Category: Free Essays

The Services Available to Disabled Children
Introduction

Disability is all too often seen as a social problem i.e. it is seen either in terms of personal tragedy or of blame. Disability has been theorised in a number of different ways, most of which locate the problem in the individual rather than the broader social, political, and economic influences. This has implications not only for the location of the blame for social problems but also for the ways in which services for certain groups are delivered and accessed. All too often access to services is hindered for children with disabilities and the burden of care is left to the family (Moore, 2002). In many cases it would seem that if a child has a disability then this is seen as a matter of private concern for families. The present Government advocates a mixed economy of welfare where welfare is provided in part by the state and partly by private companies operating for profit. The shift from public to private has received much publicity and contributed to social problems and to social exclusion (Giddens, 2001).The mixed economy of care (largely as a result of the 1990 NHS and Community Care Act) has meant that access to care for children with disabilities has become problematic. Thus families who are already stretched both financially and emotionally face further stress as the result of being unable to access appropriate care and services for their child. This tends to support the view that having a child with a disability results in the family as a whole being disabled by the unjust society in which it is situated (Fazil et al, 2002)..

Within the human services great emphasis is placed on the rights of the service user, and this discourse is also evident in Government debates on social support and caring for people with disabilities. All too often however, this remains at the level of discourse and is not followed through when it comes to policy making. This assignment will therefore undertake a critical review of research into the services available to disabled children to assess whether the problem is as broad as some theorists would have us believe, and what might be done to alleviate the problems faced by families who have a child with a disability.

Research Question

What services are available to children with disabilities and what are the difficulties associated with accessing them.

Protocol

The area of interest is children with disabilities. The outcomes are what services are available and what if any difficulties might be associated with accessing those services.

Objectives
To carry out a critical review of literature to discover what services are available to children with disabilities.
To ascertain whether it might be argued that perceptions of disability might affect what services are on offer and how these might be accessed.
To assess whether parents receive accurate information from professionals
To make recommendations
Search Strategy

A broad search was undertaken of the following:

Disability and Society

Community Care

British journal of social work – Child: Care, health and development

www.doh.gov.uk/research

www.socresonline.org.uk

www.jrf.org.uk

www.leeds.ac.uk/disability-studies/archiveuk/archframe

A broad search of Taylor Francis journals and Google Scholar was also undertaken. Key word and key word phrases were, disability, family, service users, disabled children, disabled children and their access to services, access to services for disabled children, effects of disability on family life.

Part of the problem for disabled children and their families has been an over-reliance on the medical model of disability which locates the problem within the person. Inclusion discourses and debates about discrimination tend to suggest that this pathologising of children with disabilities is further extended to their families for example Bowler and Lister Brook (1997) when speaking of children with Downes Syndrome say that:

The identification of a genetic basis for Downes Syndrome led many researchers to explore the possibility that there might be behavioural phenotypes in addition to physical phenotypes that result from specific genetic abnormalities (Lister and Brook, 1997 p.13).

Clearly this is locating the problem within the child and does nothing to improve perceptions of either the disabled child or his/her family thus discriminating against the family as a unit. Most of the studies looked at in the following review, and the ones concentrated on in the analysis, report distorted perceptions of disabled children and their families. They also report that services for disabled children are not consistent nor easily accessible.

The key concepts that were present in the literature were an assumption that people have plenty of extended family support, use of formal and informal care arrangements, any difficulties in securing access to appropriate services, and the effects that having a child with disabilities has on families. Most of the research indicated that across the board service provision for children with disabilities was at best patchy and at worst lamentable and that it was this, along with perceptions of disabled children and their families that affected access to appropriate services.

The review begins with an indepth assessment of three studies in particular and then reviews the concepts generally.

Families and Children with Disabilities

Fazil et al (2002) undertook a triangulated study (i.e. one that uses both qualitative and quantitative research methods) into the circumstances of twenty Pakistani and Bangladeshi families in the West Midlands who had at least one disabled child. The aim of the research was to try and understand whether and in what ways the discrimination that these families might face was compounded due to the fact that they had a child or children with disabilities. The researchers used a combination of structured questionnaires and semi-structured interviews to obtain their results. The research focused on parents’ experiences, their use of formal services, their material circumstances, and the ways in which having a child/children with disabilities affected their lives. A significant finding of this research was that while Government discourses centre on the integration of service provision in Birmingham (where these families live) there was:

The absence of systematic services which came across most strikingly (Fazil et al, 2002,p.251)

This view is supported by research undertaken by the Audit Commission (2003) whose findings suggested that across the country, rather than the integrated and joined up services that are promised, service provision was a lottery. How much service and what kind of services offered to disabled children and their families depended very much on which part of the country they lived in.

Clearly the move to make partnership working the norm does not always succeed. Molyneux (2001)^[1] maintains that this only works when certain guidelines are established at the outset. His research into successful inter-professional working established three areas that contributed to the success of such partnerships. Staff needed to be fully committed to what they were doing and personal qualities of adaptability, flexibility and a willingness to share with others were high on the agenda. Regular and positive communication between professionals was seen as endemic to good working relationships and service delivery. This communication was enhanced (in the study) by the instigation of weekly case conferences which allowed professionals to share knowledge and experiences (2001, p.3).

Dowling and Dolan (2001) undertook secondary analysis of a qualitative study using the social model of disability as an analytical frame. Disability is usually defined too ways, as a medical model where the problem is located in the person and the social model where the problem is located in society i.e. as a social problem. The researchers found that having a disabled child in a family could marginalize the whole family who then suffered from unequal opportunities and outcomes. Through their use of the social model of disability as an analytical framework the researchers found that these families often suffered financial hardship along with stress created by social barriers, prejudice and poor service provision.

Some studies tend to suggest that much of the care that is on offer is discriminatory – that is to say it takes the view that disabled children and their parents have a tendency to be over reliant on services. This article was a summary of the work undertaken in Leicester and it did not therefore, contain the views of parents and their children. Bush (2005) is a senior manager in children’s services and in his summary of what are called ‘inclusive’ services for disabled children he points out that the services are only on offer for a short while so as to discourage over-dependence on the service. This is not to say that some of the tasks undertaken by this partnership group are not beneficial, but there is no guarantee that any of the services would be ongoing.

Fazil et al (2002) focused on the problems faced by members of two specific ethnic groups, the study was included because it was felt that the problems and feelings expressed within the study were quite representative of the feelings and experiences of many parents who have a child or children with disabilities. Although the study was very small, consisting of only twenty people, the use of both qualitative and quantitative data gave the study a breadth that it might not otherwise have had. Certainly the implications of the study were that services are difficult to access and all too often professionals make assumptions about the level of care and support that parents are able to give – these assumptions were also made in relation family support systems that the respondents may have had. The research also found that lack of support and the continuing struggle to access services and make ends meet affected parents’ views of themselves and their abilities to cope.

Bryman (2004) has this to say about the use of both quantitative and qualitative methods

It implies that the results of an investigation employing a method associated with one research strategy are cross-checked against the results of using a method associated with the other research strategy (Bryman, 2004, p.454).

All in all the study was fairly well balanced, and did not for example, appear to exaggerate parent’s fears. The use of data triangulation tends to add weight to the findings of this particular study.

Dowling and Dolan’s (2001) study tends to support the findings of Fazil et al. There appears to be a common feeling that when families have a disabled child or children then they, along with their child, are marginalised. Such marginalisation leads to stress in families and problems in accessing care. In many cases professional assumptions about these families increase the stress involved in obtaining appropriate services and care. This in turn supports the findings of Gregory (1991) that perceptions of disability and the assumption of parental responsibility has a huge impact on family relationships and on respondents’ own views of themselves as parents.

Bush’s (2005) summary of a particular project in Leicester supports the idea that parent’s of disabled children are in some way responsible. The services in Leicester operate to help parents cope with their disabled child in the short term and then the onus is placed back on parents in the long term. The project aims to prevent what it terms as an over dependence on service provision. It seems to be the case that the feelings that the parents of disabled children have expressed in other studies are generated by the kind of services that treat parents as though they are trying to shirk their responsibilities to their children. This was a very short article that briefly described the services on offer, some of which would need to be continued even though they were only provided on a short term basis, for example physiotherapy. As the author of the article states:

Each intervention is administered with the intention of ensuring that the services are short-term and discourage dependency (Bush, 2005, p.128).

This may seem overly critical of the project because until its inception two years ago many of the services that it offers were not available at all in Leicester. The fact that even now they are only available in the short term tends to support the notion that access to services for disabled children is often problematic.

Access and Attitudes in Service Provision

Case (2001) found that parents of children with learning disabilities were often dissatisfied with the professionals with whom they came into contact and when services were provided they tended to be reactive to the problem rather than proactive in solving it. Perceptions of children with disabilities, and particularly learning disabilities are often devalued by society and this devaluation is evident in poor service provision (Chappell, 1997). King et al (1997) maintain that service provision often reflects how children with disabilities are perceived by medical and social work professionals rather than the needs of an individual child. This follows the view among many researchers that the medical model of disability is still at the forefront of most professionals’ minds.

The problem … is that medical people tend to see all difficulties solely from the perspective of proposed treatments for a ‘patient’, without recognising that the individual has to weigh up whether this treatment fits into the overall economy of their life. In the past especially, doctors have been too willing to suggest medical treatment and hospitalisation, even when this would not necessarily improve the quality of life for the person concerned. Indeed, questions about the quality of life have sometimes been portrayed as something of an intrusion upon the purely medical equation. (Brisenden, 1986:176).

The medical model leads to the treatment people with disabilities as passive objects of medical attention. This view is oppressive of people with disabilities and spreads to other social relationships, it sees disability as pathological i.e. rooted in a person’s biology, and thus unchanging. Contained within this model is the perception of people with disabilities as problematic. As an adjunct to this model, disability has been theorized as a personal tragedy, which means that individuals with a disability are seen as victims.

Treating children with disabilities as victims arguably leads to their becoming almost invisible in service provision. Goble (1999 cited in Case 2001)) maintains that the needs of disabled children and their families are often not addressed because issues that are important to service users, rather than service providers, are not really considered and are under researched. Hornby (1994 cited in Case 2001) has argued that professionals often neglect to provide parents with all the information that they should have when it comes to the needs of their child. If children with disabilities are to get the correct treatment and have access to appropriate services then the parents should be fully informed.

Clearly disabled children’s access to services is hampered by social perceptions and by the perceptions that professionals have. This has resulted not only in problems accessing services, but when services are accessed they are not always appropriate to a particular service user’s needs. Research tends to focus on perceptions of disability and the disadvantage that it brings but as yet there is little evidence of what disabled children and their families actually want from service providers.

Conclusion and Possible Policy Implications

The prevalence of the medical model of health and the ways in which families are kept under-informed regarding the disability of a family member, particularly a child, affects family relationships. It also affects the attitude that professionals may take to disabled children and their families. Gregory (1991) maintains that when a person is diagnosed as ‘disabled’ this affects the ways in which society and the family respond to and deal with that person. Families themselves can tend to see the disabled family member as ‘sick’ and different. Gregory (1991) found that having a disabled family member also affected the way in which mother’s viewed themselves because ideological images of motherhood focus on having an able child. Thus a woman may feel that she is somehow not a mother because of the ways in which society defines motherhood. While doctors may diagnose a physical or learning disability families are often left to cope without either sufficient information or professional help. In a number of cases families have reported that hospitals have refused to admit non-emergency cases unless a parent or carer remains on site to provide additional support (http://www.cafamily.org.uk/rda-uk.html). A shortage of nursing staff and the increasing tendency to perform surgery on a day care basis means that many families are left with extra caring responsibilities once they take the disabled child or adult home. (http://www.cafamily.org.uk/rda-uk.html).

In conclusion it would appear from the literature that service provision is sporadic and often not appropriate to the individual needs of disabled children and their families. It might be recommended that more research is needed into what users actually want from service providers and that perhaps as one study suggested users fare much better if they are assigned a single key worker who will liase with all service providers.

