Category: Free Essays

“Psychiatrists are increasingly churning out new syndromes at the behest of their funders in the pharmaceutical industry”. The above quotation, drawn from a news feature from the Independent news paper, highlights an issue of concern associated with mental health diagnosis. According to the (Social Exclusion Unit, 2004), approximately one in six people in England experiences some form of mental health problem at some point in their lives and the estimated annual costs of providing services is ?77 billion. Wrong diagnosis affects not only the patient being diagnosed, but also the patient’s support network. In communities where mental health is not well understood by the vast majority and where people tend to get embarrassed by it, wrong diagnosis can make it difficult for those diagnosed to seek help. Additionally, people with mental health illnesses have to contend with a number of social issues such as: stigma, acceptance from friends and family, employment challenges and adjusting to losing their independence as a result of the effects of illness and / or the side effects of medication, (Sheppard, 2002; Elder et al, 2009). While these issues affect all mentally ill people, research shows that for black and ethnic minority groups, being diagnosed with a mental illness compounds social challenges and perpetuates poverty, deprivation and social exclusion, (Hocking, 2005; Ndegwa and Olajide, 2003). The challenge for social work is to advocate for clients in a field where social work expertise might be challenged by the medicinal nature of mental health diagnoses.

As a background to the research proposal, this paper will briefly evaluate the effect that wrong mental health diagnosis has on black and ethnic minority families. In selecting the objectives, my starting point is that wrong diagnosis affects people’s lives regardless of their race or ethnicity. Therefore, the proposed research will aim to identify whether and, if so, how black and ethnic minority families are affected by being wrongly diagnosed with mental illness.

Introduction:

According to Hocking (2005), culture and race have an important role to play in the likelihood of someone being diagnosed with mental health problems. Her findings are mirrored in the results of recent psychosis studies which indicate that there are disproportionately high numbers of people from black and ethnic minority groups diagnosed with severe mental illness, (Count Me in, 2010). Citing Bhui (1997)’s review of (Lloyd and Moodley, 1992)’s research, (Bhui and Bhugra, 2002) also state that there is a substantial body of evidence that highlights disparity between the experiences of people from black and ethnic minority groups in comparison to white groups, when it comes to accessing mental health services. They argue that white people, who are mentally ill, stand a better chance of being given a diagnosis and appropriate treatment.

Data from a mental health and ethnicity census conducted by partnership between the Healthcare Commission, the Mental Health Act Commission and the National Institute for Mental Health in England, found that almost 10% of mental health inpatients were black or mixed race. Analysis of the findings also concluded that compared to the rest of the population, black people were three times more likely to be admitted to psychiatric hospitals in England and Wales and stood a 44% chance of being detained under the Mental Health Act, (Care Quality Commission, 2005). The findings also indicated that black men experienced high rates of control and restraint from staff within psychiatric services and were more likely to be put into seclusion or in medium or high secure wards, (Bhugra and Gupta, 2010; Kaye and Lingiah, 2000).

It is with this background that this paper evaluates the impact of wrong mental health diagnosis on black and ethnic minority families. In terms of methodology, the proposed research will take a similar form to this paper i.e. I will use the same key terms, research objectives, search terms and data collection methods. A paragraph on the proposed methodology follows the literature review.

Defining Key Terms:

In addition to cultural differences and subjective assessments of mental capacity, definitions of mental health are influenced by perspectives from various disciplines. In order to conduct a robust research, definitions of the key terms are explored below:

Although the Mental Health Act (2007) does not give a definition of mental health, it describes mental health in terms of mental disorders and refers to mental health as any condition that disorders or disables the mind, (Bartlett and Sandland, 2007).

Psychological perspectives define mental health as a level of cognitive or emotional wellbeing which includes a person’s ability to enjoy life by balancing the demands of everyday routines to achieve psychological resilience, (Shaw et al, 2007).

According to the World Health Organisation (WHO), mental health is a state of wellbeing in which an individual realises that they can cope with life’s normal stresses, can work productively and fruitfully and contribute to their community, (WHO, 2005).

Definitions of mental health that are based in evaluating the positive signs of health, such as how an individual copes with environmental stressors, are still under debate as scholars, practitioners and policy makers consider the importance of factors such as religion, individual aspirations, social class, race, gender and lifestyle choices impact on mental health, (Clarke, 2008; Kay and Lingiah, 2000, Heller and Gitterman, 2011).

The English dictionary describes diagnosis as the identification of an illness or a discovery about what is wrong with someone who is ill or something which is not working properly, after examination. It implies identification of the nature and cause of a thing.

