about Nga Takepu straight from Matua Taina Pohatu himself just reaffirms the fact that Maori should be teaching all things Maori. His definitions of the meaning therefore mean more to me than if I had read them in a book at school. Being a great social worker to me is when you reach a point where you already know the guiding principles, when to use them, how to use them, and doing so, so much that you subconsciously use all of yourself to engage in relationships with people.

The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance Mauri-ora (well-being). Utilizing theories of human behavior and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work. Incorporating Nga Takepu Principles encompasses social workers duty to tangata whenua – Members actively promote the rights of tangata whenua to utilize tangata whenua social work models of practice and ensure the protection of the integrity of tangata whenua in a manner which is culturally appropriate (ANZASW Code of Ethics, 2008). Tino rangatiratanga (absolute integrity) is not just an important part of my learning here at Te Wananga o Aotearoa but it is an important part of who I am as an individual, how I hold myself and how I appreciate difference and strive to learn more.

All cultures have a special way to define time and space. Understanding how cultures do it differently increases our understanding and communication cross-culturally. (Inglis, 2000). It is through knowledge that we are able to gain an understanding of how people are defined by there culture, or cultural differences. Understanding Ahurutanga (safe space) allows social workers an environment where they are able to freely engage in discussion, an environment where all parties involved are able to open up and truly be in a space that is free from prejudice and any other outside influences. Ahurutanga (safe space) is the first step social workers take when first establishing a relationship. Ones ability to build and maintain positive helping relationships with clients is fundamental to social work practice. (Sheafor, Horejsi & Horejsi, 2000). Knowing when to create Ahurutanga encourages a greater thinking on the social workers behalf, and encourages a healthy relationship.

Creating a safe space to engage in is one of the steps taken to ensure the basis of the relationship is comfortable and an open environment is thus created. The well-being of the client(s) should be present throughout. Mauri-ora is as explained by Matua Taina Pohatu is the pursuit of well-being (Pohatu, 2001). Mauri-ora for me is knowing and having clarity of the past and of your purpose here on earth. Having the ability to grow from these strengths and flourish as an individual all in the pursuit of an ultimate well-being. Mauri-ora is being fully aware of transformative possibilities, responsibilities, accountabilities, guide practice and respectful relationships. From a social workers point of view Mauri-ora would come in the final stages of empowering a client, or fulfilling their needs.

In conclusion interpreting and reshaping take pu to inform and guide our practice in each new activity, give time and place for the active re-engagement with the thinking and voices of earlier generations. The possibilities are immense and boundless if there is the will to respectfully ‘engage’. (Pohatu, 2003). The fact of the matter is there are hundreds if not thousands of principles that we can use to shape how we engage in relationships with people from different cultures. Knowing what principles you already have, and are constantly learning throughout your life help us to respectfully engage with people. Nga Takepu for me are Maori principles that I can incorporate into my studies to help me engage with tangata whenua. All my life experiences add to who I am as a person and how I treat others. All through school I have engaged with people from all different cultures, I have always gone in with an open mind and a willingness to understand more about the true character of a person. Take pu for me is a vital part of my learning towards becoming a social worker, using all of them will surely help how I engage in all relationships now and in the future.

The needs of older people are rarely considered outside of their age-related ailments. Community services remain geared towards the younger generation more specifically children and young people, while older people’s needs tend to be looked at peripherally. A question that springs to mind is how risk is assessed in an older person with mental health issues.

A starting point could be to look at a definition of risk. Risk can be defined as ‘the possibility of beneficial and harmful outcomes and the likelihood of their occurrence in a stated timescale’ (Alberg et al in Titternon, 2005). Risk is also a common feature in assessment frameworks by agencies and policies in social care and health. Hence the need to attach significance to risk issues in several public inquiries. However, these seem to be primarily related to child death inquiries where risk assessment and risk management are seen as the ongoing needed requirements to improve best practice. Most available research studies of risk and older people seem to focus on falls and other everyday risks they might encounter when seeking to return home after a hospital admission.

Langan & Lindlaw (2004) comment that mental health service users have become increasingly defined in terms of risk and dangerousness, despite consistent research evidence that their contribution to violence in society is minimal. They further stipulate that continued focus upon risk means that there is a danger that people so defined will be excluded from decision-making about their lives. This could be related to theory and research evidence that suggests that although older people with mental health needs are at increased risk of admission to long-term care, staff tend not to be well informed about their mental health needs (Nicholls, 2006). This could be related with mental health issues coexisting with other medical conditions in later life, leading to this client group being commonly treated in mainstream settings rather than mental health related institutions.

In regards to legislation and policy that incorporates risk assessment, we have the NHS and Community Care Act (1990) which spells out the duty to assess those in need of community care services. More specifically to risk related interventions, these should be the least restrictive and clients ought to be encouraged to use their own resources or develop new ones as per Mental Health Act (1983), Mental Capacity Act (2005) and Safeguarding Adults. Moreover in context of the National Service Framework for Older People (2001) ‘person-centred care’ is key, where the aim is for older people to be treated as individuals and receive appropriate and timely packages of care which meets their needs as individuals, regardless of health and social services boundaries (DH, 2001). The No Secrets guidance (2000) encourages services users to have greater control of their lives by being given the opportunity to take and manage risks. There is also the Risk and Choice Framework (2007) which provides guidance on risk assessment and tools.

However, current policy and legislation seems to hold long-held ageist assumptions about capacity and capability. For instance, the NSF for Older People (2001) and Essence of Care (2003) require service providers to ensure that care for this client group is fully integrated and holistic in nature. Hence the intended use of the FACS (Fair Access to Care Services) criteria to ensure equality. Yet, these eligibility criteria can prevent an important focus on an older person’s biography in terms of the strengths and abilities they gained over their transitional experiences. In this instance, policy relating to risk assessment needs to consider the impact of age and life course stage.

Moreover, has concluded by McDonald (2010) legislation alone will not change the way in which professionals respond to older people and further analysis is needed in regards to the factors that influence decision making in the context of risk.

Through our lifespan risk can be perceived as beneficial and part of everyday life as it enables learning and understanding. However, one cannot dismiss the negative consequences of risk and subsequently the need for it to, at times be monitored and restricted. Thus risk assessment becomes a significant element of many frameworks.

Risk assessment has been defined as ‘the process of estimating and evaluating risk, understood as the possibility of beneficial and harmful outcomes and the likelihood of their occurrence in a stated timescale’ (Titterton, 2005: 83).

In that context, such process should look at a situation or decision, identify the risk and qualify/rate it in terms of likelihood, harmfulness or even low, medium or high risk. Thus, a risk assessment will only identify the probability of harm a risk may have to the related client and others. Subsequently, intervention strategies should aim at reducing harm. Irrespective of this a risk assessment cannot prevent risk (Hope and Sparks, 2000) and most models of risk assessment recognise that it is not possible to eliminate risk, despite the pressure on public authorities to adopt defensive risk management (Power, 2004).

This defensive risk management is perhaps in response to some of the high profile cases dominated in the media over the recent years, which has directed the focus of community care policy to minimise risk. Also the government current emphasis on risk when it comes to mental health related incidents/cases conveys a highly misleading message to the public which in turns seems to contribute to the defensive nature found in the professionals that carry assessment and are meant to support this client group.

As commented in the Health Select Committee (2000) the current “blame culture” risks driving away much needed staff from mental health services. The parallel concern becomes what are acceptable risks and how these might conflict with the agenda of person-centred assessments and user empowerment. As put in Carr (2011) defensive risk management or risk-aversive practice may result in service users not being adequately supported to make choices and take control, hence being put at risk.

Risk assessment is not only about negative labelling with adverse consequences. It has the value of promoting safety and, where necessary, identify appropriate intervention and support for service users. The methods most used in assessing risk in social work are: actuarial and clinical methods. Adams, Dominelli and Payne (2009) state that the actuarial method involves statistical calculations of probability where an individual’s behaviour is predicted on the basis of known behaviour of other in similar circumstances; clinical assessment employs diagnostic techniques relating to personality factors and situational factors relevant to the risk behaviour and the interaction between the two. This latter is the more familiar method in social work practice. Both methods have limitations in terms of generalising behaviour (actuarial method) and risk assessment being a subjective process (clinical methods), i.e. influenced by assessor’s background, values and beliefs. As such, it is central for professionals to be aware of the limitations of risk assessment tools.

Thus far, risk and its assessment seem to vary which reinforces the need for partnership and collaborative working as a way forward in integrating health and social care to provide a person centred support to mental health service users. Alaszewski and Alaszewski (2002) found that users, families and professionals had differing views about risk and safety. Nicholls (2006) refers to the Green Paper on Independence, Well-Being and Choice, which found that service users believe that professionals are too concerned about risk, and that this gets in the way of enabling service users to do what they want to do.

In relation to older people, the Single Assessment Process stipulates the need for a coordinated approach by which health and social care organisations work together to ensure person-centred, effective and coordinated care planning (Nicholls, 2006). This entails sharing information, trusting one another’s judgement, reducing duplication, and together ensuring that the range and complexity of an older person’s needs are properly identified and addressed in accordance with their wishes and preferences.

Such collaborative working between professionals and service users can address potential conflict, evaluate strengths, needs and risk where the effectiveness of intervention is likely to be improved and the outcomes for service users more positive (Adams, Dominelli and Payne, 2009).

The implications for social work practice is that the needs for service users with mental health issues frequently cross organisational and professional boundaries. For example, professionals working with older people with mental health issues are more than likely to work alongside a range of practitioners from different health and social care disciplines and organisations. Thus, one needs to consider how organisational cultures may impact or influence on how risk is perceived as subsequently assess. As put by Neil et al (2009, p.18) risk decision making is often complicated by the fact that the person or group taking the decision in not always the person or group affected by the risk.