Bibliography

Bowler, D and Lister Brook S. 1997 “>From general impairment to behavioural phenotypes: psychological approaches to learning difficulties” in Fawcus, M ed Children with Learning Difficulties: A Collaborative Approach to their Education and Management London, Whurr

Bryman, A 2004 Social Research Methods Oxford, Oxford University Press

Bush, C. 2005 “Inclusive services for disabled children” Practice Vol 17 (2) pp 127-130 Routledge

Case, S. 2001 “Learning to partner, disabling conflict:”Disability and Society Vol 16 (6) pp 837-854

Coffey, A and Atkinson, P (1996) Making sense of qualitative data, Sage, London

Dalley, G. 1988 Ideologies of caring: Rethinking Community and Collectivism London, Macmillan

Dowling, M and Dolan L. 2001 “Families with children with disabilities: Inequalities and the social model” Disability and Society Vol 16 (1) Jan 1st 2001 pp. 21-35

Fazil, Q. Bywaters, P. and Ali, Z. 2002 “Disadvantage and discrimination compounded: The experience of Pakistani and Bangladeshi parents with a disabled child in the UK” Disability and Society Vol 17 (3) May 1st 2002 pp. 237-253

Gough, D and Elkbourne, D 2002 “Systematic research synthesis to inform policy, practice and democratic debate” Social Policy and Society 1 (3) pp. 225-36

Gregory, S. 1991 “Challenging Motherhood: Mothers and their deaf children” in Phoenix, A and Lloyd E, eds. 1991 Motherhood: Meaning Practices and Ideology London, Sage

Macdonald, G 2003 Using Systematic Reviews to Improve Social Care London, Social Care Institute for Excellence

Millar, J 2000 Keeping Track of Welfare Reform York, York Publishing Services for the Joseph Rowntree foundation

Molyneux, J 2001 “Interprofessional team working: What makes teams work well?” Journal of Inter-professional Care 15 (1) 2001 p.1-7

Moore, S. 2002 Social Welfare Alive 3^rd ed. Cheltenham, Nelson Thornes

Morris, J 2003 “Including all children: Finding out about the experiences of children with communication and/or cognitive impairments” Children and Society Vol 17 (5)

Oliver, P. 1990 The Politics of Disablement Basingstoke, Macmillan

Oliver, M 1996 Social Work with Disabled People Basingstoke Macmillan.

Such, E. and Walker, R. 2004 “Being responsible and responsible beings: children’s understanding of responsibility” Children and Society 18 (3) Jun 2004, pp.231-242

Swain, J. Heyman, B and Gilmour, M 1998 “Public Research, private concerns: Ethical issues in the use of open-ended interviews with people who have learning disabilities” in Disability and Society 13 (1) pp. 21-36

Walsh, M. Stephens, P. and Moore, S. 2000 Social Policy and Welfare. Cheltenham

http://216.239.59.104/search?q=cache:7JMuRPBUQgMJ:www.audit-commission.gov.uk/Products/NATIONAL-REPORT/EE944EBA-B414-4d76-903E-A4CA0E304989/Disabled-report.pdf+access+to+services+for+disabled+children&hl=en&ct=clnk&cd=6&gl=uk&lr=lang_en&client=firefox-a

www.doh.gov.uk/research

www.socresonline.org.uk

www.jrf.org.uk

www.leeds.ac.uk/disability-studies/archiveuk/archframe

1

The Disabled American Veterans is an association sanctioned by the US Congress for military disabled veterans of the US Armed Forces that helps them and their families through different means. It as of now has more than 1.2 million individuals. Charity Navigator does not rate the DAV as it is a 501(c)(4) association. It does rate the Disabled American Veterans Service Charitable Trust.

Debilitated veterans in the US in the result of World War I ended up truly impeded, with minimal legislative backing. A number of these veterans were deaf, blind, or rationally sick when they came back from the front lines. A surprising 204,000 Americans in uniform were injured amid the war. The thought to structure the Disabled American Veterans emerged at a Christmas party in 1920 facilitated by Robert Marx, a U.S. Armed force Captain who had been harmed in November 1918. Despite the fact that it had been utilitarian for a few months at that point, the Disabled American Veterans of the World War was authoritatively made on September 25, 1921, at its first National Caucus, in Ohio. While visiting over the U.S. as a major aspect of the election battle of James M. Cox, Judge Marx promoted the new association, which immediately extended. It held its first national tradition in Detroit, Michigan on June 27, 1921, at which time Marx was selected the first national administrator.

In 1922, an auxiliary women’s organization was established. The DAVWW continued working through the Great Depression to secure the welfare of disabled veterans, despite the fact that their efforts were vexed by fundraising challenges and the desire of the public to put the World War behind them. In the midst of these agitated years, DAVWW was issued by Congress federal charter, on June 17, 1932. The demands of World War II required the pressing expansion of the organization, which officially transformed its name to Disabled American Veterans to recognize the impact of the new war. In 1941, DAV propelled a direct mail campaign, distributing miniature license plates which could be joined to a key ring with instructions that lost keys should be mailed to the DAVWW, who would return them to the owners.

In 1944, the DAV started offering a National Service Training Officer Program at US University in Washington, the first venture of training that finished with a two-year mentorship program. In 1945, the DAV extended the program and accumulated the assembling house, inevitably buying complete responsibility for program in 1950. The program demonstrated dependable and very effective, both in acquiring donations and utilizing veterans in production. By 1952, 350 individuals were utilized in the endeavor, which acquired over $2 million a year in donations. In the mean time, the quantity of disabled veterans had been expanded by the as yet progressing Korean War.

The DAV suffered a decrease in the later 1950s and into the 1960s, with lessening funds and leadership; however it energized around the veterans of the Vietnam War furthermore concentrated intensely on living up to expectations for detainees of war and lost in action. Vietnam veterans soon filled the decreased ranks of the National Officers Service. On Veterans Day, 1966, the DAV moved its central command to Cold Spring, Kentucky. The accompanying year, the IdentoTag program was ceased for giving location marks, with an appeal for gift, when changes in license plate rehearses made proceeding with the IdentoTag program impracticable.

The DAV experienced generous change in 1993, when inner contentions concerning the administration of the association prompted a watershed election that turned over the organization to new hands and the National Program was redesigned. In 1998, DAV National Wilson Arthur joined with Lois Pope and for Secretary for Veterans Affairs Jesse Brown to push for congressional approval of the American Veterans Disabled for Life Memorial. When fundraising was finished in 2010, the DAV and its offshoots had raised more than $10 million for the memorial. Dedication of the memorial is situated for October 5, 2014.

This mission of DAV association is to give free proficient aid to veterans and their families in getting advantages and administration earned through military administration by the Department of Veterans Affairs (VA) and different organizations of government. It likewise gives effort concerning its program administrations to the US individuals by and large, and to disabled veterans and their families particularly. Broadening DAV’s central goal of trust into groups where these veterans and their families survive a system of state-level offices and neighborhood sections; and giving a structure through which disabled veterans can express their empathy for their kindred veterans exhaustive a variety of volunteer projects.

The Disabled American Veterans Organization gives administration for nothing out of pocket through an across the country system of 88 DAV National Service Offices. The Disability Assistance Transition Program administration give free help to administration individuals at Intake Site areas at military establishments by Disabled American Veterans Transition Service Officers with treatment records, recording introductory cases for VA profits and meet with the U.S. Division of Defense, the U.S. Bureaus of Veterans Affairs and U.S. Division of Labor facilitators and different members in the move process from military life to regular citizen life.

Numerous outreach programs like DAV’s Mobile Service Office, Veterans Information Seminars, Homeless Veterans Initiative and Disaster relief grants. The Mobile Service Office Program is designed to bring assistance for disabled veterans and their families living in geographic provincial areas on veterans’ benefits, documenting claims and services closer to home by taking out long trips for veterans to the National Service Offices. This outreach project is design to instruct veterans, their families and survivors who are unconscious of veteran’s legislature benefits and programs, counseling and claims recording assistance service by DAV’s National Service Officers (NSO) at communities all through the nation.

The Disabled American Veterans Homeless Veterans Initiative is supported by the DAV’s Charitable Service Trust and the Columbia Trust, This activity promotes the advancement of supportive housing and necessary services to assist homeless veterans get to be gainful, self-sufficient members of society. DAV Disaster relief grants may be issued with the end goal of giving: nourishment, attire, and transitory shelter or to acquire relief from damage, illness, or personal loss resulting from regular or national disasters that are not secured by insurance or other disaster relief agencies. Since the DAV disaster relief grants program commencement in 1968, $8.7 million has been disbursed to veterans that suffered losses amid characteristic disasters.

References:

STEVE WILSON, Have a financial plan before transitioning, 2015

Wilborn, Thom ,“Architect of Modern DAV Retires”, May 2, 2013.

Orkin, Lisa Emmanuel, “Disabled Veterans Memorial has DC Groundbreaking, 2010.

The aspect of social work practice I feel most difficult to perform is the gerontological social work. This paper would firstly describe the context of social work practice with old people. After that, I would exam the reasons preventing me from effectively conducting helping process by evaluating my attitudes, emotions and experiences as well as by reviewing professional literature on social work practice with old people. In the end, I will shape a personal plan on how to address this weakness in the future.

Keywords: social work practice, aged, difficult aspect

Reflection Paper on Difficult Part of Social Work Practice

There is a universal folk saying that everyone wishes to live a good long life, but no one wishes for old age. Although in virtually every helping process attempt, social workers bring their own emotional or cognitive influences to intervention, I feel especially difficult to perform in the interventions dealing with older adults.

Describing the context of social work practice with old people

With the development of medical and health care and with the baby boomer generation’s entering into their old years, the aging of population in the twenty-first century has become increasingly concerned by more and more people. In responding to the drastic transformation of social institutions such as elderly social service and health-care system, the social work practice with old people turns out into one of the most popular social work aspect today.

Apart from the well-known nursing homes and hospital, there are other settings for gerontological social work as well. Geriatric care management, community social service agencies, adult day health care, legal services??home health-care agencies , macro settings for gerontological social workers and community planning also play their active roles in serving the older adult in a variety of ways.

The gerontologiacal social work, which needs high level of self-awareness, commitment and professional skills, is somehow a complex mission for us to carry. Many social workers admit that social work practice with old people is both challenged and exciting for the reason that, at one hand, it reminds of feelings about death, aging of our family and one’s own attitudes toward helping the disadvantaged and vulnerable old adults; on the other hand, it also presents joys and delightful pictures and makes us think more about ourselves.

Root of difficulty
Review own personal factors

Among all the factors that influence my ability to perform this particular area, the subtle effects of my social and personal massages and the counter-transference feelings of old people would be matters of cardinal significance. Furthermore, I also affected by my characteristics and cognition to certain kind of old people.

Stereotypes. When I was a child I always heard people saying that old people are vulnerable and need help, and older adults are less valuable as human beings because they have to rely on their children. At home, I was asked to behave properly and not offend grandparents; otherwise I would get scolds and punishment. While at school, I was required to help older people for that they have trouble getting around. These stereotypes toward elderly are usually negative for me and imply an attitude or unintentional message that old people are hard to take care of, stubborn, old-fashioned and unpleasant.

Consequently, I always feel that I cannot handle the relationship with older people well and they will not like me. I feel uncomfortable in front of many of my eldership because I do not know how to keep conversations going with my poor eloquence and interpersonal skills. Even though I understand ageism is a destructive social justification when I grow older, I still cannot change the comments I once made on aging and I am a little bit afraid of old people to some extent.

Personal emotion factors. I am by nature a sentimental and emotional person from an early age. My grandma passed away when I was in primary school. She left me even before seeing my admission into university and engagement with my fiance. I always think that if she could see these, she would be very pleased and also, I would be the most delight person in the world. She always lived a difficult life when she was young and did not enjoy much in her late years. Sometimes all my family members would feel guilty for missing the chance to treat her well before she left us.

As a consequence, when facing the dying older people, especially female elderly suffered from chronic disease or cancer, I inevitably feel urgent to ‘save’ them and so scared to face the truth that they will eventually die someday. I doubt myself about what I can do for them and I am so scared that they will leave me before I can do anything right or helpful. In fact, that is one of the most difficult challenges in social work practice for me.

Real understanding of old people. As a social worker, I appreciate that getting old does not inevitably mean the loss of intelligence, memory and cognitive functioning. I also understand that developing a level of understanding is necessary from a social worker standpoint, and it helps me to anticipate client needs and perform an ongoing self-critique in order to improve and grow my helping process. However, many times I feel I am not able to truly understand them and consider things from their perspective of views as I never experienced true aging. Many decisions I made somehow reflect my own perception of the situation such as to decide whether an old adult should stay in own home or hospital, or to conclude that an older person is showing poor judgment about financial decisions. Furthermore, it would be even harder to perform my role as a social worker when a balance between the opinions of the older adult himself, his family and the social worker need to be achieved. This obstacle prevents me from behaving more successfully at building a sustainable relationship with elderly clients and I simply do the work and move on.

When everything needs more time and patience. With the tight time schedule and many objectives to be accomplish, sometimes a social worker needs to be in a hurry to push on the intervention process. And some other times even if I have explained many times, it is still necessary to have extended periods describing complicated appointments to older clients. I always tend to speed it up although in that case, in order to attain my goal I should slow down to give them more time to think about the process. Lack of patience would be another problem preventing me from effectively working with elderly or even almost every aspect of social work practice.

Reviewing the professional literature

Many social workers admit that, even though both meaningful and satisfactory, working with elderly people can need a high level of self-awareness and self-discipline. The truth that everyone must eventually face the developmental stage of aging and death for themselves and their families may contribute to the anxiety and complexity of the helping process, as social work practice in the aspects of domestic violence or drug abuse may not personally affect worker. This can impact workers with older clients on both a conscious and subconscious level.

Ageism and Death Anxiety. In most cultures around the world, particularly the Chinese culture, people feel uncomfortable when deal with death or anything related to death. From an early age, children are asked to avoid to talking death and dying, and to replace the word death with phrases such as “passed on,” or “gone on to another world”. Therefore, the social workers dealt with older people may require more self-control and comfort on the acknowledging the real pain caused by the loss of human life of family and friends.