However, diagnosing mental illness seldom involves a set of specific or straight forward tests. Rather, psychiatrists diagnose based on their observation of symptoms and comparison with a diagnostic schedule, (Elder et al, 2009; Arrigo and Shipley, 2005). As a result it is often difficult for mental health problems to be diagnosed and sometimes patients can feel that they have been misdiagnosed. Detailed discussion follows later in this proposal.

The Research Question:

This paper briefly reviews mental health literature in order to set the background for a proposed research into the extent to which wrong mental health diagnosis affects Black and Ethnic Minority families in Britain.

Research Objectives:

The objectives set prior to writing this paper and indeed proposed for in-depth research are:

Reviewing the literature that is available on mental health diagnosis and how mental health impacts families in general.

Exploring the role of social workers in working with people that have been diagnosed with mental illness.

Identifying any discernable differences in how diagnosis affects Black and Ethnic Minority families in comparison to their white counterparts.

Highlighting the impact of wrong mental health diagnosis on families in general and on Black and Ethnic Minority families in particular.

Identifying any gaps in practice and in the literature in order propose areas for future study.

Rationale:

I first became interested in studying this area because four of my relatives had been diagnosed with severe mental illnesses and three were later found to have been wrongly diagnosed. In the three months prior to being told that the diagnoses were wrong, our family relationships had been tested to the extreme as we tried to adjust to the challenges of caring for loved ones whom we thought were mentally ill and in denial. The relief that came from hearing the news that three of them had been wrongly diagnosed was quickly replaced with feelings of injustice towards professionals, because of the strain that had been put on the family relationships.

Search Terms, Databases Used and Linguistic Clarifications:

When researching literature to review, I used several on-line catalogue systems which included: EBSCOHost, InfoTrack, ProQuest, Ingenta, eLSC, CareData, academic journals, mental health action group websites and read various newspaper articles reporting on multiple mental health related issues. My initial searches produced a lot of literature, which I narrowed down by browsing subject indexes and reading abstracts. The search terms included: “Diagnosing Mental Health in England”, “the impact of Mental Health diagnosis on families”, “Mental health diagnosis and minority ethnic families”, “The role of social workers in mental health cases”, “the impact of wrong mental health diagnosis on black and ethnic minority families”, “community mental health” and “coping with mental health at home”. My decision to use online catalogue systems has more to do with my lack of knowledge in how to use manual cataloguing systems. Additionally, I was aware of my own limitations as a researcher and did not want to add any more complications to my task.

Literature Review:

Prior to commencing discussions about how diagnosis, right or wrong, impacts on families, it is important to note that diagnosis infers illness. Therefore, the extent of the impact on families is not determined by the diagnosis, but by how the inferred illness affects day-to-day activities directly or indirectly. The impact will vary depending on factors such as the severity and duration of the diagnosed illness, the family composition and the extent to which the illness affects aspects of family life, (Clark, 2008: Heller and Gitterman, 2011). For example, where short term illnesses can be treated by the family’s general-practitioner and where the members are older or resilient, families will cope better with a mental health diagnosis.

For many black and ethnic minority families, being diagnosed with a mental illness adds to stigma, as these communities tend to have many myths and misconceptions about mental illness, (Ray et al, 2008; Bhugra and Cochrane, 2001; Bhugra and Gupta, 2010). This can affect families’ social interaction as they worry about the unpredictability of the diagnosed member’s public actions and reactions. The result is that individuals within the family or the entire family can easily become isolated, thus perpetuating a cycle of social exclusion, (Beresford, 2004). However, this view is widely contested as some scholars argue that mental health problems are not derived from social injustices or oppression nor are patients any more likely to experience social exclusion and discrimination as a direct result of their difficulties, (Sheppard, 2002). Scholars acknowledge that people with mental health problems can experience vicious circles of social isolation, poverty, unemployment, poor housing and scarce social and support networks but that these are neither causal nor circular factors.

In 2010, the Care Quality Commission published a psychosis study which tested the theory that psychiatrists, wittingly or unwittingly, allowed their professional judgement to be influenced by the colour of their patients’ skin, (Count Me In, 2010). The study, which tracked year-on-year results from 2005 to 2009, was aimed at highlighting inequalities in access and outcomes that affect patients from Black and Minority ethnic communities, how hospital stays are managed, national debates about mental health and guide positive action, revealed that at 53.8%, black people represented more than half of the people detained under the Mental Health Act. These finding are consistent with other studies, which highlights that black men were more likely to be diagnosed with psychotic illness than whites and to be detained under the Mental Health Act, (Ray et al, 2008).