Waterson (1999) further suggests that professionals and users tend to disagree on the levels of risk, not least because risk is subjective and can apply to environments as well as to people. Alaszewski and Manthorpe (1998) equally argue that risk is perceived differently by different professionals and allocating blame is one of the main concerns of public enquiries into failures of community care interventions.

As current society develops into a culture of blame and risk-aversion, there is an emphasis on the need to minimise uncertainty about risks and attribute individual culpability. As put by Parton (1998) ‘blaming society’ is now more concerned with risk avoidance and defensive practice than with professional expertise and welfare development. This defensive form of social work in risk assessment put at risk effective and open collaborative and partnership working. Today’s dominance of individual accountability (or culpability) might make social work lose sight of their traditional values where service users are meant to be empowered to make informed decisions about the risks they are prepared to take and the support they feel they might need. As stated in Carr (2011) practitioners are less able to engage with individuals to identify safeguarding issues and enable positive risk tasking. As a result issues of discrimination, inequality and anti-oppressive practice start emerging with a client group that is already vulnerable.

Both stigma and discrimination against older people is further accentuated by a diagnosis of mental health. It is reported that older people with mental health needs are at greater risk of abuse than other groups of older people (Nicholls, 2006). In regards to risk assessment, literature stresses the need for mental health service users to be included in that process, to have choice and opportunities to take risks towards maintaining their independence and self-determination, as put by Lawson (1996: 55) ‘risk taking is choosing whether or not to act to achieve beneficial results in an awareness of potential harms’.

As mentioned before risk taking is part of life, but too often for older people the presence of an element of risk results in the prescription of care solutions or admission to residential care which may not be the older people’s own wishes. For example, in placement experience when older clients were admitted to hospital the local authority primary goal was to ensure clients remained at home for as long as possible however the package of care was delivered in accordance with the local authority’s interpretation of these client’s needs such as dictating bedtime routines and dismissing the need for social interaction. In this instance, the risk assessment tended to focus on the worker’s interpretation of perceived need. This could relate to the findings of Langan & Lindlaw (2004) study where service user involvement in risk assessment was variable and depended upon individual professional initiative. The concern here is that being overpreoccupied with risk can be to the detriment of assessing needs suggesting a primary concern with organisational procedures and resource-allocation over service user’s wellbeing. As put by Munro (2002) social work should be much more than minimising risk, it should be about maximising welfare. Carr (2011) further suggests that this also impacts of practitioners’ ability to engage with service user to enable positive risk-taking, leaving clients unsupported in taking control.

Discrimination may also occur has a result of the level of risk attributed to a service user. Whereby over-estimation can lead to unwarranted labels and under-estimation lead to inappropriate service provision and/or risk to others (Langan & Lindlaw, 2004). Inflexible labelling is both unhelpful and often stigmatising. As found in research, people with mental health problems are a far greater risk to themselves than they are to the general population and while there are instances where intervention is required this should not be done in a way that pigeonholes this client group as if the category of “dangerousness” (Tew, 2011) is solely related to mental heath issues.

In an attempt to answer the initial question, of how risk is assessed in an older person with mental health issues, risk assessment of older people with mental health issues is more likely to take place in crisis situations. Hence interventions might be more reactive rather than proactive, where professionals’ focuses on weaknesses and inabilities rather than strengths and abilities. Professionals may ‘play safe’ by minimising risk at the expense of user empowerment.

To better understand how risk, strengths and difficulties are assessed in regards to risk assessment in older people with mental health needs (and other mental health service users) we need to put it in the context of current political and social perception. The latter being significant given that research into causes and effects of mental health in older people are limited, also there is limited research on how mental health service users manage risk. Therefore, it is essential that risk assessment moves from a “one-size fit all” approach or a sort of tick-box exercise to being an inclusive process where the individual involved brings expert knowledge that needs to be incorporated into the assessment of risk. As found in Langan and Lindlaw (2004) few service users were fully involved in risk assessment. Similarly, Stalker (2003) makes reference to the omission from research of services users who are perceived to be at risk or a risk. Littlechild & Hawley (2010) suggest that little is known about how social workers actually assess risk and that judgements made by individual professionals can vary when using the same risk assessment tools. Petch (2001) adds that overemphasising the importance of accurate risk assessment may lead to misleading conclusions about the level of risk posed by someone and as such expose this group to unnecessary restrictions.

From some of the literature review and research available risk can be viewed as a social construction, perception of risk differs between professionals (and service users) and society has its own normative views on risk and it’s overtly concerned with the consequences of risk behaviour in relation to mental health. Moreover, the role of the media in shaping and, one could argue, amplifying some of these concerns must also be acknowledged. Nonetheless, this does not make risk inexistent. The key seems to be for the needs and risk of mental health service users to be assessed from a holistic approach, avoiding judgements, placing the service user at the centre and valuing their perspective as a contributing expert while at the same time recognise that risk is contextual as well as its fluid, i.e. risk can change.

Risk assessments need to be comprehensive and build on a bigger picture of the service user by drawing on their strengths and aspirations. Tew (2011) reiterated that the dominant discourse around risk tends to pathologise service users where social and environmental context is not considered. Also that this leads to a paternalistic practice where service user’s needs are provided for without considering their rights.

The concept of ‘risk’ is complex, making its assessment challenging. This is reflected in the different ideas and approaches to risk assessment as well as the inkling that we are moving to a risk dominated society. As a result, the attitudes and behaviours of such society are weighed in policy and practice in relation to service users with mental health issues whereby isolated incidents involving people with mental health issues become exaggerated to generate perceptions that such client group are inherently dangerous and need to be controlled and confided (Gould 2010). Undisputedly, it is a major challenge to get the right balance when making difficult risk decisions.

On the other hand, risk assessments are needed to improve the validity and reliability of decision making particularly where there may be concerns about an individual’s capacity to make informed judgements. However, risk can never be eliminated altogether, and occasionally decisions will be made in good faith, on the best evidence available.

As proposed by Stalker (2003) more studies are needed to address the complex nature of risk as well as positive-risk taking in regards to service users with mental health needs. This in addition to the need for research to include services users perspectives as well as other variables such as race and gender.

In regards to older people, if as a social group they tend to be institutionally marginalised then it might be equally easy to negate the views of people with mental health problems who equally challenge society’s assumptions of capability in regards to managing risk. Risk assessment is central to social work practice; however it must not depersonalise the service user and merely identify them through a compilation of risk variables. Additionally the discourse around risk assessment needs to move from a concern about risk adversity to a probability of negative and positive risks. Equally antagonistic is the use of the term “dangerousness” to define vulnerable service users. Such language can impact on collaborative and partnership work between professionals and service users. Moreover, as put in Tew (2011) the ongoing rituals of risk assessment may impact further on service user’s sense of self and undermine their capability to manage risky situations. Also, as stated in Petch (2001) there will always be people in the community who pose risk, whether or not they suffer from mental health, and singling out or blaming a particular group of professionals will not change this.

Thus, a risk assessment is made on a balance of probabilities rather than exact conclusions. While striving for uniformity within risk assessment is a move towards equity, flexibility is also important given the subjective contexts of risk and mental health needs. People’s lives involve many changing and interrelated variables which will always create some difficulty in balancing risk assessment. In the end, life cannot be without risk and risk-taking is part of the process that makes us who we are, complex beings.

The second part of the report concentrates on to understand process of ageing. It will then assess the role and function of social work within wider socio-political policy context especially in terms of poverty and inequalities. Finally it will be demonstrated how the identified issues may inform the policy and organisational context and the points raised will be summarised in the conclusion.

According to World Health Organisation, most developed world countries have accepted the age of 65 years as a definition of “elderly” or older person. (WHO: 2012) However, in the United Kingdom the Friendly Societies Act 1972 S7(1)(e) defines old age as, “any age after fifty”, where pension schemes mostly are used age 60 or 65 years for eligibility. (Scottish Government: 1972) Ageism can be defined as process of discrimination and stereotyping against people because of their age. It affects many institutions in society and has a number of dimensions such as job discrimination, loss of status, stereotyping and dehumanization. Ageism is about assuming that all older people are the same despite different life histories, needs and expectation. (Phillipson: 2011) According to Erikson (1995) psychosocial stages of life older age has been defined as the period of integrity versus despair. This stage involves the acceptance and reflection on one’s life.

The authors describe older people as a group of marginal concern that has moved to one of central importance in social work profession (Phillipson: 2011) This is caused by the speed of demographical change that is most remarkable in its expand. The number of older people is increasing both in absolute numbers and as a proportion of the total population. The ageing of the population indicates two main factors such as the downward trend in the birth rate and improvements in life expectancy. (Phillipson: 2011) In Scotland in 2010 there were an estimated 1.047 million older people age over 60, where older people are one fifth of Scottish population. (Age Scotland: 2012) In the last hundred years Scotland’s life expectancy has doubled from 40 in 1900, to just over 74 for males and just over 79 for females in 2004. By 2031 the number of people aged 50+ is projected to rise by 28% and the number aged 75+ is projected to increase by 75% (All our future: 2007) It has been estimated that in the UK in 2005, 683,597 people suffered from dementia, the number is expected to triple by 2051 to 1,735,087 people. (Alzheimer’s research trust: 2010)The issue require to be deeply analysed in terms of how society will be able to respond effectively to the complex needs of older people.