The anxiety of aging and dying process on one’s own work, combined with generally indisposed experiences about the proximity of death surrounding older adults, bring about some social workers’ avoiding work with the aging. According to the Hong Kong Social Workers Registration Broad’s data gathered from its members about their areas of practice, despite older adults make up about 12.8 percent of Hong Kong population, less than 6 percent of social worker identify gerontological social work as their field of practice, which compared to nearly 30 percent for mental health.

Countertransference. The reactions, real, and unreal, to a certain individual can occur irrespective of origin and can be based on one’s own past or present experiences or characteristics. Counter transference can be described as social worker’s reactions involve feelings, wishes, and unconscious defensive patterns onto the client. In the professional relationship with old people, a social worker may place negative feelings or dislikes of older persons onto the client, which restrict his willingness (no matter consciously or unconsciously) to continue investigating and result in impatience or intolerance of the aging. On the other side, old clients who evoke images from one’s past such as parents, grandparents or other elderly family members can make process even more arduous to advance as a result of ‘destructive’ sympathy and the ‘need to save an older person’.

The Independence/ dependence fight. Old people want to maintain their independence to make decisions while the social worker commits to promote self-determination and dignity of the individual. But things are not that simple. When an elderly claims for increasingly supporting service and experiences growing difficulties to maintain independence on his own, it will be confrontational to live up to the elderly expectations.

McInnis-Dittrich (2008) states ‘A worker can appreciate the desperate efforts on the part of an older adult to stay in his or her own home. Yet when an older adult is struggling with stairs or a deteriorating neighborhood, and difficulties in completing the simple activities of daily living challenge the feasibility of that effort, professional and personal dilemmas abound.’ This is a good example to understand that sustaining independence in the gerontological social work is a critical goal which has no simple good answer.

Private functions become public business. Discussing the topic such as an old woman’s bladder and bowel functions or an older man’s maintaining an erection or urinating with clients may cause awkward and uncomfortable resistance when social workers and other helping professional get involved. Therefore, sometimes it is important to be sensitive to the deeply personal nature when social workers try to acquire necessary comprehension of an older adult’s health conditions. A better understanding of interpersonal skills and psychosocial adjustment to aging would be helpful and essential.

Personal plan to address this weakness
Overcome stereotype influence

First of all, I hope that from now on I will pay more attention to those featuring active, healthy, productive, and successful older persons so that I will develop a balanced understanding about aging and elderly. Aging is not painful and debilitating. Many wise, gracious, and humorous elderly have made admirable contribution to the world and have shown remarkable strength to achieve a positive as well as enthusiastic life.

Secondly, another important thing for me is to keep the lines of communication open with older adults. If I can open my heart to communicate, they will share more with me. The stronger relationship between us will help me cope better with the stereotype challenges.

Last but not least, in my future helping process I will often ask myself: ‘does it reinforce stereotypes again?’ I should start from every thing in daily life to alter the attitude that hinders my ability to face the normal changes of aging. Make a change in attitude is not easy, but I will try my best to drive myself on the right direction.

Awareness and Introspection

Awareness of the emotional influence is the first and the essential key to solve my problem. How well do I manage my own anxiety with this client’s situations should be my first concern. I will always remind myself that do not be affected by my experience and differentiate my experience of losing a family member from the intervention my client. That will help me to distinguish between the older people’s need and my own need and, to remain focused on the clients’ need.

Furthermore, I could seek help from colleagues and supervisors as well. By discussing the situations with them, I can expose and explore my own feelings and get advices in order to effectively facilitate help process.

To truly understand elderly

Above all, I will try to get in touch more with old people to truly feel their emotional and cognitive problems, as well as to open my heart and listen to them. Maybe I can join them more in their music, art activities in communities. Aging does not necessarily mean the loss of memory and cognitive capacities, and I will try to explain the information in a variety of ways so that we can build understanding relationship.

Moreover, reading more books about the psychological problems of the elderly would be really useful to analyze their psychological changes and behavior patterns. Equipped with a better look at the findings from professional social workers, I will more effectively comprehend the aging process the distinguishing features of elderly.

Finally, I should learn from experienced social workers to get more suggestions when I feel difficult to continue. For one thing, they can improve my ways of carrying intervention by pointing out my mistakes. For another, they can help me understand and get the most from their strength and weakness by providing convenient and professional advice.

When the National Health Services (NHS) was founded in 1948, one of the principles was to provide complete services to all and free at the time of need in UK (nursing times.net 2009). Access to healthcare services is based on clinical needs of an individual and not the ability to pay the services. This means everyone has the rights of accessing to health and social care, although it is still a major problem for low social group and ethnic minority who are facing personal, socio economic, cultural and problems happening as results of the structure of health and social care processes (POSTNOTE 2007).

In this essay, a case study will be used to demonstrate a patient with learning disability who faces various problems during his access to health and social care services and factors that contributed to these problems. Also it will focus on how nurses could support these individuals to make decisions about their care. The meaning of learning disability will be explained. The assignment will also look at major cultural and social economic influencing the health and health choices of individuals. Also it will analyze the differences between health education and health promotion and with their importance in individual in accessing health and social care. The challenges inherent in meeting the needs of people of varying abilities and social backgrounds will be look at as well as the factors that trigger the accessing of multi-professional health and social service. The essay will also discuss the understanding of the legislation related to the provision of health and social care, as a nurse why are we needed to be aware of the inequalities in provision. A name mentioned in the case study has been changed in order to comply with the code of NMC (2008) and consent was obtained from the patient and the name Anil will be used in stead.

Anil is a boy of eighteen years old who came to UK from South East Asia seven years ago. He lives with his parents in the housing estate of East London where majority are ethnic from South Asia. His father who earns minimum wages works in a food factory in six days a week, speaks English and his mother is a fulltime housewife and does not speak English, only Hindu.

Anil was born with Asperger syndrome, a lifelong disability that affects how a person makes sense of the world, processes information and relates to other people. People with Asperger can find difficult to communicate and interacts with other (NAS 2010). Anil had never been to hospital in India and he was treated by traditional healers. He only started seeks medical assistance when he moved to UK. Anil physical condition has deteriorated recently. He does not eat well; look tired, sometimes suffered headache and finding difficult in sleeping. Since he came to UK, he had been to school for three years only and he never had friends. He does not mix well with other people and his parents do not bother about this. At times he lets himself become a little neglected.

Anil represents a small and vulnerable group in a society who find difficulty in accessing and using health and social care because of the greater health care needs they have than general population. Motor and sensory disabilities, Epilepsy, hypertension and Alzheimer’s disease are some of the conditions that are common in this group (NURSING STANDARD 2010). The MENCAP report (DEATH IN DEFFERENCES 2007) states that people with learning disability are being treated wrongly in all part of healthcare provision and they are not equally valued in the health services. The government also revealed that people with learning disabilities are poorer particularly uptake of invitations on primary care and hospital provisions such as access screening services (ALD 200/01). Because of their greater needs of healthcare, they are more prone to a wide variety of additional physical and mental health problems as it shows to Anil. According to Tudor- Hart (cited in Hart 1985) there is an increasing in evidence of an ‘inverse care law’ where those who needs are greatest get the least.

Learning Disability is a life long condition which has a significantly reduced ability to understand new or complex information and it is vary from one person to another. The World Health Organization (WHO) defines learning disability as impairment of the body function which limits the activity of an individual in performing a task or action (WHO 2010)

According to Thomas and Woods in their book ‘Working with people with learning disabilities 11(2003), a learning disability is a terminology used to label people with lower level of intellectual that is lower than the average to normal people in the society. The term itself was widely accepted in England following a speech in 1996 to MENCAP by Stephen Dorrell, the then secretary for Health. From time to time the title and labels have changed and this has been driven by several influences. The term used to cover children with specific learning problems that may arises from a number of different things like emotional problems, medical problems and language impairment (BILD 2004). In the past, many people with learning disability were lived in institutions and have been labeled differently by their generations. Many different forms of terms have been used before. Terminology such as menace, sub- human organism, unspeakable objects of dread, holy innocent, diseased organism, eternal child and many more (WOLFENSBERGER,1972). There are about 1.5 million people with learning disability in UK who require different levels of support (MENCAP). It has been identified that approximately 26.5% of people who have learning disability as being associated with genetic factors (Craft et al 1985).

Learning Disabilities is caused by problems during brain development before, during and after birth (RCSLT 2009). There are different types of learning disabilities some of which are Asperger syndrome (a specific type of Autism) which affect a person the way interact to the world, reading disabilities, writing disabilities, non verbal learning disabilities (NVLD) and many more (ALD 2000-2010), reading disability (dyslexia), speech and listening disability, and auditory processing disorder. It is often detected in early childhood.

In UK there are laws and policies which describe how the needs of people with learning disabilities should be met. The purpose of these laws and policies is to improve quality of life and based on empowerment, making choices and decision, having the same opportunity and rights as other people and social inclusion. Policy such as` valuing people’ which explain how the government will provide same opportunity and choice for people with learning disabilities and their families to live full and independent lives as part of their local communities and to ensure they gain maximum life chance benefit ( DOH 2010).

The Disability Discrimination Act 1995 which is a piece of legislation promotes the rights of people with learning disabilities to access healthcare and other care services. Healthcare providers must respect, support them and their families and conforms to professional standard (NHS 2006). It is the NHS duty to make sure they provide an equal service that can be easily accessed by anyone according to this Act.

Most of the people with learning disabilities have sensory and physical impairment that make it hard to make their choices and to understand by others. A piece of legislation which protects them in England is Mental Capacity Act 2005 which is empowers and protects vulnerable people who are not able to make their own decision. People with learning disability will still have the right to give their consent for daily living and accessing the services despite of having significantly reduced ability to understand new learning skills (NURSING STANDARD 2010). If the person lack a capacity of giving or refusing consent, it is still possible for care providers to provide care and treatments for the best interest of the person (DOH 2003). A survey showed that nearly 62%of all people with learning disabilities depend on their parents and other caregivers (EMERSON et al 2005).

However, healthcare providers have a duty to understand and recognize the needs of a person with learning disabilities and make sure their needs are met. It is a nursing role to work in partnership with the clients to overcome barriers by identifying what management and decision to represent the person mostly professionally although clients and their cares may make their own decision.

People with learning disabilities in lower social classes are particularly disadvantage relative to the higher social classes in accessing healthcare services because of physical, social, psychological and economic barriers that limit their full participation in society. Acheson (1998) identified the links between inequalities and poor health. He noted that health inequalities were widening with the poorest in society being more affected than those who are well off. The post code lottery which depends on where you might live is a big issue in NHS. The availability of better treatment, drugs and waiting time in a deprived area where people depend on state healthcare provisions will carry on experience poor access to services and treatment than those who have the power of buying services in private services (GUARDIAN 2000).

People from ethnic backgrounds experience healthcare service differently due to their lack of knowledge which can be limited by the ability to communicate in English. They may find challenge to enter healthcare services because it may require, for example making a telephone call, appointment, coping with a queuing system and complex procedures ( NHS 2006). Different in culture’s attitude and stigma between where they came from and UK can impact Anil’s health. It is believed that South Asian parents don’t have positive attitudes towards disabilities because religious and superstitious beliefs (ROYAL COLLEGE OF PSYCHIATRIC 2003). Anil’s parents might not take his problem seriously because of their background and social stigma of having a child with disability (AUTISM-INDIA 2008).

According to the report of Department of Health (2009) a review in development in tackling health inequalities of Acheson, recommended the improvement of living standards of people with lower income than average. Among the people in this group are people living in a deprived area and depend on social housing. Also people with learning disability may fail to get the necessary services because of lack of understanding about health issues articulating their needs based on their poor experiences of education system (Mathews 1996).

Research carried out by Cartwright & O’brien1976 found that General Practitioners spend far less time with their patients from lower classes ( cited in Hart 1985,p59). The situation may be more complex for service users who have little or no verbal communication and those with learning disability. A learning disability person may be unable to identify and describe the signs and symptoms requiring accurate medical attention. The information may not be presented in accessible format and the staffs may ask questions which can not understand (NURSING STANDARD 2010).

Unavailability of an experience interpreter in the healthcare settings can be barrier. It can affect the sensitivity of patient’s values and attitudes. To use a professional interpreter can reassure patients to communicate and feel freer when describing their religious beliefs and unsatisfactory environment conditions but to healthcare professionals may feel disempowerment and may depend on interpreters in order to carry out their roles (ROYAL COLLEGE OF PSYCHTRIC 2003).

Sometimes physical access may be an issue for people with learning disability; they find their appointment times are often too short to understand the system because of their difficulties and transport needs to access healthcare facilities are more distant. Practitioners may be given job in deprived areas with all facility available but they may be in the risks of vandalism, theft and anti social behavior (Thomson J et al 2003 p59).