Additionally, knowledge about mental illness, like many other aspects of human life, has undergone paradigm shifts over time. For instance, conditions such as sadness, anger, or disappointment, which were once considered to be in the normal spectrum of human behaviour, are now seen as psychiatric or psychological disorders, (Beam, 2001). This, coupled with the fact that there are no specific or straight forward ways of diagnosing mental illness, makes mental health diagnosis challenging. In order to diagnose a mental illness, psychiatrists observe a client’s symptoms and match them to a diagnostic schedule. Prentice (2010) reports that in recent history, research has shown that even seemingly simple changes in the description of conditions such as attention deficit disorder, autism and childhood bipolar disorder, captured many patients who would have been better off not entering the mental health system.

One of the initial challenges that families have to overcome when a loved one is first diagnosed with a mental illness is the feelings of denial as they come to terms with what the illness will mean for their loved one and for themselves. This combined with having little or no knowledge about the diagnosed illness, causes panic, (Beresford, 2004). When, as in our case, families later find out that the diagnosis was wrong the relief can easily be replaced with anger as they recount the toll of strained inter family relationships that were a result of their caring responsibilities. In such circumstances, guided by professional values and ethics, a social worker would be duty bond to empower the family by ensuring that the family have all the information they need in order to understand the implications of the illness. This includes advocating for those for whom English may not be a first language and being creative with working partnerships, (Beresford, 2000).

Wrong mental health diagnosis often means that the patient will be prescribed medication to stabilize the “illness”. Consequently, the family may have to not only deal with the challenges of caring for a loved one whose behaviour may be unpredictable but also come to terms with the medication’s side effects such as apathy and a lack of motivation, (Ray et al, 2008). In her review of a number of qualitative research publications on how families cope with mental health, (Bhui, 2002) found that family members were fearful that the constant stress and concern for their loved ones created family problems that may never be over come.

When the diagnosed family member is a parent, the inferred illness will have a profound impact on family life. Research shows that when a parent is diagnosed with mental illness, children are especially vulnerable, as their coping strategies tend to be dependent on the adults in their lives, (Heller and Gitterman, 2011). Parental mental illness compromises the parent’s ability to care for their child and in some cases, especially where there is no other adult to take responsibility, children can become their parent’s carers, (Ritter and Lampkin, 2010: Arrigo and Shipley, 2005). A wrongly diagnosed parent who keeps insisting that there is nothing wrong with them, can easily be seen as being in denial thus escalating welfare concerns. The dilemma for social work lies in their dual role of control and care.

Depending on the nature of the diagnosed illness, the risks to a child’s welfare can be severe even when the child’s physical safety is not at risk. Social workers would need to give consideration to issues such as how the illness affects the child’s emotional, behavioural and mental development. There is a vast body of research which indicates that children of psychotic parents are themselves particularly vulnerable to psychiatric problems, (Heller and Gitterman, 2011; Bhugra and Gupta, 2010; Ndegwa and Olajide, 2003;).

In order to explore this topic in detail, I propose to conduct research that addresses the objectives set in this paper, using methodology that focuses on reviewing secondary data. The intended research process is as detailed in the question, objectives, rationale and search terms of this paper. The proposed research will have relevance for policy and practice in that it will enable better service provision for black and ethnic minority families as a result of understanding not only the causes of wrong diagnosis, but also why minority groups are disproportionately over represented within mental health services. It will also evaluate how national and international legislation, current studies on mental health and user involvement initiatives, impact on service delivery for minorities.

In conclusion, I have shown that by inferring illness, mental health diagnosis does impact on families regardless of their racial or ethnic backgrounds. However, while the issues discussed here are not necessarily unique to black and ethnic minority families, research indicates that people from black and ethnic minority groups are disproportionately over represented in mental health services in England. Complex and multifaceted factors such as a lifestyles, social stressors, genetic predisposition and lifecycle transitions, make diagnosing mental illness difficult. This can present challenges for social workers as they perform their dual roles of control and care. Professional ethics and legal responsibilities mean that they must advocate for the marginalised groups while continuing to work in partnership with medical professionals without having the expertise to make a judgement call on the accuracy of diagnosis. These issues require deeper exploration in order to understand how wrong mental health diagnosis affects people from black and ethnic minority families.

‘Indigenous Australian Cultures’
The Dreaming

The English language has no exact word or phrase that depicts The Dreaming and each Indigenous Australian language groups has its own term to refer to this epoch. In Western Australia Ngarinyin people refer to it as Ungud, the Central Australian Aranda people as Aldjerinya, the Pitjantjara of north-west South Australia as Tjukurpa, while in the Broome region it is Bugari. While the English word suggests fantasies or vague recollections of the real world the Indigenous Australian translation see’s The Dreaming as inherent reality (Edwards, 1998).