“Look beneath the surface” the needs and issues of older people

The policy All our future (Scottish Government: 2007) indicates the age over fifty as a stage where life circumstances start to change in ways that can be significant for the future. An example of this can be; children leave home, change in working patterns, people have less work and more time for themselves and perhaps more money. It is worth pointing out that caring responsibilities for elderly relatives at this stage can also increase. The time fifty upwards is a time when physical health can deteriorate causing possible health problems such as osteoporosis, osteoarthritis or coronary heart disease. What is more, the state of health after that time decrease substantially and become greater in its extend. People must face changes in appearance such as wrinkles, hair lost or change of hair colour to grey. In addition, they physical state deteriorates and they are not as fit as they used to be. Form psychological point of view this must be difficult to accept it. However, ageing can also concerns some psychological effects such as changes in memory function, decline in intellectual abilities or even memory loss. As a result of a degenerative condition of brain’s nerve cells or brain disorders many people may suffer dementia, Alzheimer or Parkinson disease. Wilson et al. (2008) who draws attention to physical, biological and psychological effects of the ageing, pointing out that ageing is not itself a disease but some specific diseases may be associated with this process. (Wilson: 2008)

Social work underwent fundamental changes from the 1960s following broader ideological, political and economic developments. To understand the current role of social work within society and wider policy framework, particularly with older people, it is important to analyse the past socio-political and economic trends that have reflected on contemporary practice. By the 1960s, more attention was beginning to be paid to the social consequences of capitalism that started to be seen as the economic order of an unequal and unfair society. The strong critique of that system is known as radical social work that grew on the ideology of Marxism. (Howe: 2008) The publication of the Kilbrandon (1964) consequently led to introduction of Social Work (Scotland) Act 1968, which embedded social work firmly within state sector with the voluntary sector as complementary. (Ferguson & Woodward) Social work wanted to be seen as unified profession that offered generic services, to overcome earlier fragmentation and overspecialisation of services. Social workers were obligated by law to assess needs and promote social welfare by providing services. However, the government of Margaret Thatcher began to weaken state welfare responsibilities to help people in need leading to the major ideological shift in 1980s called neoliberalism. As a result Barclay Report (1982) intended to clarify the role and task of social workers employed within statutory or voluntary sector, the later Griffiths Report (1988) were similar to Barclay Report in terms of promoting greater choice, participation and independence of service user and carers. However, neoliberalism undermines the role of welfare professionals, allow the rich become richer and marginalise the poorest and most vulnerable individuals. Woodward and Ferguson (2011) argue that neoliberal trend has been continued under New labour government, leading to managerialism and bureaucratisation. Therefore, contemporary practice is drawn by extreme pressure through the forces of marketisation, managerialism and consumerism, that led to profession dominated by stress, frustration and strongly focus on meeting deadlines. The labour government has also been driven by the development associated with consumerists ideas such as personalisation that place service user at the centre of service design and delivery or direct payments that emphasise independence and individual choice through giving service user their own money to buy own services. For a long time neoliberal economic and social policies in the UK speculated a very different concept of what social work should be about. The Changing Lives report of the 21st Century Social Work Review (Scottish Government: 2006) has brought significant shift within social work polices through an expression of dissatisfaction of social work that was mainly caused by lack of opportunity for relationship based work with service user.

The policy has reshaped social work practice towards providing social workers with additional space to develop good social work practice. There have been initiatives to improve recruitment and increase professionalism and standards within workforce as well as improve integration in the planning and provision of social work services. Integration has been developed through Modernising Community Care: An Action Plan (1998) and Community Care Joint Future (2000) that introduce Single Shared Assessment (SSA). In Scotland Joint Future is the driving policy on joint working between local authorities and the NHS. The other key policy themes are personalisation, self-directed support, early intervention and prevention as well as mixed economy of care on the grounds of more effective partnership. (Scottish Parliament: 2008) Another significant report that brought about change in policy and later in Scottish legislation is the Sutherland Report (1999) that provided free personal and nursing care on the basis of assessed needs. (Petch: 2008) The above review of social work policy framework is a good illustration of constantly changing role and function of social work. Social work operates within socio-political framework of constantly developing policies and legislation of health and social care. The reality and ideology constantly has changed people and society faceing new challenges. Social work makes a key contribution to tackle these issues by working with other agencies to deliver coordinated support and to increase the wellbeing of older people.

The critical analyse of needs of older people and current issues in the delivery of social work services.

The first issues when working with older people is partnership of health and social care within four main areas: assessment, care management, intermediate care and hospital discharge. (Wilson: 2008) The main problem is tight budget this is in particular importance especially in statutory setting. (Wilson: 2008) The problem increases when local authority must, as normally is a case, work in collaboration with other bodies. This raises an external question who are going to pay for services? That causes unnecessary delays and constraints. One might expect that new Integration of Adult Health and Social Care Bill (Scottish Government: 2012) will resolve problem by the joint budget and equal responsibilities of Health Boards and Local Authorities. Wilson et al. stresses the importance of rationing services in social work due to low budget that lead to delays in provision of services and lack of time to develop more creative forms of practice.

The next issue is the assessment process that is seen as balance between needs and resources. A major element during assessment is the relationship with service user and appropriate methods of communication to understand and be understood. Practitioner must take the time to get know the older person and resist pressure from other professional to do a quick assessment. (Mackay: 2008) The problem of autonomy and protection is the other one in relation to work with older people. This raises the question of capacity, consent and the deprivation of liberty of older people. This group of service users is often a subject of legislation that deprives their rights and liberty, this is because they are likely to be affected by cognitive disorder such as dementia. The term dementia include Alzheimer’s disease, vascular and unspecified dementia, as well as dementia in other diseases such as Parkinson’s. It has been estimated that in the UK the number of patients diagnosed is 821,884, representing 1.3% of the UK population. (Alzheimer’s research trust: 2010) The assessment of incapacity or mental disorder is not straightforward and ethically and morally difficult for both service user and social worker. Social workers have to manage the balance between acting in accordance with the wishes of the individual and their best interest. It has been suggested by policy and legislation that the views and wishes of people expressed through self-assessment would remain at the heart of intervention. (Department of Health: 2005)

The another issue is abuse of older that may have many forms and can be very severe in its extend. Older people are vulnerable to abuse or to not having their rights fully respected and protected. The problem came to public awareness not as long as few years ago. Despite the fact that legislation came into force through Adult Support and Protection (Scotland) Act 2007 it is estimated that elder abuse affects 22,700 people in the Scotland each year. (Age Scotland: 2012) Older people are a subject of physical, psychological abuse, neglect, sexual or financial harm, that normally takes place at home, in hospital, residential care or day centre.

Age discrimination is next issue to consider around 24 per cent of older adults in the UK report experiencing age discrimination. (Age Scotland: 2012) The new NHS policy that came to force 1st of October this year, states that it is unlawful for service providers, policy makers and commissioners to discriminate, victimise, or harass a person because of age. A person will be protected when requesting and being provided with services. If anybody will be treated less favourably because of their age, they will be able to take organisations or individuals to court and may be awarded compensation. This mainly relates to health boards individual clinicians such as consultants, GPs or other health professionals. (Department of Health: 2012)

Older people are disadvantaged based on the relatively low socio-political and cultural status in contemporary society. They are repeatedly presents as a drain on resources as they no longer actively contribute to grow of society. They do not work and do not pay taxes anymore. Older people are systematically disadvantaged by the place they occupy within society. Wilson et al. (2008: p. 620) rightly suggests that old age is “socially constructed”. A good example of this is retirement that makes people officially old and unavailable to work, despite factual physical and emotional state of the individual. Other forms of social construction that significantly affect the experience of old age is class, gender, race and ethnicity. (Wilson: 2008) An illustration of this can be statement that older people have much more in common with younger people from their class then they do with older people from other classes. (Philipson: 2011) Disadvantages and inequalities experiences during life can magnified the process of ageing through differences in access to health facilities, health status and lifestyle that may influence life expectancy. There is no doubt that experience of ageing is subjective and depends on many factors but it seems to be a matter to consider class, gender and race at first place. When discussing poverty and inequalities the things that have to be in mind are issues of discrimination of older women who are less likely to have as a great pension as male due to the fact many women are paid a lower wage then men. Moreover, women tend to live longer than men so they are more vulnerable to live alone and in poverty. (Age UK: 2012) There are many forms of disadvantage associated with older people in poverty such as; low income, low wealth and pension, debts or financial difficulties, feel worse off, financial exclusion, material deprivation and cold home. The first three are experiences by around 20% of older people, half of older people experienced at least one of the nine forms of poverty described above, and 25% had two or more. A minority 3% suffered from three or more forms of poverty. (Age UK: 2012) In terms of ethnicity and race there are significant inequalities in the process of ageing. An illustration of this can be the black community of older people who are more likely to face greater level of poverty, live in poorer housing. In addition, they are more susceptible to physical and mental illness due to often heavy manual work, racism and cultural pressures. (Phillipson: 2011)

Most of older people want to say at home as long as possible this is supported by policy All Our Future (Scottish Government: 2007) that helps people through services such as free personal care, telecare development programme, care and repairs services or travel scheme free bus passes. The policy aims to improve opportunities for older people, foster better understanding towards this group of service user, create better links between generation to work together and exchange experiences, to improve health and quality of life: promote well being and active life within community, improve care support and protection, housing and transport as well as promote lifelong learning.

The role of social work in working with older people is described by Marshall’s text (1990) and cited by Scottish Government (2005) It has been suggested that a key issues are: communication, including sensitive listening and awareness of non-verbal communication, taking time to assess needs always in the presence of service user. Supporting people in managing crises that arise through loss or change such as bereavement, mental health issues or physical constrains like illness or disability. Offer practical help and organise resources. Working with other professionals and people involve in the process of intervention and together combat ageism.