The aims of the government today in UK is convince individuals to be more involved in their health. But the problems with availability of health promotion services and involvements are some of concern due to the restructuring of health and social care for people with learning disabilities has been accelerated by NHS and community care Act (DOH 1990, Emerson Et al 1996 chap 11). For example, most of the health promotion discussion and activities to accessing suitable primary healthcare is focus on medical involvements such as immunization (Stanley et al 1998 p71). Some of this medical approach can lead to reinforced dependency for people with learning disabilities. Those with severe learning disabilities, their needs are becoming known to service providers through secondary and tertiary care after being referred by primary care. Among health promotion is prevention which is focusing on decrease of risk occurrence of diseases, disabilities and handicap. These activities occur in health care settings. Primary prevention is to prevent from risk factors such as obesity through education, exercise and diet. Primary prevention produces information on various health issues in pictorial and easily understandable format such as cancer. On secondary prevention, it involves identifies early signs of diseases occurring such as cancer screening and tertiary prevention is involves reducing the impact of the disease and promoting quality of life through active rehabilitation (Thomson et al 2003).

Anil’s state of confusion may be caused a number of factors which might need further investigation. It is the duty of his General Practitioner (primary prevention) to refer him to hospital (secondary prevention) for investigation. A consultant may decide whether Anil has physical or mental illness.

To deal with and removing barriers such as difficulty with interpersonal communication, health promotion will need to promote inclusion and reduce inequalities in service provision (Thomson et al 2003 p129). World Health Organization (2010) has made it clear that health promotion is the process of enabling individual to improve and increase control of their health. Many primary healthcare professional do not have skills to overcome this problem as results those people who have learning disabilities are less likely to receive lifestyle advice than those who do not have learning disabilities (Fitzsimmons & Barr 1997). Learning disability nurses have a variety of skills in communication and observations which could be useful to teach other healthcare professionals in health and social care settings (Thomson et al 2003 p131)

Health education as a part of health promotion is defined as a planned communication activities designed to attract well being and ill health in individuals and group through influencing the knowledge, belief, attitudes and behavior of those in power of the community at large (Tannahill 1985p167-8). For people with learning disabilities, health education might promote social inclusion through decreasing negative stereotyping by valuing and respecting their needs. On a more individual level, people who receive health education messages have a choice to decide whether to follow or not the message given (Thomson J et al 2003).

Building partnerships between nurses, careers, other professional and people with learning disabilities is essential in order to promote and educating health by identifying their physical and mental health condition (DOH 1995). A partnership is not only the way to bring up to date statutory services but also is about developing and acknowledging the collective responsibility for the health and wellbeing of the community which they belong (Thomson J et al 2003, p102).

Having the opportunity to make choice about their healthcare is critical to their sense of inclusion in society. It is also a key factor in allowing individual like Anil to feel in control of his life. The NMC (National Midwifery Council) code of 2008sets out number of responsibilities on nurses to promote choice and respect the decisions of those they care. Nurses need to help them making their choice by making some simple adaptations. The first step can be taking a little more time to explain something and giving the person with learning disability more time to understand what is being said (NURSING STANDARDS 2010, P53).

Other approach could be the involvement of relative or paid career not to make choice on behalf of the person with learning disability but to use their knowledge of the person to help the care professional interpret or to explain treatment options. In all this processes, nurses need to ensure that they obtain consent before they begin assessment and treatment. Any decision to be taken by the staff must be in the interests of the person and must regard to his or her human rights.

To conclude, the essay has set out key difficulties experienced by people with learning disabilities in accessing healthcare services and the gap between rich and poor who are accessing healthcare appear to be widening. People who have learning disabilities are generally underestimated and find themselves failure to succeed their expectation. They experience more health problems than any other group in a society but use healthcare services less than the general population (RODGER 1996). Inequalities in health for people with learning disabilities must be dealt with by healthcare providers in health care provision with the aim of closing the division between the general public experiences and this group. By using good quality of health care and respecting people’s rights to access, and making reasonable adjustment, the lives of people with learning disabilities can be changed. Healthcare providers have a duty to ensure that people with learning disabilities are offered regular checking and are included in health screening program.

This essay discusses on the different types of discrimination and the different coping strategies or behaviours used. The Oxford Dictionary defined discrimination as the unwarranted or hurtful treatment of different groups of people, especially on the grounds of gender, race or age. Coping is defined as a change in cognitive and behaviour to evade harmful event. Discrimination affects an individual physically, mentally and emotionally. Studies have shown that discrimination can lead to depression. However, there have been various coping behaviours that have been identified to help victims of discrimination. Further studies need to be conducted to address other types of discriminations such as old age, disabled, workplace and others.

Keywords: Racial Discrimination, Gender Discrimination, Coping Behaviours

Discrimination and Coping

Discrimination has been present for hundreds and hundreds of years. Discrimination is defined as the unwarranted or hurtful treatment of different groups of people, especially on the basis of gender, race or age by the Oxford Dictionary. Acts of discrimination can be witnessed through many historical events such as the Holocaust, where the Jews were discriminated and murdered because the German’s believed that they were superior. Not only that but, the blacks were also a target of discriminatory acts during the Civil War where they were forced to become slaves. However, there are various ways to cope with discrimination. Coping is defined as a change in cognitive and behaviour to evade harmful events (Rantanen, Mauno, Kinnunen & Rantanen, 2011). There are many causes of discrimination.

In the western world, history is marked by BC and AD, however there was a third category which is 9/11. 9/11 marked a very tragic day in the history of United States as that was the day when the al-Qaeda launched an attack on the United States by hijacking planes and crashing them into the World Trade Center and The Pentagon. Post 9/11 witnessed a rapid increase and all time high report of discrimination, hate crimes and religion profiling (Ahluwalia & Pellettiere, 2010). Many Sikhs became the target of prejudicial and discriminatory act as they resembled the appearance of the terrorist whom wore turbans. Turbans are worn by the Sikh as a sign of faith. Therefore the Sikhs became the target of racial discrimination due to the media constantly and continuously portraying images of suspected terrorist wearing turbans. (Ahluwalia & Pellettiere, 2010).

Not only that, but it was mandatory that baptized Sikhs carry a kirpan. Kirpans are dagger liked shaped and is a symbol of peace and truth. There were such cases where the Sikhs residing in United States were sacked, downgraded, placed under probation and even came across false criminal charges due to them carrying the kirpan (Ahluwalia & Pellettiere, 2010). Due such unexpected events occurring, the Sikhs were forced to go against all their believes in order to lead a risk-free life. No stones were left unturned post 9/11 as the innocent Sikh children experienced the backlash of this event. Majority of the Sikh students in New York testified to being abused at schools due to their religion and country of origin (Ahluwalia & Pellettiere, 2010).

The September 11 attacks did not only impact the lives of the Sikhs in the United States in a negative way, but also the Muslims. A good number of atrocities took place on the streets, in convenience stores, petrol stations, educational institutions and at mosques (Abu-Raiya, Pargament & Mahoney, 2011). Many Muslims reported that they stayed indoors as they feared that they would be a victim of hate crime. Not only that, but many Muslims were concerned about their future in the country (Abu-Raiya et al., 2011).

Due to the sudden change in their environment, the Sikhs and Muslims had to find various coping methods to overcome these negative outcomes. Various research discovered that the Sikh would seek out assistance from their family, community and faith before pursuing mental health facilities (Ahluwalia & Pellettiere, 2010). The pious Sikhs seek assistance from their holy scripture the Guru Granth Sahib. This holy scripture taught them to oppress the feeling of being a victim and take control of the situation when undergoing superficial suffering such as discrimination and biasness. On the other hand, there were many Sikh men who decided that they could no longer handle the constant abuse and discrimination and made drastic changes against their culture such as cutting their hair and choosing to not wear turbans.

Similar to the Sikhs, the Muslims depended extensively on coping method related to religion such as reciting scriptures, praying and forgiveness. Research evidence found that religious behaviour increased post 9/11 attacks. There were two patterns in regard to religious coping; one pattern was positive religious coping methods and another was negative religious coping methods (Abu-Raiya et al., 2011). Researchers concluded that positive religious coping resulted in posttraumatic development whereas negative religious coping resulted in loneliness and mental instability (Abu-Raiya et al., 2011)

Asian Americans were also a target of discriminatory act pre 9/11. From way back then when Asians first stepped foot in America till now they have been faced with racism and discrimination. One might consider that discrimination against Asian-Americans might reduce as their population gets larger, however, that is not accurate. Asian-Americans are faced with discrimination on a day-to-day basis right from discriminatory terms to physical abuse (Yoo & Lee, 2005). Research validates that ethnic identity operates as a vital psychological asset that allows ethnic and racial minorities to fight against racial discrimination (Yoo & Lee, 2005). Therefore, we can see that having a strong ethnic identity and believe in one’s culture can help an individual overcome discrimination.

Another study investigated the relationship between racial discrimination stress and depressive symptoms and various coping strategies. Research suggested that the understanding of the intricacy in the involvement between perceived discrimination and health can be broadened by combining other factors into the model (Wei, Heppner, Ku, Liao, 2010). Racism and discrimination can negatively have an impact on the psychological health of their victims. Asian Americans very often encounter prejudicial insults, intentionally and unintentionally ( Alvarez & Juang, 2010). Continuous exposure to such insults and actions can take a toll on a person. It was reported that continuous taunting were positively correlated with depression ( Alvarez & Juang, 2010).

The level of coping with discrimination can be influenced by several extrinsic factors such as how frequent the discrimination occurs, the period discrimination occurs and the various types of coping behaviours either before or after the event. Research evidence also presented a previous study that was conducted by Noh and colleagues (1999, 2003) whom investigated both the individualistic coping behaviour of the Western culture (active coping) and the collectivistic coping behaviour of the Eastern culture (forbearance coping) (Wei et al., 2010). Noh and Kaspar (2003) identified that active coping helped decrease the perceived racial discrimination on depression for Korean Canadian immigrants. It can be concluded that Asian Americans should learn to practice active coping strategies by viewing the stressor in a positive way that will help develop their mental health.

Approach-type coping is another coping strategy that can be utilized to overcome the after effects of discrimination. This is then categorized into three common forms which are social support seeking, cognitive restructuring and problem solving.Social support seeking is defined participating in behaviour directed at gaining emotional support from others (Yoo & Lee, 2005). For example, an individual should open up about how they are feeling instead of oppressing everything inside. Another type of coping strategy is cognitive restructuring. Cognitive restructuring is defined as tactics that alter the significance of the harmful event and make an effort to perceive it in a positive way (Yoo & Lee, 2005). For example, an individual should view a discriminatory act as motivating and not de-motivating. Not only that, but problem solving is another coping strategy that is defined as participating in behaviour oriented at solving an issue (Yoo & Lee, 2005).

Similar to other studies, families play a very crucial role in helping victims of discrimination cope with their lives. Asian Americans have a tendency to cope with racial discrimination by communicating and socializing with their family members (Wei et al., 2010). Many cultures have faith in their religion and often turn to spiritual coping. However, it was discovered that Asian Americans did not patronize their religion and spirituality and reported it to be not constructive in coping with discrimination (Wei et al., 2010). This could be due to Asian Americans feeling more comfortable and protected with verbal support as compared to spiritual and mental support.

Other studies reported different types of coping behaviour. One study extensively classified coping as either problem focused or emotion focused. Problem-focused coping would require a confrontation with the offender whereas, emotion-focused coping would require pursuing social support (Alvarez & Juang, 2010).

Workplace sexual harassment is also a form of discrimination. Woman are more prone to this type of discrimination as they are often seen as the weaker half. Sexual harassment has been proved to negatively affect workers psychological and physical health. Not only that, but it has been identified that sexual harassment ended with female workers undergoing deterioration in their physical and emotional well-being ( Schneider, Swan & Fitzgerald, 1997).

Female workers often turn to various coping strategies to cope with workplace discrimination. Research implies that women do not use direct coping strategies such as confronting the harasser. Not only that, but it is proven that female students who undergo workplace discrimination often change plans, change workplace in order to avoid being further discriminated (Schneider et al., 1997)

Another discrimination that should be addressed other than racial discrimination is sexual discrimination. The current era has a predisposed thought that same-sex couples are very distinct from heterosexual couples. To the contrary, the faithful relationships of same-sex couples are recognized by same or parallel characteristics of heterosexual couples. However, many same-sex couples are distinguished by stigma and are confronted with discriminatory acts countless times (Rotosky, Riggle, Gray & Hatton, 2007).

Many individuals are not able to accept the fact that the number of same-sex couples is growing and it will soon become a common thing around the world. Just because two people of the same gender love each other does not make them any less of a human. In spite of this, same-sex couples undergo tremendous amount of discrimination from their family and religion. Religious and legal institutions have discriminated same-sex couples by saying that they are going to burn in hell because of their intimate relationship. These institutions that are the basics of every culture does not want to recognize that two people of the same gender can have an intimate bond (Rotosky et al., 2007).

When the discrimination against same-sex couples started becoming more and more prolific, it took a toll on them. These couples found it difficult to carry on with their everyday lives as their community and people around them made them feel like they were a cursed human-being. These couples had to gradually find ways to cope with this growing problem. The first step to coping for various couples was self-acceptance, by accepting themselves as sexual minority and seeing their relationship in a positive way. Another step was by originating a support systems made up of family members, friends and other same-sex couples (Rotosky et al., 2007).