The Dreaming is how Aboriginal people explain how their world came to be. Clarke (2003, p.16) suggests culture and lifestyle in traditional Aboriginal culture are shaped by their values, beliefs and the relationship between Indigenous Australians and every feature of landscape and living creature. The spiritual beings that feature in The Dreaming accounts are the spiritual Ancestors of the present day Aboriginal community and continue to influence the beliefs and values of Aboriginal Australians (Clarke, 2003, p. 16).

The Dreaming tells of the creation of land, trees, plants, rocks, waterholes, rivers, mountain, stars and animals and the journeys the Aboriginal Ancestors travelled. The spirits of these Ancestors whom often resembled people and or animals continue to inhabit these features of the world today. Both consequences and punishments are depicted in The Dreaming and form life lessons that are shared throughout generations. For example the Dhuwa shares The Dreaming of a hunter who abducts a young girl and traps her in a cave with him. While he sleeps she transforms into a butterfly and escapes. In his anger he transforms into a bat and is trapped in the prison he made forever (Abc.net.au, 2015)

Kinship

For Aboriginal Australian’s kinship is more than family genetics or blood ties. Kinship is a complex system based around social organisation, which outlines responsibilities within Nations, clans and family groups. (University of Sydney, 2005-15)Kinship and family are especially important to Indigenous Australians. As it guides responsibilities to their ‘kin’ and environment. Kinship is so dominant for the Wiradjuri people they speak of kin as their ‘whole world’ (MacDonald, 1998 p. 303).

Kinship in the many Aboriginal Nations shares common components as well as differences. The all-embracing systems have been handed down through generations from Ancestors of The Dreaming and are based on reciprocal actions, such as giving of privileges in return for similar privileges. Rights and obligations are determined by an individual’s kin, and such influences include who you may marry, share food and resources with, who will look after an individual and who might educate them.

Kinship systems consist of Moiety, Totems and skin names. Moiety is a form of social organisation meaning ‘two halves’. Each individual is assigned a moiety group from either the matrilineal (mother) or patrilineal (father)’s line. Moiety governs where partners are chosen from. For example a marriage partner must come from the opposite moiety. Each nation has their own names for each half of moiety. Arnhem Nation refer to it as Dhuwa and Yirrity while Wiradjuri as Dilbi and Kuputhin. Each individual belongs to a totem dependant on when they were conceived. Aboriginal totems can be animals or plants, they hold special meaning to a group of individuals (Bani, 2004). They are filled with the spirit of their ancestors. Individuals become the generational custodians of their particular sacred places, ceremonies and dreaming stories. A person has four totems that represent Nation, Clan, family and a personal totem that recognises their strengths and weaknesses, this totem maybe given at birth or later in life (University of Sydney, 2005-15).

Economic organisation

Goodall (1996, p. 2) has suggested Indigenous Australians have been practicing sustainable land and economic management for thousands of years. Long before European settlement Aboriginal Australians “have used techniques to increase the numbers and growth of plants and animals”. Clearing trees and creating grasslands for grazing while maintaining patches of forest for shelter are examples of these techniques (Australian National University, 2011).

While The Dreaming and kinship organisation describe Aboriginal men as hunters, and women gatherers, Women are more reliable food suppliers than men due their sources being more plentiful, whereas hunting cannot be guaranteed (Dingle, 1988 p. 13).

Aboriginal people created trade routes across the country and exchanged food, shells and psycho-active drugs such as Pituri. Individuals would not travel the entire distance, they would meet at waterholes, where exchanges would be made and then return to their Nation.

Resource management is critical to the sustainability of the Aboriginal culture. Seasonal calendars impact the strategies used to ensure effective methods were utilised, including hunting animals at the time of year they are at their fattest therefore providing maximum nourishment. Ensuring animals weren’t hunted during breeding season or carrying their young was another resource management strategy used. (Anon, 2015)

References

Abc.net.au, (2015) DustEchoes. (online) Available at: http://www.abc.net.au/dustechos/dustEchoesFlash.htm, (March 11, 2015)

Anon, (2015). 1st ed. [ebook] Available at: http://www.larrakia.csiro.au/pdf/MingayoorooSeasonsCalendar.pdf (Accessed 15 Mar, 2015).

Australian National University. (2011). Bill Gammage discusses ‘The Biggest Estate on Earth’ http://www.anu.edu.au/vision/videos/5001/, (March 9, 2015).

Bani, E. (2004). Torres News, the voice of the islands: What is a totem? In R. Davis (ED.), Woven histories, dancing lives: Torres Strait Islander identity, culture and history (pp.151). Acton A.C.T: AIATSIS.