Ageing can be defined as discrimination against older people m

The current trends in adults social care have began through Green paper Independence, Well-being and Choice (Department of Health: 2005) and the subsequent White Paper , Our Health, Our Care, Our Say (Department of Health: 2006) these documents set out the agenda for future. This is based on the principle that service users should be able to have greater control over their own lives, with strategies that services deliver will be more personalised than uniform, this is referred to as personalisation. Personalisation enables the individual to participate and to be actively involved in the delivery of services. Personalisation also means that people become more involved in how services are designed by shaping and selecting services to receive to support that is most suited to them (Scottish Government: 2009) Personalisation is a wide term covering a range of approaches to providing individualised services, choice and control. The programme directly response to wants and wishes of service user regarding service provision. Personalisation consists of person centre approach, early intervention and prevention, is based on an empowering philosophy of choice and control. It shifts power from professionals to people who use services. (Department of Health: 2010) However, it could be argued that approaches extending service user control in realty can be seen as transferring risk and responsibilities form the local authority to the individual service user (Ferguson: 2007)

Another option recently promoting by government is Self Directed Support (SDS), a Bill has been introduced into the Scottish Parliament last year and recently has passed stage three. The bill seeks to introduce legislative provision for SDS and the personalisation of services and to extend the provisions relating to direct payments. (Scottish Parliament: 2012) The SDS approach before has been brought into Parliament were reflected in many reports and policy initiatives such as: Changing Lives, Reshaping Care for Older People. SDS let people to make informed choices about the way support is provided, they can have greater control over how their needs are met, and by whom. Social worker working on behalf of local authority will have a duty to offer SDS if the individual met eligibility criteria. The four options to consider are: direct payment to the individual in order that that person will arrange own support, the person chooses the available support and local authority will make arrangement for services on behalf of that person, social worker will select support and make arrangement for provision, the last option is a mix of the above options. (IRISS: 2012) There is no doubt that the ideas of SDS are glorious because express a great opportunity for service user to expand their control over services provided. However, this raises a question of how many people will be ready to utilise option one of SDS, if a ordinary person who use services will have skills and knowledge to take responsibility for own care such as to employ own carers or personal assistance and to buy own services. One could envisage that it could be possible if the role of social worker will change from care management to brokerage and advocacy. The new model of care requires also to support communication, have experience in employment practice, manage record keeping and pay roll services. A potential care broker will provide assistance to obtain and manage a support package, drawing on individualised funding. It can be questioned if social workers who are mostly employed by local authority and accountable to statutory agencies are reliable to perform this task working across three sectors.

Service User Involvement

Dalrymple and Burke (2006) discuss issues that influence contemporary social work such as social justice, empowerment, partnership and minimal intervention. The service user participation has began in 1990 through NHS and Community Care Act. (Ray, 2012) There is still increasing acceptance that people who receive services should be seen as own experts in defining their own needs. This is in accordance with exchange model of assessment presented by Smile and Tuson et al. (1993), where social worker view the individuals as experts of own problems. The role of practitioner is to help service user to organise resources in order to reach goals that are define by the service user. Government policy addressing to older people highlights the importance of developing services that focus on maintaining independence, encouraging choice and promoting autonomy such as Independent living in Scotland (2011), Reshaping Care for Older People (2011), All our Future(2007). The policies highlights the importance of user participation in risk management and risk taking within independent community living for older adults. One of the action enhance independent living is direct payments. This has been seen as a way of improving choice and autonomy of older people. Social workers have a moral obligation to ensure that direct payment, when offered, do in fact provide better opportunity for this group of service user to meet their needs in creative way. (Ray: 2009) One may expect that active involvement and participation in service provision will have a crucial role not only in exercise more control and choice but also in challenging social exclusion. Shaping our lives is a notional independent user network that aims to make sure the voice of older people are heard so they have equal chance in defining outcomes in social care. (Crawford & Walker: 2008)

It could be argued that one of the main needs of older people is the importance of active listening of this group of service user, who are often because of age ignored or disregard. This is supported by Kydd (2009) who highlights how important it is for older people to feel that they are being listened too.

In social work there is constant need to evidence based practice on the grounds of empirical knowledge that guide decision making process. An example of this can be three stages of theory cycle presented by Collinwood and Davies. (2011) There is no doubt evidence based practice is important but the view undermine relationship based practice that is equally important. Rightly Wilson (2008) refers to relationship-based as a main feature of social work practice that shape the nature and purpose of the intervention. It is a unique interaction between the service user and the practitioner that help to obtain more information and define the best way of intervention.

A fundamental part of working with older people is to recognise and respond to the way in which they may be marginalized. An example can be the role of social worker as advocate that seek; to provide accurate information in relation to the services the individual is entitled and to enable the person to live where she/he wants to live. (Dalrymple & Burke: 2006)

New World Enclopedia (2012) defines foster care as full-time substitute care of children outside their own home by people other than their biological or adoptive parents or legal guardians.

According to The Adoption Foundation (2012) Foster care means placing a child in the temporary care of a family other than its own as the result of problems or challenges that are taking place within the birth family.

Johnson (2004) defines Foster care as a 24-hour substitute care for children placed away from their parents or guardians and for whom the State Agency has placement and care responsibility.

To summarise the Foster Care aim is to provide the opportunity to children victims of abuse and/or neglect to live in a substitute family on a temporary basis. The role of the foster parents is to give support to the child and help him to grow physically, emotionally, socially and spiritually.

3.2 History of Foster Care

The Children Aid Society (2012) stated that placement of children in foster homes is a concept which goes as far back as the Old Testament, which refers to caring for dependent children as a duty under law. Early Christian church records indicate orphaned children lived with widows who were paid by the church. English Poor Laws in the 1500s allowed the placement of poor children into indentured service until they became adults. This practice was imported to the United States and was the beginning of placing children into foster homes. The most significant record of fostering was in 1853, a child was removed from a workhouse in Cheshire and placed in a foster family under the legal care of the local government. At the beginning of the 1900s only orphaned or abandoned children under the age of 11 years were fostered, and they had to have a demanding psychological profile – well adjusted, obedient and physically normal.

Jeune Guishard-Pine (2007) identified that in 1969 research was carried out on the foster care system and it was found that foster families required training on how to deal with the foster children and make them fill secure in the placement.

3.3 Foster care as a global concept

Johnson (2005) emphasised that foster care is most likely the most widely practised form of substitute care for children world-wide, depending on the needs of the child, the culture and the system in place. According to Askeland (2006) there are many different kinds of fostering and definitions of ‘foster care’ vary internationally. It can be short -term, a matter of days ,or a child whole childhood. A review of foster care in twenty-two countries found considerable diversity in the way of fostering in both defined and practised.

Mannheim (2002) stated that kinship foster care, which is the most common form of fostering in African countries, is not called ‘foster care’ in all countries. ‘In Ireland for example only children placed with no relatives are said to be fostered’. According to Colton & William (1995) in some countries foster care is only seen as a temporary arrangement.

Johnson (2005) stated that the procedures to be registered as foster parents in different countries such as United Kingdom, Australia, Uganda and South Africa are similar. In some countries foster care programme is managed either by the government or an agency, and each country has their own basic criteria that should be fulfilled, such as; being physically and mentally fit and healthy, having a room for the child ,having time to spend with the child. According to Blatt (2000), the process to be registered as foster families can take approximately six months or more. Individuals who are willing to become foster families must make their applications to the agency. A home study is conducted by a social worker to assess the capability of the applicants for taking care of a child. The assessment form is then forwarded to a panel who gives the approval.

3.4 Placement in Foster care

According to (Blatt 2000; Zuravin & Deponfilis 1997), children are removed from their homes to protect them from abuses. These children have suffered physical, sexual abuse, or neglect at home, before they are transferred to a secure milieu. Some children are abandoned by their parents or legal guardians, or have parents or legal guardians who are unable to take care of them because they have financial difficulties, some are alcoholics, others are irresponsible. These children are then placed into foster care until the parents or guardians are capable of taking the parental responsibility.

Elisa et al (2010), states that in all foster care cases, the child’s biological or adoptive parents, or other legal guardians, momentarily gives up legal custody of the child. The guardian gives up custody, but not necessarily legal guardianship. A child may be placed in foster care with the parents’ agreement. In a clear case of abuse or neglect, a court can order a child into foster care without the parents’ or guardians’ consent.

Duncan and Shlonsky (2008) emphasizes that before any placement the foster care family is screened by the Government or agency through a psychologist or social worker that assess the foster care families under certain criteria such as emotional stability, motivation, parental skills and financial capabilities. Elisa et al (2010) states that the government provides foster families with an allocation taking in foster children. The foster parents are required to use the funds to buy the child’s food, clothing, school supplies, and other incidentals. Most of the foster parent’s responsibilities toward the foster child are clearly set in legal documents.

According to Blatt (2000), foster placements may last for a single day or several weeks; some continue for years. If the parents give up their rights permanently, or their rights to their child are severed by the court, the foster family may adopt the foster child or the child may be placed for adoption by strangers.

3.3.1 The Aim of Foster Care System

According to Hayden (1999), the aim of foster care system is to protect and endorse the security of the child, while providing foster parents and biological parents with the sufficient resources and available services needed to maintain the child’s healthy development. Foster care environments are proposed to be places of safety and comfort, and are monitored by several welfare agencies, representatives, and caseworkers. Personal caseworkers assigned to a foster child by the state or county are accountable for supervising the placement of the child into an appropriate foster care system or home. The National Conference of State Legislatures (2006), states that the caseworker also carries out regular visits to the foster care family home to monitor progress. Other agents involved in a child’s placement into foster care may include private service providers, welfare agencies, insurance agents, psychologists, and substance abuse counselors.

3.3.2 Types of Foster Care

Ambrosino et al (2008), emphasis that parents may voluntarily place children into foster care for various reasons. Such foster placements are monitored until the biological family can provide appropriate care for the child, or the biological parental rights are terminated and the child is adopted. Legal Guardianship, is a third option which can be used in cases where the child cannot be reunited with their biological family and adoption is not a suitable option. The Guardianship option most commonly occurs for older children aged 10years old onwards, who are strongly bonded to their biological parents.

Geen (2003) mentions that voluntary foster care can be utilised when the parents are unable or unwilling to care of a child; a child may suffer from behavioural or psychological problems and requires specialized treatment. Involuntary foster care is applied when the child is in danger and should be removed from the family to be put in a secure place.