The studies aforementioned discuss racial discrimination and sexual discrimination and the various coping strategies to cope with it. In order to improve the understanding of discrimination and it’s detrimental effect on an individual’s health, further studies needs to be conducted. Not only that, but other types of discrimination such as discrimination against the old age, discrimination against the disabled, workplace discrimination and others should be addressed.

Clear and effective communication between partners is central to working with children and young people, it allows partners to put the needs and requirements of the children first enabling them to achieve the best possible outcomes for the children and their family. Good communication between partners allows trust to be built between everyone and enables everybody concerned to share their views and have them considered and valued. Having clear and effective communication between partners helps with the collection and sharing of relevant information between all parties involved regarding the child, which may also contain sensitive information. Clear and effective communication also ensures that everyone is working towards the same aims helping to prevent any misunderstandings between partners, with one of the aims being working together to meet the emotional, health and educational needs of the children. It will also help with the process of collecting and maintaining information/records about the children providing an understanding of the children’s needs and requirements which then allows partners to provide the correct activities for individual children and maintain a safe learning environment for the children and young people. Regarding the importance of effective communication between parents/carers, clear and effective communication encourages the parent, carer or legal guardian to seek advice when needed and to use services provided which is the key to establishing and maintaining working relationships. Clear lines of communication also allow the parent/carer to discuss issues more freely and resolve problems with ease between partners if they feel there is foundation of trust built and good communication.

The policies and procedures in the work setting for information sharing are as follows,

Information regarding the children must remain confidential

Information must be stored/recorded as stated (Data Protection Act 1998)

Confidentiality & Respecting Confidentiality

Establishments storing records on a PC must be registered on the Data Protection Register

The Data Protection Act 1998 gives individuals the rights to view all information stored regarding themselves.

Staff must be familiar and conform to the guidelines

Confidential matters should not be discussed with colleagues unless necessary

Information regarding the children, establishment and staff should not be shared with third parties unless it regards to safeguarding

Confidential information must be handled with care & stored securely

Never leave sensitive paperwork/files unattended or where individuals who do not need to know will have access to them

All records must be stored safely and password protected ensuring restricted access only

Confidentiality within a setting is vital; breach of confidentiality is only acceptable when it is on a need-to-know basis. For example particular personal information may have to be shared with members of staff that specialize and deal with a child’s health, welfare or well being. Working within this type of environment means particular information has to be gathered and recorded regarding the children and stored securely, this information includes:

Names
Addresses & Contact Numbers
Medical History Records
Dietary Requirements/Nutritional Restrictions
Family Changes
Progress Reports
Child’s GP & Dentist Details
Emergency Contact Details
Special Educational Needs SEN

Sharing any of the above information is in fact a breach of confidentiality and should only be shared on a need-to-know basis, breaching confidentiality can cause great upset for a lot of individuals, loose trust and cause damage to working relationships. Breaching confidentiality within a childcare setting should only be done so in extreme circumstances, for example bullying, suspected child abuse and a medical emergency concerning the child.

Within a childcare setting there is a responsibility to ensure that all information/records are correct, kept up to date and confidential, following the settings policies and guidelines and passed onto relevant staff members only. Information and details provided by the parents/carers is given in trust and concerns the child and their family. This information should only be shared between individuals who are directly involved with the child, for example a named carer or member of staff who works directly with the child.

As a practitioner you may find yourself in a position where you want or need to share information but have been asked not to disclose any information. It may even be due to a matter of safeguarding a child within your care who you feel is at risk, putting you in a difficult position where you must break the confidence discussing it with your line manager.

When you are in the position of having to share information and maintain confidentiality, conflicts or dilemmas may surface.

For example you may find yourself being given confidential information by a parent who has trusted and confided in you as a practitioner discussing with you personal family issues, providing you with information regarding her husband leaving her and filing for divorce resulting in her feeling that she cannot manage and is also struggling to manage but requests that no one else is to be told this information. But as a practitioner being given this type of information gives an automatic concern for the child or young person’s welfare. This then may result in causing conflict or dilemma because you were placed in a position of trust and confidentiality by the parent who confided in you and specifically asked you not to tell anyone else but you are also in a position where you must consider the welfare of the child or young person and speak to your line manager, the manager has to know this information in order to care for the child effectively bearing in mind the Children Act 1989 – The welfare of the child is paramount. But it is important that the parent(s) is informed that you are going to tell your line manager this information.

Conflicts or dilemmas may also arise if a concern has been made about a child by for example a practitioner, key worker or manager directly to the child’s parents. The parents may in fact feel there is no reason for concern or that there is nothing wrong and therefore request that there is no further action to be taken or required and that no confidential information is to be shared with any other outside agencies. Putting the person with concern in a difficult position as this concern regards the welfare of the child or young person involved.

You may also find conflicts or dilemmas arising in relation to sharing information with partners and maintaining confidentiality in situations such as having concerns regarding a child’s welfare because for example you have observed frequent bruising and the child is now refusing to get changed for P.E and appears nervous and jumpy. You want to share this information but it would be inappropriate to ask permission from the child’s parents as this could possibly put the child at further risk of harm. Finding yourself in a very difficult position where you want to share information with a senior member of staff e.g. Line Manager or possibly with outside agencies.

It is important to record information clearly, accurately, legibly and concisely, meeting legal requirements to ensure any decisions or actions that have been put into place for a child or young person are not forgotten or lost and to ensure that written records are not misspelt, are containing incomplete sentences and long confusing paragraphs making it more time consuming for an individual to find the information they are want. This also allows everyone involved regarding a child or young person to receive the most accurate and up to date information and records when required and will enable individuals to refer back to the information for future reference and for the monitoring of children and young people’s behaviour patterns, giving an insight on whether the child’s behaviour has improved or gotten worse over time. It will also prevent any misunderstandings with any future reference at a later date and prevent any complications reading back on the written records. It is also important because all written records need to be up to date, dated and signed to meet the legal requirements of the Data Protection Act 1998. All settings handling personal and sensitive information/records have a number of legal obligations to protect this information under the Data Protection Act 1998. Information must also be recorded clearly, accurately, legibly and concisely, meeting legal requirements for self protection reasons to ensure that there is documented evidence in the case of something happening, which will abide by the procedures and policies put in place within your setting.

Communications and records are recorded and securely stored meeting data protection requirements by carefully carrying out the following:

All written records must be stored carefully

All records must be adequate, sufficient and relevant

Paper records should be kept stored in a locked filing cabinet

Electronic records must be (password protected)

Invoices, bills and money details are to be stored in locked files (password protected) on the computer.

Personal details about each child are to be kept within locked files and password protected documents on the computer.

All records must be maintained, kept up to date and accurate

Records and recording must comply with the Data Protection Act 1998

Personal information must be kept securely & only used for the purposes it was originally stated for.

Records must be kept safe and secure away from any unauthorized access.

Within the setting the following actions are taken to record and store information securely meeting data protection requirements

Invoices, bills, money details – Are stored in locked files (password protected) on the computer which are only accessible to the manager.

Outside agencies – If there has been a meeting of any kind with an outside agency regarding a child or young person within the setting a detailed and clear report must be typed up and a copy of the report distributed to only the relevant concerning parties involved with the child or young person.

Personal details about each child – Each child within the setting has their own individual file containing personal and sensitive information from things such as letters to parents/carers to special dietary requirements. These files are securely locked away within a filing cabinet where they must be kept and used only for the purposes originally stated. They are not to be shared with anyone other than the parents unless they have given permission to do so.

Child protection records – When making a child protection record an appropriate form is to be completed recording the concerns. The written record should consist of relevant details and accurate information. These sensitive records are then locked away and strictly controlled where only limited staff can have access, they are not to be kept on file for any longer than a 6 year period.

Child development records – Child development records are made by observing a child or young person on a daily basis and filling out an observation form and keeping a “daily diary” sometimes including photographs. These records are only shared with the child’s family and contain sensitive & confidential information which is then kept stored individually and securely.

All young children within a setting have their development monitored and recorded on day-to-day basis but if a member of staff believes there is reason for concern or a parent/carer shares concerns regarding their child’s development a meeting will be arranged where the concerns can be shared, the child’s development record reviewed and where information can be gathered on the child’s home life. If the conclusion is that the child in fact requires additional help and support with their development then the manager within the setting will complete the appropriate forms, which will then be sent to the corresponding agency(s) that will make contact with the parents/carers. For example a child who has been assessed as having a speech impediment would be referred to a speech and language team/therapist that will then assess the child and establish a programme that would then be put in place for them which would then be implemented by the teachers and TA’s within a school setting. They may also arrange one to one sessions for the child with the consent of the parents/carers and will assess the child to help recognize the cause of the speech problem or delay.

Referrals are made to ensure that a child or young person is receiving the best possible outcome and start in life. Referrals are usually made by practitioners who observe and make recordings of the child’s development and may pick up on any additional support needed, problems or difficulties the child may be experiencing. It is important to indentify a child or young person’s needs as early as possible to ensure that the child’s needs are assessed quickly and that they are referred to the appropriate setting or agency.

Referrals are made for many different reasons such as concerns regarding a child’s safety and welfare or well being etc. When a referral is required for a child who is in need it should ideally be accompanied by the consent of the child’s parents/carers. If a child or young person is suffering significant harm or abuse then social services will be involved in their case, in some cases depending on the severity of the harm the police may be involved. Other children may suffer from different problems such as emotional and/or learning difficulties. For example a child who has been assessed as having separation anxiety and sensory issues may be referred to CAMHS where they will under go different investigations and have an occupational therapy assessment and may be seen by a child psychologist. Or a child may be displaying signs of behaviour problems and thought to be displaying signs and symptoms of ADHD such as inattention during class time. And therefore may be referred for an ADHD assessment after under going a CAF assessment. They may then be referred to a hospital and consultant where further testing may take place to find out the outcome.

When a child is thought to be in need of additional help or support then a common framework is put into place known as CAF, CAF firstly provides a checklist to ensure that the child’s needs are being met and are up to the standard requirements. If the child’s needs meet the CAF standards required according to the checklist then a meeting would be held where the child’s needs would be accessed and possible support would be discussed within the group, giving the practitioner the opportunity to share their assessments, plans and recommendations for support. It is important to provide a precise, accurate and factual view on the child’s specific needs and requirements including both their strengths and weaknesses. A decision should then be made after the meeting on whether further support is required and a CAF may only then be completed once you have made an agreement with your manager and the child’s parents/carers on whether the child requires additional help and support which is not provided within the setting. During the CAF procedure the agreement will contain permission to share the findings of the CAF assessment with other agencies as sometimes outside agencies may need to be brought into the equation for the benefit of the child and their needs. You must have the parent’s permission for the competition of the CAF process when it is concerning a child and they should be kept well informed but a young person is required to give permission themselves. On competition of the assessment a plan must be built addressing the child’s needs, this should consist of short and achievable goals for the child and should include how these targets can be achieved. Plans must be reviewed and updated on a regular occurrence and referrals must involve the parents/carers and a senior member of staff.

Through attending the course of “Knowing ourselves, knowing our world”, I have increased self- awareness. Every week, I keep learning more and more about myself. Self awareness, according to Wong (2003), means recognition of our personality, strengths and weaknesses and likes and dislikes. Developing self-awareness can help us to recognize when we are stressed or under pressure. Self awareness also promotes effective communication and interpersonal relations, and also for developing empathy for others.

After I have gone to the camp, I learn to face something I used to evade. I was raised up by my aunt when I was young. I always feel difficult to live in the love between my own parents and my aunt. These persecute me for long. All these years, I have never told the others about the above thoughts. I just want to escape from these things. However, I feel so pleased that I have finally let my thoughts released out when I told my classmates in the camp. I used to evade the problem of “how to balance the relationships between my parents and my aunts and uncle”. Learning to increase self- awareness, Rothman (1999) suggests that it brings increased openness to other ways of thinking and a greater insight into other kinds of life experience. I will not escape from tackling the relationships and I can know more about my deep self. This enables me to understand my clients when they have something used to evade. I can then guide my clients to release their feelings and increase openness.

It does help me to be more aware of myself by knowing how my past experiences influence my personal values. Having an uncle who experience three marriages because of having other relationships outside of his marriage (with women from the mainland China), I personally dislike women who are come from mainland China, come to Hong Kong to marry a man and to grab our resources. I dislike like them as I think that they always intervene in their marriage. However, this hatred towards new immigrants makes me unable to make appropriate decision when a client who is a new immigrant seeks help from me. Furthermore, Biestek (1961) suggests that the relationship between the social worker and the client has been called the soul of casework. With such a bias, I may have personal value judgment and uncontrolled emotional attitudes toward the clients. As a result, it may be difficult for me to develop close relationship with the client. However, now I know and realize that my past family experiences are affecting my values and thoughts, Rothman (1999) suggested that it assists the worker to work with clients, and to control and minimize the influences of personal attitudes and beliefs that may be harmful and prejudicial toward clients.