Clarke, P. (2003). Where the ancestors walked: Australia as an Aboriginal landscape. Sydney: Allen & Urwin.

Dingle, T. (1988). Aboriginal economy and society: Patterns of experience. Melbourne: McPhee Gribble and Penguin Books.

Edwards, B. (1998). Living the dreaming. In C. Bourke, E. Bourke, & B. Edwards (Eds.), Aboriginal Australia: an introductory reader in Aboriginal studies (2^nd ed.) (pp.77-99).

St Lucia, QLD: University of Queensland Press.

Goodall, H. (1996). Invasion to embassy. St Leonards: Allen & Unwin

MacDonald, G. (1998). Continuities of Wiradjuri tradition. In W.H. Edwards (ED.), Traditional Aboriginal society: An introductory reader in Aboriginal studies (2^nd ed.) (pp. 297-312). South Melbourne: MacMillan.

University of Sydney. (2002-15). The kinship module. http://sydney.edu.au/kinship-module/ (March 10, 2015).

Cant remember if I used this one

Aboriginal art and culture centre – Alice Springs

http://aboriginalart.com.au/gallery/gallery_intro.html

The remit of this essay is to explore and discuss the concept of therapeutic relationships in mental health and what is involved in building these relationships. The question is in two parts, so in the first part of the essay, the author wishes to explore the meaning of a therapeutic relationship and discuss what is needed from the nurse and service user to maintain this. In the second part, the author will choose two key elements that contribute to a therapeutic relationship in mental health nursing and discuss the importance they have. The two key elements that have been chosen is communication, both verbal and non verbal, and the importance of these elements in a relationship between a nurse and a service user. To achieve this goal the author will use various resources available, for example the internet, literature from class and appropriate reading materials.

Main Body

“Building relationships is central to nursing work…,” (Nursing Times) and extremely important in mental health nursing. A therapeutic relationship involves respect, empathy and genuineness (Callaghan and Waldock 2006). Both the nurse and service user should show respect for each other and the nurse should respect the beliefs of the service user, even if they do not agree with these. The relationship should be person centred, allowing the service user to be at the core of their care plans etc, their beliefs and wishes must be respected at all times. Service users must be at the centre of their care and recovery. Choices and decisions should be made by them. If there are any changes to be made to a care package, the service user must be informed and have their say. In a therapeutic relationship the nurse will support the service user in all aspects of their care and recovery. With reference to the quote in question, “…did it at my level and pace all the time…,” (Brown and Kandirkirira 2007) this is vital in recovery and for a therapeutic relationship. The nurse must work alongside the service user and support them in aiming for the goals that the service user has made and not what the nurse expects them to be able to do. The service user should always remain at the centre of their recovery and to develop such a relationship, the nurse should share their knowledge of the illness, which gives the service user an understanding of what they are experiencing and some control on the situation and both will be able “to take an active role in the management of the illness,” (Owen 2004).The nurse should be able to show empathy, being able to put themselves in the service users’ position and imagine how they would feel and how they would wish to be treated, “accurate empathy is always empowering, since it represents an understanding and acceptance of the speaker’s feelings” (Millenson 1995). This skill shows the service user that the nurse has taken on board what has been said and that they can put themselves in the individuals’ situation. Those involved in the therapeutic relationship should always show genuineness and hold non judgmental attitudes towards each other. “Genuineness is based on the ability of the practitioner to be open with his patient…It will help to reassert the patient as the centre of the treatment and promote the patients trust in the practitioner and his treatments,” (Owen 2004). The nurse should want to work alongside the service user and offer support when needed to achieve and maintain this relationship.

“The people have the right and the duty to participate individually and collectively in the planning and implementation of their health care,” (World Health Organisation 1978).

A therapeutic relationship does not occur overnight, it takes time and a great deal of trust is essential between the nurse and the service user. Trust is very important for the relationship to develop and if this is achieved the service user will accept the nurses support and advice on treatments available and also work alongside each other instead of the nurse suggesting that they know best as they are the professional. “…patients themselves value therapeutic relationships which offer respect, trust and care and it seems that such relationships may in themselves prove to be healing in the broadest sense.” (Mitchell and Cormack 1998). If trust is maintained throughout the development of the relationship the service user will begin to realise that the nurse does in fact care about their situation and does wish to support them on their road to recovery offering support and advice when necessary. The trust gained from both people should help each other to begin feel at ease the more they meet with each other and the service user may slowly begin to open up to the nurse and enable them to talk about how they are really feeling, what may scare them and accept their advice and support. It will also show the service user that they are at the centre of their care and that they will work at their own pace and when they are ready to take that one step further down their path to recovery, they will.