(Blatt 2000; Bath 2010;Moe 2007) mention different types of fostering:

(i) Foster family home, relative – ‘A licensed or unlicensed home of the child’s relatives regarded by the state as a foster care living arrangement for the child’.

(ii) Foster family home, non-relative – ‘A licensed foster family home regarded by the state as a foster care living arrangement’.

(iii)Group home or Institution – ‘A group home is a licensed or approved home providing 24-hour care for children in a small group setting that generally has from 7 to twelve children. An Institution is a facility operated by a public or private agency and providing 24-hour care and/or treatment for children who require separation from their own homes and group living experience. These facilities may include child care institutions, residential treatment facilities, or maternity homes’.

Associated Problems with Foster Care System

According to Mannhein (2002) stated that in the United States, placement success rate was 40% and failure rate was 60%.From previous studies carried out, Children and Family Research Center (2004), Proch & Taber (1985), there are many associated problems with the foster care system that leads to the removal of the child from the foster care home such as time of placement in the foster care family, characteristics of home, foster parents characteristics and child characteristics.

According to a study carried by Mannhein (2002) in the United States, placement success rate was 40% and failure rate was 60%. Fernadez and Bath (2010) states,that foster children face a number of problems both within and outside the foster care system. Foster children are more exposed to neglect, abuse, family dysfunction, poverty, and severe psychological conditions. The trauma caused to a child when removed from their home is also severe and may cause depression, anger, and confusion. Psychological conditions of abused and neglected children are required to improve when placed in foster care, however the separation from their biological parents cause traumatic effect on the child.

3.3.4 Time of Placement in Foster Care family

According to Bremner & Wachs ( 2010) many studies which has been carried out show that behaviour of the child is the strongest predictor of placement disruption and is one of the main reasons foster parents request removal the children from Foster Families. Newton et al (2000) confirms that children showing sign of behaviours such as disruptive, aggressive or dangerous behaviour in the foster homes are requested to be removed from Foster Families. Zandberg & Van der Meulen,(2002) study show that behaviour becomes a critical issue for foster placements for children over the age of 4 years.

Webb et al, (2010) states, that children are more prone to experience insecurity in the foster home during the initial phase of placement and the first six months of a placement are crucial as 70 % of removal of foster children occur within this period. According to Whittaker et al (2010) older children experience more placement instability during the initial phase compared to infants and older girls are at the highest risk of placement disruptions than boys.

3.3.5 Characteristics of the Home

Berridge & Cleaver, (1987) stated that children have difficulty to adapt in foster home when they are placed with other children who are roughly the same age or if they are placed in foster homes where the foster parents have children of their own. Foster Children placed with other children may feel insecure and start competing for affection and materialistic objects eventually this leads to conflicts in the foster care family.

3.3.6 Foster Parent Characteristics

According to Walsh & Walsh (1990) to deal with a child’s problem behaviour is mostly related to the Foster Parents character and sense of understanding. Doelling and Johnson (1990) states that ‘the other most predictive characteristics of foster parents is their “goodness of fit” with a child including a match temperaments and having a relationship that is described as close’. Butler & Charles (1999) also state that a mismatch in temperament between a foster parents who is inflexible and a child with negative mood will eventually lead to disruption.

Walsh and Walsh (1990) study also shows that for a placement to be successful the foster parents should be motivated, they should accept the child, they should feel the desire to parent the child and they should be motivated by their own childhood experience. According to Fine (1993), Social Support in foster family is important to prevent placement disruption and foster parents who have good relationship with their family and friends are more likely to be successful.

3.3.7 Child Characteristics

According to Children and Family Research (2004), the behaviour of a child is closely linked to placement disruptions. As stated by Lindheim & Dozier (2007) foster parents do not understand the behavioural problems of the child and finally they request removal of the child from their custody. The behaviour of the child is a result of the child characteristics i.e the background of the child. Foster children are more exposed to neglect, abuse, family dysfunction, poverty, and severe psychological conditions. The trauma caused to a child when removed from their home is also severe and may cause depression, anger, and confusion.

Psychological Trauma in Children

Psychological trauma is a type of damage to the mind that occurs as a result of a severely distressing experience. When that trauma leads to disorders , damage possibly will involve physical changes inside the brain and to brain chemistry, which modifies the person’s reation to future stress.

A traumatic event involves a single experience, or an enduring or recurring event or events, that fully surmount the individual’s capacity to deal with or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks, years or even decades, as the person fights back to cope with the abrupt situation. Psychological trauma can lead to serious long-term negative consequences that are often overlooked even by mental health professionals:

Trauma can be caused by a wide range of events, but there are a few general aspects .There is, putting the person in a state of tremendous puzzlement and lack of confidence. Psychological trauma may accompany physical trauma or exist seperately of it. The usual causes and dangers of psychological trauma are sexual abuse , domestic violence, being the victim of an alcoholic parent, particularly in childhood. Long-term exposure to situation such; as extreme poverty or milder forms of abuse, such as verbal abuse, can be traumatic.

Psychological trauma may happen during a single traumatic event or as a result of repeated (chronic) exposure to overwhelming stress (Terr, 1992). Children exposed to chronic trauma normally have considerably worse effect than those exposed to severe accidental traumas. In addition, the failure of caregivers to satisfactorily protect a child may be experienced as betrayal and further supply to the adversity of the experience and effects of trauma. Acute psychological trauma causes impairment of the neuroendocrine systems in the body. excessive stress triggers the fight or flight survival response, which activate the sympathetic and suppresses the parasympathetic nervous system. Fight or flight responses increase cortisol levels in the central nervous system, which enable the individual to take action to survive (either dissociation, hyperarousal or both), but which at extreme levels can cause alterations in brain development and damage of brain cells. In children, high levels of cortisol can disrupt cell differentiation, cell migration and critical aspects of central nervous system integration and functioning. Trauma affects basic regulatory processes in the brain stem, the limbic brain (emotion, memory, regulation of arousal and affect), the neocortex (perception of self and the world) as well as integrative functioning across various systems in the central nervous system.

Traumatic experiences are stored in the child’s body/mind, and fear, arousal and dissociation associated with the original trauma may continue after the threat of danger . Development of the capacity to control affect may be destabilized or disrupted by trauma, and children exposed to severe or chronic trauma may demonstrate symptoms of mood swings, impulsivity, emotional irritability, anger and aggression, anxiety, depression and dissociation. Early trauma, mainly trauma at the hands of a caregiver, can distinctly modify a child’s perception of self, trust in others and perception of the world.

Children who experience severe early trauma often develop a foreshortened sense of the future. They come to anticipate that life will be dangerous, that they may not survive,and as a result, they give up hope and expectations for themselves that reach into the future (Terr, 1992).

Among the most demoralizing effects of early trauma is the disruption of the child’s individuation and differentiation of a separate sense of self. Disintegration of the developing self occurs in response to stress that overwhelms the child’s limited capacities for self regulation. Survival becomes the focus of the child’s interactions and activities and adapting to the demands of their environment takes priority. Traumatized children lose themselves in the course of handling with ongoing threats to their survivalI?they cannot afford to trust, relax or fully look at their own feelings, ideas or interests. Characterlogical development is shaped by the child’s experiences in early relationships (Johnson, 1987). Young trauma victims often come to believe there is something naturally wrong with them, that they are at fault, unlovable, hateful,helpless and unworthy of protection and love. Such feelings lead to poor selfimage, self abandonment, and self destructiveness. Eventually, these feelings may create a victim state of body mind spirit that leaves the child/adult vulnerable to subsequent trauma and revictimization.

Acute trauma in early childhood affects all area of development, including cognitive, social, emotional, physical, psychological and moral development. The pervasive negative effects of early trauma result in significantly higher levels of behavioral and emotional problems among abused children than non-abused children.In addition, children exposed to early trauma due to abuse or neglect lag behind in school readiness and school performance, they have diminished cognitive abilities, and many go on to develop substance abuse problems, health problems and serious mental health disorders. Serious emotional and behavioral difficulties include depression, anxiety, aggression, conduct disorder, sexualized behavior, eating disorders,somatization and substance abuse. Early childhood trauma contributes to negative outcomes in adolescence, including dropping out of school, substance abuse, and early sexual activity, increasing the occurrence of sexually transmitted diseases, early pregnancies and premature parenting. Early childhood trauma contributes to adverse adult outcomes as well, including depression, posttraumatic stress disorder, substance abuse, health (Harris, Putnam & Fairbank,2004).

Although the effects of child abuse and neglect vs. family environmental and

genetic factors have been debated, recent twin studies confirm a significant causal

relationship between child abuse and major psychopathology (Kendler, Bulik, Silberg,Hettema, Myers & Prescott, 2000). Acute trauma in early childhood seems to set in motion a chain of events , a negative path that places those children who have the highest exposure and a less positive mediating or ameliorating factors at greatest risk of significant debilitating effect on development and increased occurrence of psychopathology (Perry, 1997, 1999, 2001I? Eth & Pynoos, 1985I? Pynoos, 1994).

The Adverse Childhood Experiences Study (1998)carried a study where researchers mailed questionnaires to over 13,000 people who had freshly had medical workups at the Southern California Permanente Groupin San Diego. These patients were asked about their experiences with any of seven categories of childhood trauma: psychological, physical, or sexual abuseI? violence against the motherI? or living with household members who had problems with substance abuse, mental illness, were ever imprisoned or committed suicide. Over 9,000 patients responded. Among those who reported even one such exposure, there were substantial increases in a awful range of disorders, together with substance abuse, depression, suicide, and sexual promiscuity, as well as increased incidences of heart disease, cancer, chronic lung disease, extreme obesity, skeletal fractures and liver disease.