According to Rothman (1999), as an adult, one has his own viewpoint towards something. The most concerned part in self-awareness is about the unaware perceptions, especially those negative feelings towards the others, such as biases, prejudices or stereotypes. According to Rothman (1999), they are hidden inside and covered by “acceptable” excuses and rationale. Take several minorities for an example, general people usually have some negative personal feelings and comments towards the disabled, homosexuals, prostitutes, the street sleepers and so on. Unaware perceptions may be expressed in conversations, acts or behavior since they are hidden in the subconscious. Having these unaware perceptions, as a social worker, I may unconsciously say some words which hurt clients’ feelings and make them become defensive and do not trust in me. Thus making it hard to develop good relationship with the client and hard to have intervention processes.

Besides, sharing my own feelings and opinions among peers can also help to make up my own viewpoint towards the population. I can know more about the peers’ attitudes and how the others react towards some issue by listening and sharing among a group of peers. By exchanging opinions in an overview, I can learn to think more comprehensively and to view an issue with different perspective. By gaining opinions and experiences from the others, I may then gradually change my former views towards an issue.

When it comes to the social work profession, it is common to have values or attitude conflicts with certain aspects. Self-awareness promotes several essential traits, such as openness, acceptance, willingness, trust, knowledge, interest and courage towards the clients (Rothman, 1999). When social worker can have comprehensive thoughts and view towards an issue, it can enable social worker to have a better understanding on the perceptions of the clients. Even the opinions of clients is different from the social worker’s personal view, the social worker can give clients an appropriate advice without any bias and would be more comfortable and easy to deal with the circumstances with their attitudes, values and beliefs (Rothman, 1999).. Social workers’ role is to stands right on the clients’ situations to provide services for them according to their wishes and needs. Self-awareness enables social workers to assist clients in a suitable and appropriate way.

According to Segal E.A, part of self awareness is understanding one’s down personal problems and biases, and addressing them so that they do not interfere in work with others. As a social worker (in the future), self awareness enables me to know myself and be aware of their own values, assumptions, beliefs, strengths, and weakness, so that I am able to help the clients effectively. Rothman (1999) suggests that increased awareness brings increased openness to other ways of thinking and a greater insight into other kinds of life experience. So, keeping my mind open, as a social worker (in the future), I can then listen to client’s sharing patiently, even when clients have other point of view different from mine, I can have an appropriate response and advice.

Self awareness promotes effective communication and interpersonal relations, and so as developing empathy for others. These are all elements which enable social workers to provide skillful service and positive attitude to clients. Increasing self awareness do helps me with my professional development.

DEVELOPING RURAL AREAS

Contents

Introduction.

Literature review

Current efforts to address this problem locally

Plan

References

Introduction.

Rural social work is poised to face many challenges that make it difficult for a social worker to provide services to a needy person in the community. Oppression by the society and also other social classes in the society has caused the poor to be looked down upon in the society and thus becoming hard to get the best social services.

In most of the cases that have been happening the women has seen a vast range of problems socially in the rural areas. Women and children have hence become the part of the population facing a lot of social problems. (Teasley, Archuleta & Miller, 2014).

The issue of a bad economy state has also been an obstacle to the providence of proper social services to the community. When inflation hits a country, it makes it hard and difficult for the rural community to survive with the raising prices of commodities.

Lack of support from the authorities has also caused a lot of poor service development for the needy in the rural areas. Therefore it has been seen in many cases that the policies put into place do not really favor the rural communities. Taking for instance the policies to do with medical services, high medical services hit the poor in the society and hence lives get lost every now and then.

For a good providence of social services to the rural community, resources have to be there. Lack of these resources render the social workers unable to access the areas with specific needs.an example of services that can be required is transport facilities for the social worker. If transport channels become a challenge for the social worker, it becomes hard for him/her to reach a good number of the rural population. (Witkin, 2014).

Literature review

Social working practice dates back to the ancient times where the church used to provide charity services to the community even before organizations dealing with social workers were formed. Social work was linked with the idea of charity work and by 580AD the church had already started charity work in the world and it was circulating food stuffs to the needy in the society.in the middle ages, the church become influential to the most parts of Europe and with time the practice of charity work become charity work in the 17^th century. (Vanagas & A?iA?ikienA-, 2015). Social work become a profession as well as people could now train to become social workers and serve the community.in the 19^th century it became a profession in the united states as a movement began in the states and England. In this case a system was established in which the poor were sorted into different categories as idle poor, bodied poor and impotent poor.in this particular century, revolution especially in the industrial sector took place. (McPherson & Cheatham, (2015). Therefore, technology and other scientific innovations came in to place and therefore a rural urban migration took place in those days in the western world. With this happening, social problems took course in the urban areas and therefore a missionary came into place to publicize and spread the Pentecost denominations ad therefore missioners attempted to come up with solutions for these problems in the urban areas because the cities were affected by prostitution, poverty and diseases. Therefore the church started activities like prayers and evangelism as it was releasing relief food to the poor in these areas. One of the people of steered up social work in the United States was Jane Adams who founded the US settlement house movement. Many schools to train people about social work came in to place at around 1915. This took place at the national conference of charities and corrections. After this, social work became a profession. (Parrish & Oxhandler, 2015).

Current efforts to address this problem locally

Organizations have come up now days with different strategies to deal with the problem of social work degradation. Rural development is the first step that the authorities are working on to ensure that the rural community is reached through good roads and electrification. Infrastructure development is a key thing that the government and the authorities need to develop in the rural areas. Some of the rural areas have already seen some of these development. (Mazza, 2015).

Another measure that is taken to address such problem is formation of organization to handle charity work and deal with the social work that is available in the rural areas. The organizations are governmental and some non-governmental organization. The non-governmental organizations dealing with social work are many in number and this has enabled the government to step up also and start other programs on the same. (Richards-Schuster, Ruffolo & Nicoll, 2015). Social work organizations have been organizing visits to the rural areas where the elderly and those with special needs have seen help in many areas. Some of these areas include their health, financial assistance. This program has been carried mainly by the non-governmental organizations. Due to this, the government has also borrowed this idea and emerged with a strategy to start up a development fund for the elderly and the needy in the society as part of the social work development. With such efforts in place, the work of the social worker is boosted and he/she can gain the morale to do such work. The recognition that there are people in the society with special needs is what has been steering up charity work by companies and institutions through different sponsorships. (Suk bong, Ullah & Won Jun, 2015).

Plan

Networking with other agencies is a consideration to take in order to be able to get sponsors for resources. This is because resources are an important factor to consider in order to be able to reach people from different parts of the society.

Resources like enough money is a key factor to consider in order to be able to meet the people’s needs in the society.as social workers strive to meet the needs of the rural society, it’s better for necessary resources to be provided in order to have a good strategy for the development of the rural areas.

The population census of a particular place can be taken and the number of people known. The population status should be taken and this knowledge should be made aware to the social workers because it will be at the end helpful to them. If the population of the rural society is known, the allocation of resources by the agencies will be easy and hence the needs of the people will be met. (Pitt-Catsouphes & Cosner Berzin, 2015).

Infrastructure development will always depend on the features of the place in which the target project is set to take place. The less the place is accessible the more it becomes difficult to channel transport pass ways and also electrification. The resources must be in line with the peoples preferences so that much money is not spend on trying to fund a project that is not feasible. The feasibility of the projects that help social work to gain an improvement is dependent on the adaptability of the place to welcome new ideas in the society which are helpful. Sometimes political issues can really hinder development of projects in the society and hence make potential investors and other helpful agencies to shun away from helping the society.

When the needs of the people in the society have been accessed, a plan to meet these people periodically is put into place. For instance allocation of funds can be implemented in a way that every year at a particular period amount of money is allocated to these particular people maybe the elderly with particular needs. (Clarke & Wydall, 2015).

Apart from the providence of money, the agencies and the organizations can plan to give out other tangible commodities which can be helpful to the needy. Stuff like food and clothing can be an alternative to meet these people’s needs.

At times we find some parts of the world affected and to be precise the rural society being struck by natural calamities. Places that are affected by calamities like earthquakes and flood get dented by misfortunes follow the people afterword. In this situation, social working can become very hard to conduct when there’s no proper channel to conduct them. Resources such as choppers to aid in the rescue of the survivors of such a calamity can be a challenge to acquire especially when the social workers are not registered with a particular organization to work as a team.

Apart from all these, social workers can take their job with a passion and with this strive and get trainings which will be helpful to them as they provide services to the rural community. (Sullivan, Ryser & Halseth, 2014).

Training can be facilitated by the governing authority where the curriculum can be incorporated in the education system to make the present scholars equipped with these knowledge.

Such training will be helpful for any social worker in the case of outbreaks of disasters like diseases and other calamities.in general terms the necessary thing to do in order to encourage the social work in the rural areas is to provide the social workers with the maximum corporation and support they need in order for them to gain that morale to serve the people. (Force-Emery Mackie, 2013).

References

Force-Emery Mackie, P. (2013). Hiring Social Work Faculty: An Analysis of Employment Announcements With Special Focus on Rural and Urban Differences and 2008 EPAS Implications. Journal Of Social Work Education, 49(4), 733-747. doi:10.1080/10437797.2013.812906

Sullivan, L., Ryser, L., & Halseth, G. (2014). Recognizing Change, Recognizing Rural: The New Rural Economy and Towards a New Model of Rural Service. Journal Of Rural & Community Development, 9(4), 219-245.

Clarke, A., & Wydall, S. (2015). From ‘Rights to Action’: practitioners’ perceptions of the needs of children experiencing domestic violence. Child & Family Social Work, 20(2), 181-190. doi:10.1111/cfs.12066

Pitt-Catsouphes, M., & Cosner Berzin, S. (2015). Teaching Note—Incorporating Social Innovation Content Into Macro Social Work Education. Journal Of Social Work Education, 51(2), 407-416. doi:10.1080/10437797.2015.1012947

Suk bong, C., Ullah, S. E., & Won Jun, K. (2015). Ethical leadership and followers’ attitudes toward corporate social responsibility: the role of perceived ethical work climate. Social Behavior & Personality: An International Journal, 43(3), 353-365. doi:10.2224/sbp.2015.43.3.353

Richards-Schuster, K., Ruffolo, M. C., & Nicoll, K. L. (2015). Integrating Social Work Into Undergraduate Education Through a Community Action and Social Change Multidisciplinary Minor. Journal Of Social Work Education, 51(2), 329-342. doi:10.1080/10437797.2015.101293

Mazza, E. (2015). Experiences of Social Work Educators Working With Students With Psychiatric Disabilities or Emotional Problems. Journal Of Social Work Education, 51(2), 359-378. doi:10.1080/10437797.2015.1012935

Parrish, D. E., & Oxhandler, H. K. (2015). Social Work Field Instructors’ Views and Implementation of Evidence-Based Practice. Journal Of Social Work Education, 51(2), 270-286. doi:10.1080/10437797.2015.1012943

Vanagas, R., & A?iA?ikienA-, J. (2015). THE PECULIARITIES OF SOCIAL SERVICE ORGANIZATIONS DEVELOPMENT. International Journal Of Academic Research, 7(1), 24-30. doi:10.7813/2075-4124.2015/7-1/B.4

McPherson, J., & Cheatham, L. P. (2015). One Million Bones: Measuring the Effect of Human Rights Participation in the Social Work Classroom. Journal Of Social Work Education, 51(1), 47-57. doi:10.1080/10437797.2015.977130

Teasley, M. L., Archuleta, A., & Miller, C. (2014). Perceived Levels of Cultural Competence for School Social Workers: A Follow-Up Study. Journal Of Social Work Education, 50(4), 694-711. doi:10.1080/10437797.2014.947903

Witkin, S. L. (2014). Change and Deeper Change: Transforming Social Work Education. Journal Of Social Work Education, 50(4), 587-598. doi:10.1080/10437797.2014.947897

Critical Perspective on Diversity
Introduction

Mandy, a 44-year-old female with moderate learning difficulty, epilepsy, and with a congenital deformity of her limbs has restricted mobility, and limited manual dexterity. Mandy’s condition has caused her to be cared for by her parents since she was born, with the exception of two incidents. Mandy’s father was well informed, he managed to obtain for Mandy full benefit entitlement as well as a substantial payment from the independent living fund before he passed away. Mandy’s mother is the primary caregiver, and the funds that her father set into place before he died pays for her share of living expenses, food, medication, and related allowable expenses. Additionally, the money that Mandy receives permits her to have a carer visit the home for two hours, five days a week, to assist in helping Mandy’s mother. The carer assists in helping to move and wash Mandy as well as dress her and other tasks as a result of the advancing age of Mandy’s mother, whose health is deteriorating.

The loss of her mother’s husband has left her in a state of long term grieving, for which she has been taking anti-depressants as well as anti-inflammatory drugs. Mandy’s mother has always been there for her, but she is approaching 60 years of age. Over the years, Mandy’s mother has become rather rigid in her beliefs concerning what Mandy can as well as cannot do. Mandy attends a respite care unit at a long stay hospital and has informed her key worker she wants to leave home as things there have become tense and Mandy does not get along with her mother presently as she did in the past, owing to her new condition.