A key element that contributes to a therapeutic relationship in mental health nursing is the use of verbal communication. One very important aspect of this is asking open questions, which the service user is unable to reply with a simple yes or no answer. This will allow the nurse to gain a deeper understanding of how the service user really feels (Burnard 1992). This also shows the service user is at the centre of their care and maybe they will begin to talk openly and freely about their true feelings as this type of questions show the nurse does care for them and wants to support them in the best possible way, it allows the nurse to empathise, if they can get a true account of the feelings the service user has. The empathy shown may encourage the service user to talk openly more often as they know that they will not be judged for having some of these feelings and thoughts.

Another important aspect of verbal communication is reflecting and clarifying what has been said by the service user. Reflection requires the nurse to say back to the service user what they have said to ensure they understand fully. Clarifying is required by both the nurse and service user. The nurse may ask a closed question, which allows the service user to answer simply yes or no, or a single answer to be definite, to ensure they get the true meaning of what the service user is saying and in turn the nurse can explain their understanding of the illness or situation that the individual finds themselves in and what support and services are available and how they can go about setting these up, together, enabling the service user to make decisions after being given the choice to do so. When the nurse gives their views to the service user, any specialist language, for example jargon, should be avoided as this may act as a barrier within the therapeutic relationship as the nurse is not taking into account if the service user understands what is being said to them. This binds in with the core elements of a therapeutic relationship as the nurse will show empathy, genuineness and trust will increase working at the level and pace of the service user.

The nurse must be aware of their “tone of voice,” (Stickley and Freshwater 2006) when speaking to the service user, to make sure they don’t come across as patronising or uncaring. This may create a challenge in maintaining the relationship as the service user may feel belittled by the nurse and in turn may close up and not speak about how they are truly feeling therefore the relationship will not develop and there won’t be any trust. Another element of verbal communication is the nurse should “not be quick to problem solve,” (Stickley and Freshwater 2006). Allowing the service user to think of approaches of overcoming the problems that may occur during their recovery process highlights that they are at the centre of their care and shows that they have the final decision in their care and or treatment. If the nurse moves in quickly to try and help the service user, it may come across as patronising and that they are trying to take control of the situation as they have not took the time to ask what the service user wants and may cause a barrier between the nurse and the service user.

The second key element that contributes to therapeutic relationships in mental health is the use of non verbal communication. This element is extremely important in maintaining a therapeutic relationship and being aware of the skill involved is vital. The most important skill is sitting in a mirrored position, not sitting face on in front of the patient but to the side and leaning slightly in showing they are ready and willing to listen (Stickley and Freshwater 2006), sitting behind a desk can act as a barrier and come across as authoritative (Burnard 1992) and may cause the service user to feel uneasy, deterring them from opening up and feeling unable to trust the nurse. The nurse should be sitting comfortably and in a way that does not make the service user feel uncomfortable in any way. The use of eye contact is paramount in maintaining a therapeutic relationship but knowing when and how to use the skill is the key. Too much eye contact may cause the situation to intensify and both the nurse and service user may feel uncomfortable. Not enough eye contact may convey a lack of interest in what the service user is trying to tell them and may cause the therapeutic relationship to come to an end and the service user may not show what they are truly feeling or thinking at this time.

Another important aspect of non verbal communication is listening, “The role of the listener therefore is a privileged one and one that can promote healing,” (Stickley and Freshwater 2006). Listening is probably one of the greatest skills a nurse can achieve. Listening is, the nurse hearing what the service user is saying and understanding what is being said, not what the nurse thinks they are saying. “…effectiveness largely depends on the nurses ability to listen and detect cues for therapeutic enquiry,” (Stickley and Freshwater 2006). Thus again shows the nurse has picked up on the detail of the statement from the service user and can reflect back to the service user what has been said to clarify their understanding and to reassure the service user that they are being listened to. This will help the service user to build trust in the nurse as they will have a feeling of acceptance and that someone is listening to them.

Conclusion

It can now be seen that there are many key elements that contribute to a therapeutic relationship and the list is endless. A therapeutic relationship requires a lot of time and trust on both parts and the core skills required from a nurse is empathy, trust and genuineness. As the author stated she was only looking at two key elements that contribute to this relationship and feels further investigation may be required into other elements to fully understand the importance and why such skills are acquired to build a relationship with a service user and the difficulties they may come across in maintaining a therapeutic relationship. One thing the author has achieved is the importance of person centred care and how essential it is to involve and listen to the service user in all aspects of their care.

Social Work is at an important stage in its development as a profession – not only in the United Kingdom but around the world. All professions must be responsive and proactive to changing social and economic climates and conditions if they are to meet the needs of the people they are serving.