In summary, experience to extreme traumatic stress affects people at many levels of functioning; somatic, emotional, cognitive, and behavioral (e.g., vander Kolk, 1988I? Kroll, Habenicht, & McKenzie, 1989I? Cole & Putnam, 1992I? Herman,1992b, van der Kolk et al., 1993). Childhood trauma sets the stage for a variety of disorders, such Post traumatic stress disorders,eating disorder,Attention deficient hyperactivity disorder,oppositional defiant disorder,pervasive disorder,attachment disorder.(Herman, Perry, & van derKolk, 1989I? Ogata, Silk, Goodrick, Lohr, Westen & Hill, 1989

3.4 Disorders with the Foster Child

The Northwest Foster Care Alumni Study (2012) on foster care children showed that foster care children, were found to have double the incidence of depression, and were found to have a higher rate of post-traumatic stress disorder (PTSD) than combat veterans. In long term the foster care children suffer from psychopathology and cognitive disorders.

3.4.1 Psychopathology Disorders with Child

According to Barkley and Mash (1996), child psychopathology is the manifestation of psychological disorders in children and adolescents. Some examples of psychopathology are post traumatic stress, attention-deficit hyperactivity disorder, oppositional defiant disorder, and pervasive developmental disorders.

3.4.1.1 Post traumatic stress disorder (PTSD)

Cash (2006) states that posttraumatic stress disorder (PTSD) is an emotional illness that that is classified as an anxiety disorder and usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD victims re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event , and are exquisitely sensitive to normal life experiences (hyperarousal). According to Dubber (1999) 60% of children in foster care who were sexually abused had post traumatic stress disorder ( PTSD). 18% of children who were not abused faced PTSD just by witnessing violence at home. The symptoms of post traumatic stress disorder are tabulated below

Table 3. 1 Symptoms Post Traumatic Stress Disorder

Re-experiencing the Traumatic event
Avoidance and Numbing
Increased Anxiety and Emotional Arousal

Intrusive, upsetting memories of the event

Avoiding activities, places, thoughts, or feelings that remind you of the trauma

Difficulty falling or staying asleep

Flashbacks (acting or feeling like the event is happening again)

Inability to remember important aspects of the trauma

Irritability or outbursts of anger

Nightmares (either of the event or of other frightening things)

Loss of interest in activities and life in general

Difficulty concentrating

Feelings of intense distress when reminded of the trauma

Feeling detached from others and emotionally numb

Hypervigilance (on constant “red alert”)

Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating

Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Feeling jumpy and easily startled

Intrusive, upsetting memories of the event

Avoiding activities, places, thoughts, or feelings that remind you of the trauma

3.4.1.2 Attention Deficient Hyper Activity Disorder

Millichap (2010) , defines attention deficit-hyperactivity disorder (ADHD) as a psychiatric disorder and it is characterized by either significant difficulties of inattention or hyperactivity and impulsiveness or a combination of the two. ADHD impacts school-aged children and results in restlessness, acting impulsively, and lack of focus which impairs their ability to learn properly. It is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3 to 5 percent of children globally.

Robin (1998) has listed some of the symptoms of Attention deficit-hyperactivity disorder are inattention, hyperactivity, disruptive behavior and impulsivity. Academic difficulties are also common signs of ADHD. According to Ramsay et al (2008), the symptom categories yield three potential classifications of ADHD-predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type if criteria for both subtypes are met. The table below shows the Attention Deficient Hyper Activity Disorder Symptoms

Predominantly inattentive Symptoms
Predominantly hyperactive-impulsive Symptoms
Impulsivity Symptoms

Be easily distracted, miss details, forget things,

Fidget and squirm in their seats

Be very impatient

Have difficulty maintaining focus on one task

Talk nonstop

Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences

Become bored with a task after only a few minutes, unless doing something enjoyable

Dash around, touching or playing with anything and everything in sight

Have difficulty waiting for things they want or waiting their turns in games

Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities

Have trouble sitting still during dinner, school, and story time

Not seem to listen when spoken to

Be constantly in motion

Daydream, become easily confused, and move slowly

Have difficulty doing quiet tasks or activities

Have difficulty processing information as quickly and accurately as others

Fidget and squirm in their seats

Struggle to follow instructions

3.4.1.3 Oppositional defiant disorder

Matthys W & Lochman J (2010), defines oppositional defiant disorder (ODD) as an ongoing pattern of anger guided disobedience, hostilely defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior. People may appear very stubborn and often angry.

Freeman et al (2006), also listed some common features of oppositional defiant disorder (ODD) as persistent anger, frequent temper tantrums or angry outbursts and well as disregard for authority. Children and adolescents with ODD often purposely annoy others, blame others for their own mistakes, and are easily disturbed. The table below shows the signs and symptoms of Oppositional Defiant Disorder.

Signs and Symptoms of Oppositional Defiant Disorder (lasting at least 6 months, during which four or more are present)

Symptoms

often loses temper

often argues with adults

often actively defies or refuses to comply with adults’ requests or rules

often deliberately annoys people

often blames others for his or her mistakes or misbehavior

is often touchy or easily annoyed by others

is often angry and resentful

is often spiteful or vindictive

3.4.1.4 Pervasive Developmental Disorder

Waltz M (2003), defines “Pervasive developmental disorders,”( PDDP, as a group of conditions that involve delays in the development of many basic skills, most notably the ability to socialize with others, to communicate, and to use imagination.

Malmone & Quinn (2004) also states that these conditions are usually identified in children around 3 years of age — a critical period in a child’s development. Although the condition begins far earlier than 3 years of age, parents often do not notice the problem until the child is a toddler who is not walking, talking, or developing as well as other children of the same age and four types of Pervasive Development Disorders have been identified; Autism, Aperger’s Syndrome, Childhood disintegrative disorder and Rett’s syndrome.

According to Volkmar (2007), children with autism have problems with social interaction, pretend play, and communication. They also have a limited range of activities and interests. Many (nearly 75%) of children with autism also have some degree of mental retardation.

Malonne & Quinn (2004), stated that children with Asperger’s syndrome have difficulty with social interaction and communication, and have a narrow range of interests. However, children with Asperger’s have average or above average intelligence, and develop normally in the areas of language and cognition (the mental processes related to thinking and learning). Volkmar (2007) also stated that children with Asperger’s often also have difficulty concentrating and may have poor coordination.

Waltz (2003) stated that children with Childhood disintegrative disorder begin their development normally in all areas, physical and mental. At some point, usually between 2 and 10 years of age, a child with this illness loses many of the skills he or she has developed. In addition to the loss of social and language skills, a child with disintegrative disorder may lose control of other functions, including bowel and bladder control.

According to Goldstein & Reynolds (2011), Children suffering from Rett’s Syndrome which is a very rare disorder have the symptoms associated with a PDD and also suffer problems with physical development. They generally suffer the loss of many motor or movement skills — such as walking and use of their hands — and develop poor coordination. This condition has been linked to a defect on the X chromosome, so it almost always affects girls.

The table below summarises the General Symptoms in Pervasive Developmental Disorders

General Symptoms in Pervasive Developmental Disorders

Difficulty with verbal communication, including problems using and understanding language

Difficulty with non-verbal communication, such as gestures and facial expressions

Difficulty with social interaction, including relating to people and to his or her surroundings

Unusual ways of playing with toys and other objects

Difficulty adjusting to changes in routine or familiar surroundings

Repetitive body movements or patterns of behavior, such as hand flapping, spinning, and head banging

Changing response to sound; the child may be very sensitive to some noises and seem to not hear others.

Temper tantrums

Difficulty sleeping

Aggressive behaviour

Fearfulness or anxiety

Eating Disorders

Hudson et al (2007) defines ‘eating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health’. According to Hadfield (2008), obesity in

How do we make ethical decisions in social work? Discuss the process illustrating your arguments with specific case examples.

Ethical awareness is a fundamental part of the professional practice of social workers. Their ability and commitment to act ethically is an essential aspect of the quality of the service offered to those who use social work services. It is an inevitable process that social workers will find themselves within the dimension of ethical issues which will no doubt challenge the individual and bring about some critical reflection of action. Some of the problem areas where ethical issues may arise include;

“The fact that the loyalty of social workers is often in the middle of conflicting interests. The fact that social workers function as both helpers and controllers. The conflicts between the duties of social workers to protect the interests of the people. With whom they work and societal demands for efficiency and utility. The fact that resources in society are limited.” Beckett and Maynard (2006)

This assignment will address some of the areas where a social worker may run into conflict. To begin this assignment will examine the importance of values personal, professional, societal and organizational; it will further examine the vital need for a shared core base of professional values within social work. It will begin to discuss the complex nature of social work and the guidance found in the code of ethics when social workers face ethical dilemmas. It will support this concept with a case scenario. The assignment will then discuss another area where an ethical dilemmas can arise, in risk assessment, and will discuss using a case scenario how risk can be managed ethically. The core of the assignment will briefly outline an approach to how an ethical decision can be made and will draw on two theoretical aspects within ethical decision making. To finish this assignment will look at ethics within partnership working where a brief scenario will support the importance of anti-oppressive practice and ethics within organisations. The assignment will then conclude with a summary detailing the need for ethical awareness within social work.

Every day social workers are faced with stressful, even traumatic situations, such as domestic violence, child abuse, the homeless, family tension, mental illness and suicide. Therefore it is fair to say social workers work with the most disadvantaged groups and vulnerable individuals in society. Clark, (2000) p1 says “The service that is provided is seen as the most contentious of all the human service professions”.

It is because of the nature of the job, social workers often find themselves dealing with tough decisions about human situations that involve the potential for benefit or harm. Whilst underpinning the decision process is the strong expectation that social workers must be able to balance the tension between the rights and responsibilities of the people who use services and the legitimate requirements of the wider public. They must also be able to understand the implications of, and to work effectively and sensitively with, people whose cultures, beliefs or life experiences are different from their own. In all of these situations, they must recognise and put aside any personal prejudices they may have. According to Pinker, ‘social work is, essentially, a moral enterprise’ Pinker, (1990) p14 whilst Beckett and Maynard, (2006) p189 states “Almost all of the important decisions that are made by social workers have a value component.”