Mandy’s respite care is a short term break for patients from their caregivers as well as vice versa, whereby in Mandy’s situation, she is away from home as opposed to someone coming to the house (Rett Syndrome Association, 2006). Respite care is an official program that is a part of the ‘National Strategy for Carers’ that specifically is designed to provide carers with a break from devoting their time to the individual they look after, which is seen as an important component in maintaining a healthy relationship between the caregiver and the patient (Department of Health, 2007a). Prime Minister Tony Blair, in a forward to the ‘National Strategy for Carers’ document stated “The national strategy for carers – the first ever by a Government in Britain – sets out what we have been doing, and what we are going to do. It offers practical help in ways which are needed, and which will work. Carers will have better information. They will be better supported. They will be cared for better themselves” (Department of Health, 2007a). And while Mandy’s mother performs her care giving activities out of love for her daughter, the implication is clear. The publication for the government informs us that the important service rendered by carers is performed primarily by paid caregivers, representing three-fifths of the total number of people that are looking after an individual with a disability (Department of Health, 2007a).

The publication states that women are more likely to be carers than males, and that throughout the United Kingdom there are over 855,000 individuals that care for someone over 50 hours a week, with over 5.7 million, representing one out of every six households (Department of Health, 2007a). In Mandy’s mother’s case, it represents just the ten-hour break she gets on a weekly basis. Respite care is one of the initiatives under the program-implemented buy the government to provide assistance to carers. As mentioned, Mandy has told her key worker that she would like to leave home. Because Mandy attends a respite care unit, there are no cost implications as it is a part of the national program under the National Strategy for Carers (Department of Health, 2007).

Mandy’s disability allowance, as is the case with all social care allotments, requires residency in the United Kingdom, as per the following requirements 1). That the applicant must normally be a resident in Great Britain, 2). The applicant must not be subject to immigration control, 3). The applicant must be in Great Britain when making the claim, and lastly 4). That the applicant must have been in Great Britain, the Isle of Man, and either Jersey and or Guernsey for at least 26 weeks of the last 52 weeks (Directgov, 2007a). As Mandy qualifies and has qualified under the preceding, her desire to change her circumstances from home assisted living to a long stay hospital requires a local council assessment (Directgov, 2007b). The preceding is a part of the regulations and requirements in order for the local council to assess as well as work at the support the patient needs for such a change. As Mandy is learning impaired, and her mother has stated that she is the one who decides what Mandy can or cannot do, Mandy will be filing for the change in carers without the aid of her parent. The learning disability impairment makes the preceding a difficult proposition for Mandy to take on herself, thus she will need help. Her key worker at the respite care unit has offered to help Mandy and thus in order to do so, needs to contact the disabilities teams social worker that is assigned to Mandy’s case, or simply the disabilities team itself, as well as the ‘Valuing People Support Team’ (Care Services Improvement Partnership, 2007a).

The Valuing People Support Team was established by the government to address an unintended yet real concerns and problems faced by people with learning disabilities attempting to either be their own voice, or to be heard in the social care system regarding their own personal desires and wishes (Department of Health, 2007b). Prime Minister Tony Blair aptly sums up the purpose of the Valuing People Support Team in stating that People with learning disabilities can find “… themselves pushed to the margins of our society …” as a result of unintentional circumstances in being able to find “… the right care, health services, education …” and other aspects (Department of Health, 2007b). He continued that “At best they feel obstacles are constantly put in their way by society” (Department of Health, 2007b). The foregoing is easy to understand when one realizes that an individual with a learning disability has problems in not only finding out things to help themselves, they have problems in completing the paperwork and other facets of the system that has been put there to help them, but in many instances in the past did not as a result of the gap between their learning disabilities and communicating their needs to the system without the help of family members or other parties who either might not desire them to take such an action or simply do not have the time to assist them in wading through the process (Department of Health, 2007b).

The Department of Health describes people with learning disabilities as being the most vulnerable as well as socially excluded individuals in the British society (Department of Health, 2007b). In terms of social services, as well as other branches of governmental aid, individuals with learning disabilities faced, in the past, poorly coordinated services, poor planning, and most importantly they had little choice and or “… control over many aspects of their lives” (Department of Health, 2007b). The publications continues that day services, the contact point for people with learning disabilities, were “… not tailored to the needs and abilities of the individual”, the last point being ‘abilities’ as the operative word in this instance. People with learning disabilities may be able, over a period of time, or instantly, to verbalise their wants, needs and desires, however, under a system with so many departments and layers, getting in touch with the right department represented a problem. Under the Valuing People Support Team they have a governmental agency that is their road map as well as navigator and operative arm to help them through the system as quickly as possible to the services they needs and or desire.

If one thinks about it, the Valuing People Support Team also serves another highly important service, one of being in the position of patients accessing the system. Through a governmental agency helping people to use the system their experiences will provide a wealth of feedback from cases via which to monitor the effectiveness of the entire spectrum of services offered and provided by the government in this area, and make recommendation that have power. This inside system handling of the problems of users of services through its cases is the ideal manner by which to not only put the system on its toes, it represents the perfect feed back mechanism via which to implement improvements and change.

In Mandy’s case, this means the first break from one of her parents in her entire life. A prospect, if one is to put themselves in her shoes, that must seem quite intimidating and fearful, in that she has to put her trust in what can be termed as strangers to treat her as family and see to her best interests as her father did. The Valuing People Support Team operates under four key principles, which are 1), Rights, 2). Independence, 3). Choice, and 4). Inclusion as its operational foundation Department of Health, 2007b). Applying these to Mandy’s situation enables one to see the fit and vision of the preceding. The idea is to provide them with choices, thus giving them control over their lives as opposed to being immersed in a society whereby their prospect of finding the appropriate services and or information is left to a ‘well-informed carer’ such as Mandy’s father who waded through all of the necessary steps and information gathering processes to obtain the full benefit for his daughter. In terms of where Mandy is today, in desiring to take control over her life, she needs that same type of assistance, something that was difficult to find.

In order to accomplish the objective of providing individuals with learning disabilities with the options to access the system in the manner in which it is intended to work, the Valuing People Support Team was established to function as a ‘well-informed carer’. In the instance of Mandy, the Valuing People Support Team white paper set forth that it understands and has been established to help learning disabled individuals to access housing and other services that fit their needs. In this instance it entails the shift of Mandy from home care assisted living to hospital stay assisted living. Acting in a real sense as her advocate, the Valuing People Support is there to walk Mandy through the maze of social services to aid her in the achievement of her objective. As per its web site, under the Care Services Improvement Partnership, the Valuing People Support Team is there to work with 1), Learning Disability Partnership Boards, 2), Local people and organizations, and 3), Government Departments (Care Services Improvement Partnership, 2007a). The ‘Team’ 1) offers support as well as advice to people who want to and or are seeking to change services, 2) help people to get together for the purposes of talking and sharing ideas, 3) to listen to what people are saying, and 4) to feed this information back to the government to enable them to have the direct information from the users of the system so that things can be changed and improved for the better (Care Services Improvement Partnership, 2007a).

In Mandy’s instance, the Valuing People Support Team as an advocacy department that has been specifically set up for patients with problems like herself (Care Services Improvement Partnership, 2007b).

Advocacy

The preceding represents the solution to Mandy’s problem, an advocate to listen to her concerns, counsel her as to her options, obtain agreement from Mandy as to the direction she would thus like to take knowing and understanding her options, and then to take the appropriate action based upon the foregoing. The advocacy services segment of the Valuing People Support Team offers the following services 1) self advocacy to enable individuals to speak up for themselves, 2) citizen advocacy whereby people can get to know an individual that has a learning disability and thus be able to get their wishes understood as well as heard, and 3) a short term issue based or crisis advocacy whereby a person is usually paid to speak up for someone regarding a particular issue and or when that person is in a crisis (Care Services Improvement Partnership, 2007b). The Advocacy Toolkit was set up to aid individuals in waking through what this service offers and how it can help. In Mandy’s instance, she received the help of her key worker at the respite care unit to get her to the Valuing People Support Team, which is the same course of action that would have been taken by the disabilities team.

The disabilities team would have also been able to aid and assist Mandy in the getting to her destination. These teams, disabilities, represent service groups in the individual councils that are positioned within the individual authorities, whose service parameters are limited, however, they are there to assist. A typical disabilities team web site indicates its purpose as being a point of contact regarding disabilities issues that affects young people from partner organizations and other agencies (connexions, 2007). It is in place to offer and provide specialist services to young people between the ages of 13 and 25 who have a statement of special education need. They function as well as offer a limited and lower level specialist service in the pattern of the Valuing People Support Team that is on a lower level, yet in the same vein. Specifically they offer 1) support as well as guidance to personal advisers concerning individual cases, 2) training to personal advisors concerning disability issues, 3) a direct service for young people that have complex needs, 4) an innovative working arrangement with partner organizations to help young people identify need as well as secure funding, 5) independent advice, along with guidance and information regarding local as well as national special needs provisions, 6) working with individuals as well as groups as advocates and brokers, 7) and provide access to other personal advisors whereby they can help to fulfill requirements as well as guidance as set by the government concerning young people that have a learning disability and or any other type of disability (connexions, 2007).

The disabilities team would have not been able to assist Mandy in obtaining her objective of changing her carer, as a result of her age, but could have referred her to the Valuing People Support Team in order for Mandy to complete the process. Advocacy, as stated by Valuing People is that the government’s purpose and aim in putting this service into place was to provide a range of independent advocacy services in each area that permits people with learning disabilities to be able to choose the service(s) that best meet and fulfill their needs. The independent nature of the advocacy services represents one of, if not its most important features and facets as it ensures impartiality on the part of the patient (Care Services Improvement Partnership, 2007b).

In addition to advocacy services, the Valuing People Support Team handles many, many other services, including arrangement to place someone at an appropriate residence. Specifically, the Valuing People Support Team states that a long stay hospital does not represent a good place for people with learning disabilities to live in (Care Services Improvement Partnership, 2007c). This option for Mandy is closed as all learning disability patients at long stay hospitals were moved as of March 2006 (Care Services Improvement Partnership, 2007c). Thus, the Valuing People Support Team will need to work with Mandy to hear her needs, wants and desires and advise her on her options. Mandy could not be in better hands than these, as they oversee the full range of services that are available within the health care and social services system. The fact that the Valuing People Support Team oversees the full range of services under the health and social care makes it invaluable to patients as well as those seeking help for the first time. It represents a resource that aids all of the departments in getting the person to the right area quickly and avoid moving people around form service to service, and or having them call, hunt and become frustrated in obtaining the assistance and help that they need. .

Conclusion

Mandy’s situation is in no way unique! There are others that have either similar and or drastically different problems who need empowerment in order to avail themselves of assistance and help when either in trouble or seeking the right governmental services for their condition. The existence of the Valuing People Support Team would be helpful for an immigrant without papers under hospital care in finding out exactly what their options are in terms of support, aid and immigration as a result of a recent event that ended them in that position.

Specifically, the case of a gentleman named Boris who arrived in England twenty years ago and never secured his papers. Having had a reversal in circumstances, Boris has been living illegally in England and would up in a hospital as a result of kidney failure. His circumstance in living in an unheated room at the rear of a commercial establishment was unsuitable for return to after his hospital incident that requires follow up care. And as a result of his status, housing options were not open. The Valuing People Support Team represents a resource to aid Boris and the hospital to help this individual.

The Valuing People Support Team represents an important governmental resource to aid the citizens of the United Kingdom in wading through he huge maze of services regulations and requirements that is the system of health and social services care. It is helping Mandy and countless others, and will be of aid to Boris as well

Bibliography

Care Services Improvement Partnership (2007b) Advocacy. Retrieved on 1 May 2007 from http://valuingpeople.gov.uk/dynamic/valuingpeople61.jsp

Care Services Improvement Partnership (2007c) Long Stay Hospitals. Retrieved on 1 May 2007 from http://valuingpeople.gov.uk/dynamic/valuingpeople127.jsp

Care Services Improvement Partnership (2007) What is the Valuing People Support Team? Retrieved on 1 May 2007 from http://valuingpeople.gov.uk/dynamic/valuingpeople16.jsp

connexions (2007) What is this service. Retrieved on 1 May 2007 from http://www.connexionsteesvalley.co.uk/practitioners/aboutus/diabilities/

Department of Health (2007a) National Strategy for Carers. Retrieved on 1 May 2007 from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4006522

Department of Health (2007b) Valuing People. Retrieved on 1 May 2007 from http://www.archive.official-documents.co.uk/document/cm50/5086/5086.pdf

Directov (2007b) Care Homes and hospital. Retrieved on 1 May 2007 from http://www.direct.gov.uk/en/HealthAndWellBeing/HealthServices/CareHomes/DG_10031519

Directgov (2007) Disability Living Allowance – what else you need to know. Retrieved on 1 May 2007 from http://www.direct.gov.uk/en/DisabledPeople/FinancialSupport/DG_10012424

Rett Syndrome Association (2006) Guidance Note 1: Respite Care or ‘Short Term Breaks’. Retrieved on 1 May 2007 from http://www.rettsyndrome.org.uk/_downloads/respite_booklet.pdf

Introduction

Recent decades have seen a greater emphasis on service user participation than had previously been the case (Beresford, 2001). In the past, decision making

in social care and associated policy development had been led by practitioners, politicians and academics, with service users and citizens having minimal

say in what services they received and how services were provided (Beresford, 2001). This study examines how active participation of service users has

developed over the last 20-30 years and how the progress made in encouraging participation has benefited individuals and the overall quality of service

provision.