It is essential for Social Workers to be able to practise in accordance with social work values and to retain a clear professional identity, and at the same time to be able to work effectively with other professional groups and agencies.

Although there are many terms used to describe working together with other professions such as joint working, inter-professional working, multi-disciplinary working and inter-agency working the term currently used by the Department of Health publications is collaborative practice (Whittington 2003b). New ways of working that crossed professional boundaries had to be created, in order to allow a more flexible approach to care delivery (Malin et al, 2002).

Collaboration in health and social care is a relatively new field of study, with the first major studies being undertaken in the 1980s (Roy, 2001). In health and social care collaborative working is often referred to as Inter-professional working, as it is not just about professionals working together. The patients, clients or service users are a central part of the team.

At its simplest the concept of collaboration infers that people from different professional and academic backgrounds form a working relationship for the purpose of enhanced service provision. However, the exact nature of the partnership is likely to be contested, whilst fully integrated ‘joined-up’ collaborative practice has so far proved elusive.

Effective communication is an essential component of the traditional social work roles and responsibilities. It is therefore equally necessary for social workers to also have effective communication skills if they are to promote self-help and empowerment to those whom they are providing a service for.

Lishman (1994) reminds us that care managers and providers ‘will have to use a range of communication and interpersonal skills if community care is really to mean care, choice and empowerment of others.’ Collaborative working implies: “conscious interaction between the parties to achieve a common goal” (Meads & Ashcroft, 2005). It recognises both difference & similarity.

Collaboration is a process by which members of different disciplines share their skills and expertise to provide a better quality service to patients, clients or service users (Hughes, Hemingway & Smith, 2005). The sharing of information means both getting information and giving it. The act of gaining information in Social Work is an essential task – the information gained can be used for numerous purposes such as:

Making an assessment of need or risk

Writing a report

Planning an intervention

To justify obtaining resource

The ‘something’ or benefit is sometimes called ‘collaborative advantage’, and it can be seen as the fuel of collaborative working – the greater the potential or actual advantage gained by all parties, the greater the levels of energy fuelling the collaboration.

According to Wilson (2008) and Hughes, Hemmingway & Smith (2005) inter-professional and collaborative working means considering the service user in a holistic way, and it benefits the service user when different organisations, such as Social Workers, District Nurses, Occupational Therapists and other health professionals come together to provide a better service. These definitions describe collaborative working as the act of people working together toward common goals. Integrated working involves putting the service user at the center of decision making to meet their needs and improve their lives (Dept. Health, 2009).

Effective collaboration and interaction will have positive outcomes within a working environment for both the teams working together and the service user. Agencies should be encouraged to share information to ensure that all needs of the service users are met but also to ensure the safety of the service user and the other teams involved.

Caring for People (Dept. Health, 1989) stated that “successful collaboration required a clear, mutual understanding by every agency of each other’s responsibilities and powers, in order to make plain how and with whom collaboration should be secured.”

The government has been promoting inter-agency and collaborative working since the late 80’s which also saw a change in the policies set forth by the governments and a legislative backdrop was created to promote self-collaboration between companies. The stated aim has been to ‘create high quality, needs-led, co-ordinated services that maximised choice for the service user.’ (Payne, 1995). Recent events and media outcries have focused collaborative working solely on Social Work as stated in Pollard, Sellman & Senior (2005) and when viewed as a “good thing”, it is worthwhile to critically examine its benefits and drawbacks. (Leathard, 2003).

The old government set forth plans to modernize the Social Services as well as update the NHS. A clear indication of this can be found in NHS Plan (Dept. Health, 2000) and Modernizing the Social Services (Dept. Health, 1998a). This was not in fact a new plan it was part of a growing emphasis stemming from the 1970s. The death of Maria Coldwell in 1974 meant there were questions asked why professionals were not able to protect children who they had identified as most at risk.

The Cleveland Inquiry 1988 resulted in the direct opposite of 1974 when the methods of the Social Services were deemed too strict and over powering, it was deemed that children were removed from their families when there was ‘little concrete evidence of harm or abuse’ (Butler-Sloss, 1988), with too much emphasis put on the medical opinion.

The old government set forth plans to modernize the Social Services as well as update the NHS. A clear indication of this can be found in NHS Plan (Dept. Health, 2000) and Modernizing the Social Services (Dept. Health, 1998a). This was not in fact a new plan it was part of a growing emphasis stemming from the 1970s. The death of Maria Coldwell in 1974 meant there were questions asked why professionals were not able to protect children who they had identified as most at risk.

The Cleveland Inquiry 1988 resulted in the direct opposite of 1974 when the methods of the Social Services were deemed too strict and over powering, it was deemed that children were removed from their families when there was ‘little concrete evidence of harm or abuse’ (Butler-Sloss, 1988), with too much emphasis put on the medical opinion.