According to Banks, (2006) p6: ‘Values are particular types of belief that people hold about what is regarded as worthy or valuable’. Values of the client, profession, organisation and society are an intrinsic part of decision making. Traditional values of social work was first introduced in the early 60s by Biestek. His principles outlined the basics of traditional social work and were constructed of a seven-point scheme. The principles consisted of “Individualism, Purposeful expression of feelings, Controlled emotional involvement., Acceptance, Non-judgmental attitude, User self-determination, Confidentiality”.Biestek (1961). Many of Biestek beliefs were very traditional and were criticised for their diversity in their interpretation. Controversies relating to different principles caused many problematic conclusions, for example individualisation and confidentiality. Individualisation could not be possible in the fast moving modern world, people lose their identity and individualisation is not respected. Confidentiality has its limitations to be enforced for example; If a user shares information where someone will be harmed, the social workers duty is to share it as a right to other individuals. It was clear these key issues had to be developed and advanced to help social workers. Furthermore it was considered that there must be guidance on values and ethics for social workers, as they play a major part in their work.

Banks, (2006) p150 says; ‘There is recognition that personal and agency values may conflict and that the worker as a person has a moral responsibility to make decisions about these conflicts’. Therefore the social work profession is guided by the shared values that underpin its practice set out in the (GSCC 2002) code of conduct. The code is criteria to guide practice standards and judge accountability from social care workers. The work load of social workers deals with individuals who are disadvantaged in some form or another so it is important to have a shared value system to reflect the ethical problems and dilemmas they face. “‘Working from a professional value is a guide to professional behaviours that maintain identity and can protect service users from malpractice’. Parrott, (2006) p17. On their own personal values will be of limited use. Beliefs and good intentions will not give the professional the knowledge and skills they need to make sense of a practice situation and intervene in it. The difference between personal and professional values include, “professional values can be distinguished from personal values, in that personal values may not be shared by all members of an occupational group, for example, a person who works as a social worker may have a personal belief that abortion is wrong, but this is not one of the underlying principles of social work”. Banks, (2006), p 7.

The GSCC codes of practice contain a list of statements that describe the standards of professional conduct and practice required of social care workers. They are as followed; “protect the rights and promote the interests of services users and carers, strive to establish and maintain the trust and confidence of service users and carers, promote the independence of service users while protecting them as far as possible from danger or harm, Respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people, Uphold public trust and confidence in social care services and Be accountable for the quality of their work and take responsibility for maintain and improving their knowledge and skills “GSCC (2002)

It is then hardly surprising giving the complex nature of the professional role a social worker may find them self when making decisions within ethical areas facing an ethical dilemma. Theaˆ?ethical dilemma arises when there are; “two equally unwelcome alternatives which involves a conflict of moral principle and it is not clear which choice is right” Banks (2006). When social workers struggle to reach a decision they can be then guided by the code of Ethics. The primary objective of the Association’s code of Ethics is to express the values and principles which are integral to social work, and to give guidance on ethical practice. BASW (2001). Loewenverg and Dolgoff (1996) state that “Ethic are designed to help social worker decide which of the two or more competing goals isaˆ?correct for their given situational” . However alongside ethical awareness you have to be aware of the publicly stated values of your agency and make skilful judgements based upon your accumulated knowledge and experience. Ethical considerations are rarely the responsibility of one worker; however, agencies’ policies and structures of accountability offer both guidance and a standard against which your practice can be measured. “Accountability, therefore, is the process through which employers and the public can judge the quality of individual workers’ practice and hold them responsible for their decisions and actions.” (Derek Clifford & Beverley Burke 2005)

Competing values and multiple-client system are two areas where a social worker may find themselves facing an ethical dilemma. Weather it is the social work values that is competing against agency values or within each a confliction of values, which will leave the social worker in need to decide which value will take priority. Also deciding which role the social worker must take in order to reach the right decision can lead to the dilemma of role confliction. Beckett and Maynard (2006) suggest that the role of a social worker can be put into three groups: Advocacy, Direct Change Agent and Executive. “The advocacy role can be either direct or indirect. Direct change agent being counsellor or therapist, mediator, educator and catalyst, with executive role as almoner, care manager, responsibility holder, co-ordinator and service developer” (Beckett and Maynard 2006 p8).

The GSCC (2002) code of conduct says “As a social care worker, you must strive to establish and maintain the trust and confidence of service users and carers” (s2), which includes “Respecting confidential information and clearly explaining agency policies about confidentiality to service users and carers. Consider the following scenario; whilst on placement a client disclosed sensitive information to a trainee social worker regarding the well-being of her neighbours’ children. After clarification that social worker would have to pass this information on to their manager, the client did not wish to consent to the information being passed on. When the supporting relationship had ended, the social worker had to then make a decision based on where there priorities lay. As they were supporting the client who disclosed, they had a responsibility to uphold the standard of respecting her confidentiality. However they also had a responsibility to the wider society which in this case was the children who were at risk of harm.

When making the decision they assessed all the information and weighed up the outcomes. Do they withhold the information in order to maintain the trust and respect of the client or do they prioritize the needs and risk of the children? They then turned to the agency safeguarding policy and the code of ethics for social workers which clearly states; “we must not promise to keep secrets for or about a child or young person” Agency safeguarding policy, (2010) p10 and further states; “We aim to safeguard children at all times, by delivering our services safely and by sharing information when there is a concern”.p9. Clearly the value of life outweighed the needs and wishes of the client in this circumstance. However to whom did the social worker owe responsibility and which role should they take in this situation. Banks (2006) p48 clarifies this conflict by suggesting : ‘Yet while the social worker may be able to focus largely on one individual service user and take on the role of advocate for the service users rights, often the social worker has to take into account the rights of significant aˆ?others in a situation. aˆ?In the interests of justice it may not always be morally right to promote the service users rights at the expense of those of others’

The social worker if doubting her judgement, would address the BASW (2001) code of Ethics to guide the outcome of her decision, the code states; “Social workers will not act without informed consent of service users, unless required by law to protect that person or another from risk of serious harm”. (4.1.4 p8) Furthermore it guides us by stating; “In exceptional circumstances where the priority of the service user’s interest is outweighed the need to protect others or by legal requirements, make service users aware that their interests may be overridden.” (4.1.1 b p8) As you can see the code of ethics guided the social worker to the right course of action that they should take. They were duty bound by law to act on behalf of the individuals who were at most risk.

According to Parrot (2010) p86 Risk refers to the “likelihood of an event happening which in contemporary circumstances is seen as undesirable.” It is when facing issues involving risk that values become of central importance in enabling practitioners to manage risk. Consider the following scenario; a social worker visits an elderly lady in her home after a referral is made by the ladies niece. The niece is concerned for the safety of her aunt after a recent decline in her aunt’s mobility and health which resulted in a nasty fall. The niece lives quite far away and cannot provide regular care for her aunt. The lady values her independence and does not want to be put in a residential home which her niece thinks would be for the best; however there is a concern able risk that if some form of intervention is not in place the lady is at serious risk of hurting herself further. The social worker is faced with a dilemma. The lady has a right to autonomy and self-determination however there is a risk of potential harm happening. The social worker must risk assess the potential outcomes and measure the risk involved. Which on one hand the individual faces residential care involving losing much personal freedom and autonomy; on the other hand to leave a person in their own home to face social isolation and to be potentially at risk of physical danger may also be unwelcome. Social workers have to look to the consequences of their actions and weight up which action would be least harmful / most beneficial to the user, and which action would benefit most efficiently’aˆ? Parrott (2010) p51 While Kemshall (2002) p128 argues,” risk management cannot guarantee to prevent risk. It can attempt to limit the chances of risky situations tuning into dangerous ones or reduce the consequences of such situations. As she suggests, minimization rather than reduction is the key”.

In other words to approach this situation the social worker will identify the social work values that is embedded in the their practice which is; “As a social care worker, you must respect the rights of the service users while seeking to ensure that their behaviour does not harm themselves or other people”. (GSCC 2002 s4). For further guidance the social worker will identify with the code of ethics which states; we may ‘limit clients’ rights to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others,’ but it also tells us that we are to ‘promote clients’…self-determination’ Code of Ethics (1.02). Weighing up the outcomes of the individual the social worker will be committed to allowing the individual choice and empowerment. And work with the elderly lady to ensure her self-determination remains able whilst also advocating on the ladies behalf to ensure she is able to access services which will allow her to live a safe independent life. Thompson (2005,p170) cited on blackboard says it is the social workers role to enable service users and carers: ” to gain power and control over their own lives and circumstancesaˆ¦..to help people to have a voiceaˆ¦..so that they counter the negative effects of discrimination and marginalization whilst Hatton (2008, p145) cited on(class PowerPoint 2011) “sees social workers role as active change agents to create: ” an empowered and active group of service users and carers who hold us to account, share in our decision making and participate actively in the way we deliver services”

Social work decisions span a wide range from safeguarding through to allocation services and advising clients and families on courses of action to improve their lives. As we can see some decisions may involve a breach of confidentiality and assessment of high risks such as a vulnerable adult in need of services to improve their quality of life and prevent harm even death. It is important therefore for social workers to be able to justify their actions. Social worker therefore must draw upon a variety of professional knowledge – such as law, policy, research, theory, standards, principles and practice wisdom – to inform complex and sensitive judgements and decisions in uncertain situations where harm may ensue. “Much of what social workers do concerns decisions about future courses of action, which puts decision making at the heart of social work as a core professional activity”. Banks (2006) p9

This assignment will now examine how the ethical dilemma can be resolved by discussing an approach to guide the process of ethical decisions in practice. We have identified that social workers are expected to critically examine ethical issues in order to come to a resolution that is consistent with social work values and ethical principles. However how is the social worker able to organize all the components relevant to the decision and outcomes. One example of a model to help assist the social worker reach resolution is Mattison (2000, p.206) His model offers a framework to analyse ethical dilemmas such as: Define and gather information; Once the social worker has identified an ethical dilemma, they begin the process of making a decision by fully exploring case details and gathers needed information to understand holistically the client’s current circumstances. Supporting this is Horner (2005 p97) who says that social workers are to “engage holistically with both the person and their circumstances whilst at the same time recognizing the processes of power dynamics at the play in the helping relationship”

It is then important for the social worker to distinguish the practice aspects of the case from the ethical considerations (so separate practice from how you have learned to think about ethical issues). Identify value tensions The social worker must refer to the professional code of ethics – to help clarify obligations and identify the principles that have a bearing on the dilemma The social worker projects, weighs, and measures the possible courses of action that seem reasonable and the potential consequences of these The social worker after weighing up options must select an action for resolving a dilemma. This involves determining which of the competing obligations are we going to honour foremost (this may mean at the expense of others). The social worker reaches the resolution stage and this means being able to justify the decision.