For the purposes of this study, there is primarily a focus on the service user as the individual who engages in active participation although it should be

accepted that family members and carers have their own separate and sometimes conflicting needs for participation (Roulstone et al., 2006). Service users

are described by Beresford (2001, p.9) as “people who receive or are eligible to receive social care services” and it is important to note that

people can self-identify as a service user. However, active participation of people outside of the health and social care arena will also be discussed as

there is evidence that participation in community activities can be beneficial to citizens who are not in receipt of social care services.

Policy and Legislation

A shift towards more active participation has a basis in the policies and legislation introduced under New Labour. Government took a view that greater

participation would be a way of increasing the number of citizens who would be active citizens (Millward, 2005) and the Health and Social Care Act 2001 was

at the forefront of extending service user choice and the enablement of people to decide on their own services through schemes such as Direct Payments.

Other relevant legislation and guidance has included the White Paper Our Health, Our Care Our Say (Department of Health, 2006); Valuing People (Department of Health, 2001); the National Service Framework for Older People (Department of Health, 2001). With specific

reference to social care, Putting People First (2007) set out a commitment to closer working between central and local government, and the health

and social care sectors, alongside better partnership working with service users and carers. More recently, under the Coalition Government consultations

such as A vision for social care: Capable communities and active citizens (DH, 2010) and Caring for our future: Shared ambitions for care and support (DH, 2011) have continued to encourage participation with an expectation that it can

help people to live healthier and more independent lives. It is evident from cross-party support that active participation is something supported across

the political spectrum. Participation is seen as something that encourages better citizenship and it can also be argued that it offers a form of low level

democracy. Participation is also something that pulls back direct state intervention in people’s lives.

What is Active Participation?

Active participation can be defined in a number of ways and can be related to both individuals who are in receipt of health and social care services and

those who live independently in the community without service provision. Definitions such as ‘consultation’, ‘partnership’ and

‘involvement’ are often used to explain participation (Roberts, 2002). In social care terms participation might be seen as allowing and

individual to have control over day to day decisions such as what time meals would be taken or when personal care services would be delivered; at a more

strategic level, participation might involve giving a say in how services are commissioned and delivered to a wider group of service users (Mordey and

Crutchfield, 2004). Service user consultation groups or local forums for citizens to discuss how services are prioritised and delivered are examples of

this broader level of active participation.

The Social Care Institute for Excellence (SCIE) has developed some useful definitions for participation. It uses the word participation as being “to

talk about actively working together on a particular project or activity” (SCIE 2004, p.2). It also sets out a number of key values and principles

which should inform participation work. These include a belief in citizenship; the promotion of empowerment; developing a human rights culture in social

care; giving equal priority to all opinion; developing new approaches to participation; being inclusive; and making it clear what people can and cannot be

involved in (SCIE 2004). The final point is important. Active participation is rightly seen as a positive development for service users but there still has

to be a line where organisations can make decisions irrespective of service user participation. Adult safeguarding is an example of this, where sometimes

decisions may have to be made without the participation of an individual in order to protect his or her welfare. Nonetheless, the link between

participation and social work values is a positive one. It suggests that participation is grounded in a commitment to human rights and equality, something

that should bring benefits to the individuals who take up the opportunity to participate.

SCIE also draws a distinction between the different types of participation that can be found in social care, suggesting that participation can range from

providing information and actively listening to service user views, to providing assistance or even financial support to allow people to research or

provide services (SCIE, 2004). Participation can also be applied to a range of service user groups including older people, children and families, people

with disabilities and people with drug and alcohol misuse problems (SCIE, 2004).

The Personalisation Agenda

The personalisation agenda in health and social care has been critical in promoting the idea of active participation. Personalisation is primarily a new

way of providing social care support which puts the person requiring a service at the centre of the assessment process and allows individuals and their

carers a real say in identifying their needs and making choices about how services will be provided (Carr, 2010). It recognises that people are individuals

with diverse strengths and preferences, and aims to empower people through better provision of information and advocacy, early intervention to get the

right support in place and also recognising the rights of carers (SCIE, 2012). Given these aims of personalisation, one of the key benefits for the

individual would be having greater control over services provided and consequently there being a greater chance of the rights services being provided, with

positive outcomes. Another key point about personalisation and participation is that it still has to be facilitated by agencies and policy makers. As much

as people may want to participate in service delivery or more simply just in community work, they still require the tools to do so and also the autonomy to

make their own decisions.

Benefits of Participation

Greater participation in how services are delivered can bring a number of benefits to service users. Active participation can help develop more

customer/service user-friendly versions of existing services and give individuals more say in how their services are run and how they can access them.

Participation gives service users – who are also tax-payers – a greater say on how money is spent on services in their area and also helps

individuals become co-designers and co-producers of the services that they use (Leadbetter, 2004). At a wider level, it can be argued that active

participation allows for self-organisation by communities, rather than service provision being dictated by external agencies or distant central government.

Participation also supports the development of greater citizenship. Participation and influence over how public funds are spent can be seen as being an

important part of the democratic process and the concept of citizenship lends itself to ideals of equity and collective provision which are embedded in

public services. For the individual, participation in public service can increase a sense of civic attachment and impress on the individual what it means

to be a member of a democratic society (Leadbetter, 2004).

Participation and Young People

Discussions around personalisation and participation generally have an emphasis on the participation of adult service users but active participation can

also have a positive impact for young people who access social care support and services. Legislation and guidance including the Children Act 1989 and the

UN Convention of the Rights of the Child have a focus on the child’s right to participate in decision making and there are a number of benefits for

both young people and the organisations that provide services. For young people, active participation can help them gain new skills and experience, develop

self-confidence and influence the decisions that affect their lives. They can develop social networks and begin to understand how organisations work.

Participation can also quite simply be fun for young people, and it can help them feel valued and empowered (Wright et al., 2005).

Active participation can be particularly beneficial for children and young people who might be consider as disadvantaged or vulnerable. Groups such as

looked after children, young offenders, care leavers, young carers and gay and lesbian young people are easily marginalised and many agencies tend to

direct them rather than engage with them. They face a number of barriers to participation such as a lack of motivation to engage; mistrust of adults and a

feeling that their views will not be listened to because of their past experiences (McNeish, 1999).

Research studies highlight a number of positives from individual participation projects which could be used as a benchmark for future initiatives. In

Hampshire for example, a Care Action Team (CAT) was established bring together members and officer from the County Council to work with people who were in,

or had been in care. Regular meetings to gather the views of young people led to a number of improvements in how services to young people were delivered.

These included development of a new sleepover policy making it easier for looked after children to spend the night with friends; involvement of young

people in the inspection of children’s homes, and a Children’s Homes Education Policy which improved the educational support for looked after

children. A more general improvement from the establishment of the CAT was that young people developed a greater sense of worth and awareness that they

were not alone in their experiences (Wright et al., 2005).

For organisations, encouraging active participation by young people can also bring improvements to service delivery. It helps them become more responsive

to the needs of children and young people; it increases the accessibility of organisation and makes them more efficient in providing effective services

(Wright et al., 2005).

Active Participation in the Community

Active participation has benefits for society as well as the individuals involved. We live in a nation with an ageing population and many older people have

greater expectation of both opportunity and support from public services in later life. An Audit Commission report (2004, p.2) stated that “the shift

in proportion, composition and attitudes of the older age group has profound implications for public services. We need to start taking action now to shape

things for the better”.

Active participation does not only relate to people who are in need or receipt of social care services however. Participation in the community can also

benefit individuals who do not require social care provision. Many older people for example, benefit from active participation in their local communities

and government studies have suggested that active participation is linked to the overall well-being of individuals (Audit Commission, 2004).

A number of strategies can be developed to encouraged independence and participation for older people. These can include work to support people ensuring

that they have a safe comfortable home, and live in a neighbourhood close to friends and amenities. Good public transport networks allow people to get out

and about whilst social and leisure activities promote social inclusion. Information for older people on how to access amenities encourages active

participation as do healthy living initiatives which help people to stay active and healthy (Audit Commission, 2004).

Active participation for older people is also a way of tackling the ageism that exists in society. Participation allows people to feel valued and able to

challenge stereotypes that older people offer less to society that younger people. Participation allows them to have a say in decisions made about them

both as individuals and as a wider group in society.

A Department of Pensions report published in 2009 identified LinkAge Plus (LAP) pilots as initiatives which enable older people to become more active in

their communities (Willis and Dalziel, 2009). Schemes to give opportunities to socialise through social, leisure and training activities help to address

wider community and social wellbeing outcomes through the creation and development of social capital. Examples might include over 60s clubs providing

activities ranging from Tai Chi to adult art classes. Network Centres establish social networks for older people which improve confidence and well-being

and the DWP report concludes that people are “empowered when new or stronger bonds are created between themselves and the community in which they

live” (Willis and Dalziel, p.45).

Other examples of active participation demonstrate older people have an active role in local decision making and commissioning of services. The Gateshead

Older People’s Assembly for example was funded to assess the appropriateness, accessibility and effectiveness of services for older people in the

region. The benefits were twofold – the Assembly allowed a number of individuals the opportunity to become involved in stimulating research and study

activities, whilst the conclusions were feedback into local service procurement, ensuring that the views of the wider population of older people were being

heard (Willis and Dalziel, 2009).

Criticisms and Obstacles

Whilst most of the evidence points towards active participation being a positive opportunity for individuals there are some concerns about how it might

delivered and that there will be obstacles to real and effective active participation. Some commentators suggest that the whole personalisation agenda will

simply tie up social workers in drafting support plans and assisting with finances, rather than providing a more person-centred social work support, whilst

there are also concerns that the introduction of personal budgets will be seized upon by individual who have motives other than the well-being of services

users (Needham, 2010).

There are also concerns that personalisation is simply a way of implementing public sector budget cuts and introducing a level of consumerism into social

care for vulnerable people. The emphasis on individuals managing their own finances could possibly lead to financial abuse or simply people mismanaging

their personal budgets (Needham, 2010). Even outside of social care, a cynical view of encouraging people to find their own ways of participating in the

community could be that it is simply a way for the state to withdraw from provision of leisure services and have people fund and manage them themselves.

A final concern around active participation is that it could lead to discrimination against vulnerable groups if they were to become more active and

visible in the community. Services users with physical and learning disability who try to manage their own care in the community may be probe to physical,

emotional or financial abuse by neighbours and Burton et al. (2012) also suggest that disabled people trying to live ordinary lives in the community, and

participating in community activities, may cause some hostility.

Conclusions

The evidence available suggests that participation is a positive thing. The applies equally to participation in service delivery and review for those in

need of social care, and to those in the community who simply wish to remain active members of the community.

In social care, the personalisation agenda and the move towards self-directed support and personal budgets has promoted active participation. It puts

individual service users in greater control of what services they receive and allows services user groups to have a greater say in how services are

commissioned and delivered. This benefits individuals as it allows them to have a real say in how they receive support; it should also assist the

organisations that provide services to develop and improve the services that they provide. Similar principles apply in social care provision for children

and young people, as active participation allows their voices to be heard and should give decision makers a better understanding of what is needed to

support vulnerable young people

It is important to note that active participation in social care can be linked into some basic social care values. Good social work practice should involve

putting the individual first (SCIE, 2012) and initiatives such as personalisation and can help demonstrate a commitment to respect for the individual and

self-determination. Social workers that encourage active participation will generally be demonstrating a person-centred or child-centred approach that will

enable an effective and non-discriminatory relationship with the individual that they are trying to help. Again, this is further evidence that active

participation is largely beneficial to the individual.

Active participation for people outside of the social care system also appears to have a positive effect on people’s lives. It promotes social

inclusion and the evidence suggests that being active in the community promotes well-being and helps people to live more fulfilling lives.

In a modern, democratic society, there is no reason why active participation should not be commonplace. It demonstrates that as a society we value the

views and opinions of all citizens and that when people need support, they can have a say in how it is provided, rather than the state simply imposing a

service that may not meet the individual’s need. By encouraging more general participation in society, active participation also demonstrates that we

value the input of all members of society into the community, regardless of age or disability.

Cynics might argue that active participation is a way for local and central government to save money and pass the onus for some tasks back to service users

and the local community. Whilst their might be an element of truth in this, the reality is that active participation is largely a positive development.

Many citizens want to participate in decision making both for themselves and their local communities and the evidence suggests that this participation

produces good outcomes.

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