To further this ideas of influence on decisions It is also vitally important for social workers to take time to reflect on their practice and own values. This is a vital point because although guides and frameworks can be developed to offer social workers a logical approach to the decision making process, to some extent, the use of discretionary judgments is evitable (Mattison, 2000). The value system and preferences of the decision maker ultimately shape the process of working through dilemmas and so it is important for social workers to be ethically aware of their character, philosophies, attitudes and biases. Furthermore, philosophers have argued that elements of deontological and teleological thinking operate in and influences decision making in ethical dilemmas. A deontological thinker is grounded in the belief that actions can be determined right or wrong, good or bad, regardless of the consequences they produce and so adherence to rules is central. Once formulated, ethical rules should hold under all circumstances (Mattison, 2000). On the other hand a teleological thinker is ground in the belief of consequences and so weighing up the potential consequences of proposed actions is central to this way of thinking (Mattison, 2000). So a social worker following a deontological way of thinking will differ in their approach to ethical decision making compared with a social worker following a teleological way of thinking.

As part of the profession social workers often find them self-working collaboratively with other professionals such as doctors, police, nurses, teachers and probation officers to name but a few. Considering the variety of different professions merging to reach possible outcomes it is not surprising that partnership working becomes a complex problem. “Mainly because of the assumptions that we are all working towards a collective aim”. Bates cited in Parrot (2010.) Different values, ideologies, ethics and culture of working can too lead to confliction of interests. Effective partnerships require sustained relationships, shared agendas built up over time and a commitment to shared problem solving. “When different professional groupings come together in collaboration then they bring with them their own ways of working, organisational cultures and attitudes, their particular practice experience and their own ethical codes” Parrot (2010)

Consider the following scenario; a social work student commitment to anti oppressive practice is clearly challenged whilst on placement. The voluntary organisation which they are placed with worked in partnership with the crown court. One day as they were waiting for an expected family, to whom they were supporting, they are then approached by an usher (a worker of the court justice system). He commented on the family jokingly saying; “Oh no not that family again they are low life Jeremy Kyle watching scroungers, they bring the trouble on themselves”. This use of stereotypical language discriminated and negatively challenged the whole purpose of the organisations aims which is to value diversity, whilst also conflicting with section 5 of the core values of the GSCC “You must not discriminate unlawfully or unjustifiably against service users, carers or colleagues” (GSCC 2002 5.5) Parrot (2010 ) suggests “There is no appropriate way at which a social worker can condone such language weather they choose to confront the issue at hand or make a formal complaint”. Parrott (2010) further states; “what is the point in partnership working with fellow professionals only to result in the dilution of the social workers value base and the demeaning of service users”. The point of partnership working is not to deliver appropriate services to service users only to have them undermined by some partners exhibiting discriminatory attitudes.

What if in the scenario discussed above, the discriminatory attitudes and beliefs of the usher, was an unconscious influence to the social workers approach when working with the individuals involved in the scenario. This could result in an already marginalised group becoming oppressed further. Thompson, (2005 p34) describes oppression as; ‘Inhuman or degrading treatment of individuals or groups; in hardship and in justice brought about by the dominance of one group over another; the negative and demeaning exercise of power. Oppression often involves disregarding the rights of an individual or group and this is a denial of citizenship’.

Thompson further suggests that oppression can act at three levels, these levels of oppression offers a framework for looking at how inequalities and discrimination manifest themselves. “Personal level which relates to an individual’s thoughts, feelings, attitudes and actions. Cultural level which looks at shared ways of seeing, thinking, and doing. Structural level relates to matters such as policy.” Thompson (2005 p21 -23) Abramson 1996 cited in Mattison (2000) supports this by saying “The process of the decision making is forged by the prejudice and prejudgement brought to the decision making process by the decision maker”. Therefore social workers as agents of change attempt to alleviate inequalities and oppression within societies and need to be aware of the values underlying their work by referring to the code of ethics. By adopting values and anti-oppressive practice such as advocacy; social workers will be able to make informed decisions in addressing aspects, which relate to the provision of services to individuals who may have differing needs. Parrott (2010 p23) describes Anti oppressive practice (AOP) as “a general value orientation towards countering oppression experienced by service users on such grounds as race, gender class age etc’. AOP are also values of working in partnership and empowerment.”

“Social workers and their employers have an ethical duty to ensure that the organisations they work for operate in a just manner” Parrot (2010) Social work organisations therefore must uphold the portrayal that social work is something worthy and the operation of its organisation will lead to positive outcomes. The commitment to social justice ensures public organisations work under legislation to eliminate unlawful discrimination and to promote equality of opportunity and good relations between persons of different racial groups. Expectations of the social care employee are prompted by the GCSS code of conduct. For example in the case scenario discussed above if the attitudes of the usher was another social worker within an organization the social worker would act on guidance on policy procedure and ensure the commitment to social justice was withheld. If the other social workers attitudes towards service users resulted in unfair treatment and inequality of services than they are not upholding the ethical principles of effective practice stated in the IFSW (1994) “Social workers should recognise and respect the ethnic and cultural diversity of the societies in which they practise, taking account of individual, family, group and community differences.” S4.2.2 Therefore the other social worker would have a responsibility to Challenging unjust practices “Social workers have a duty to bring to the attention of their employers, policy makers, politicians and the general public situations where resources are inadequate or where distribution of resources, policies and practices are oppressive, unfair or harmful.”s4.2.1

If the other social worker is ethically aware and challenges injustice it is their moral obligation to bring to the attention of the organisation the other social workers behaviour. The social worker would participate in whistle blowing Parrot (2010) p154 defines whistle blowing as “The disclosure by an employee, in a government agency or private enterprise, to the public or to those in authority, of mismanagement, corruption, illegality or some other wrongdoing.” The organisation will then deal directly with the moral character of the social workers discriminatory attitudes.

In conclusion social work can be a challenging subject and one that will actively push the boundaries of all social workers on a personal level and professional level. It is agreed within social work that ethics, morals and values are all an inescapable part of professional practice and ‘Ethical awareness is a necessary part of practice of any social work’ (IFSW, 1994).aˆ? However as this assignment has discussed guides can be provided but inevitability it is up to the social workers discretionary judgement of the circumstances. Arguably It is therefore important as a social worker to be aware of the code of ethics, and to talk, discuss, debrief and debate with colleagues and supervisors about dilemmas they may be struggling with. Finally, the onus is on social workers to be reflective about themselves and how ‘self’ influences practice and decision making. To finish we have to be critically aware of personal beliefs and biases, bringing them to light so they do not unconsciously influence our practice decisions, leading to injustice and unfair distribution and access to services. Service users must be put at the heart of social work practice and it is our duty as social workers to take any necessary steps within our organisations to ensure mistreatment and inequality is brought to surface. We can therefore improve public trust within the social service profession and encourage service users to work in partnership to empower their lives.

References

Agency Safe guarding Policy, (2010)

Banks, S., (2006). Ethics and Values in Social Work .3rd Ed. Basingstoke: Palgrave Macmillan,

BASW (2001) The Code of Ethics for Social Work,

Beckett, C. & Maynard, A.,( 2005). Values and Ethics in Social Work: An Introduction, London: Sage

Biestek,F. (1971). The Casework Relationship, 7th Ed Unwin: University Books.

Clark, C. (2000) Social Work Ethics: Politics, Principles and Practice. Basingstoke: MacMillan

Class PowerPoint, Values and Ethics, Blackboard (2011)

Clifford, D & Burke, B, Anti-oppressive Ethics, Social Work Education, Vol. 24, No. 6, September (2005), pp. 677-692

GSCC (2002) Codes of Practice for Social Care Workers and Employers, London: GSCC

Horner, N. (2005) “What is Social Work? Context and Perspectives”. Exeter: Learning Matters

International Federation of Social Workers (IFSW) available at; http://www.ifsw.org/p38000324.html, accessed on 12/05/2011

Kemshall, H and Pritchard, J (1996) Good Practice in Risk Assessment and Risk Management. London: Jessica Kingsley Publishers

Loewenberg, F. and Dolgoff, R. (1996) Ethical Choices in the Helping Professions. Ethical Decisions for Social Work Practice, 5th ed., Illinois: Peacock Publishers:

Mattison, M. (2000) Ethical Decision Making: The Person in the Process Social Work Vol.45(3), pp.201-212.

Parrott, L, (2010) Values and ethics in social work practice 2nd ed, learning matters: Exeter

Pinker, R. (1990) Social Work in an Enterprise Society, London: Routledge.

Thompson, N, (2005). Understanding Social Work: Preparing for Practice. 2nd Ed. Basingstoke: Palgrave Macmillan.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Inter-professional Practice

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

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

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

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

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

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

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

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

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

Emerging Themes and Evidenced Based Practice

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

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

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

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

Conclusions

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

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

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

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

Word Count: 2530, apart from bibliography