The Munro Report (2010) stated that ‘other service agencies cannot and should not replace Social Worker’s, but there is a requirement for agencies to engage professionally about children, young people and families on their caseloads.

The Children’s Act 2004 was introduced after the public inquiry into the death of Victoria Climbie in 2000; the same public inquiry also resulted in the Every Child Matters movement. The failure to collaborate effectively was highlighted as one of many missed opportunities by the inquiry into the tragic death of Victoria Climbie (Laming, 2003) and Baby Peter (Munro, 2010).

Expressing what you all want to achieve in clear, outcomes-oriented language, and being able to continually recheck those outcomes as your work together proceeds, is the single most important key to successful collaboration. However, it is actually quite difficult to express outcomes in ways that are unambiguous and clearly understood by all of the potential or actual collaborators.

The quality of communication is vital. Poor communication is often behind many of the disputes that threaten to stall collaborative working relationships. Clear lines of communication need to be established across the institutions that make up a consortium to ensure everyone is aware of and is able to carry out the accepted policies and procedures. Accountabilities, in particular, should be well defined.

Participation and involvement of service user is also critical in the Social Work field. This after all is the main beneficiary of the collaborative working scheme and your goal as a Social Worker is to meet their needs and goals. If you show the service user respect they too will give you a mutual respect which will allow the Social Workers and other elements of the collaborative team to achieve their common goals.

However beneficiaries do not have to be aware that an activity is being delivered in partnership for the partnership to be successful. Regular reviews and users’ feedback can help measure its impact.

“Collaborative advantage will be achieved when something unusually creative is produced – perhaps an objective is met – that no organisation could have produced on its own and when each organisation, through collaboration, is able to achieve its own objectives better than it could alone”. (Huxham, 1996).

Huxham was showing that collaboration will work when it is done properly, and when we as Social Workers put aside any prejudices that are under lying in our working mentality and also our personal mentality, we will work well with other fields and practices to form a more efficient and organised service.

By learning with, from and about one another practitioners can understand respective roles and responsibilities, generate mutual trust, strengthen relationships and improve collaborative practice (Barr et al 2005). To summarise and conclude the development of collaborative working will undoubtedly require a change in culture and values amongst health and social care professionals; however it is working and developing quickly and for the better of not just the collaborating agencies but also for the service users.

My research will be directed towards mothers of the society. I wish to perform a detailed study and contrast and compare the working mother’s verses the stay at home mothers. I wish to analyze the differences among children raised by a working mother and a stay at home mother and the difficulties and hardships faced by working mothers and stay at home mothers in performing their motherly duties.

Significance of the research project:

The children are the future of the world and mothers are the first institution that they come in contact with, that is why it is essential to study and analyze the difference if raised by a working mother rather than a stay at home mother. This study will help us to proceed in the right direction regarding the upbringing of our children.

Research already conducted (Literature review):

There have been many controversies as to whether working women are better mothers than stay at home mothers. With both mothers certain feelings are attached that has been reviewed by researchers to make assessments. Working mothers usually cannot spend much time with their children, this leads to their feeling guilty .This guilt is experienced most acutely when women attempt to mesh the responsibilities of motherhood with paid work. (Everingham, Stevenson & Warner-Smith, 2007). . On the other hand stay at home mothers have time for children but they often over shadow their children making them too dependent or needy. However, the usual belief of the good mother is one who nurtures and cares for her family and believes that this should be more fulfilling than work (Buzzanell, Meisenbach, Remke, Liu, Bowers & Conn, 2005).

Additional research required:

In addition to the researches already made a need arises to contrast and compare the role of working mother and stay at home mother in the raising of children. Does it really make any difference if the mother is working? What difficulties are faced by working mothers in raising their children? Is raising a child easier for stay at home mother? These are a number of questions that my research project would target.

Benefits of the research:

The organization would benefit from this research as children are a point of concern for all of us. We have to contribute our share so we may help in shaping their future. Research like this provides an insight and show facts that were not clear before. Therefore, my research project will help our organization and serve the society in the long run.

Conclusion:

I am a working mother and can relate to the issues that rise with being a parent as well as being the sole provider for my household. Hence, I believe this research will provide a better understanding of mothers and help children in the process.

I would like to discuss this proposal in more detail with you. If possible, I would like to meet with you in a couple of weeks. I am excited about the opportunity to conduct my research and present the necessary finding as a result of this research. I can be reached at 469-348-4391 or by email at [email protected]

Attachments: references used in literature review are attached.

References:

Buzzanell, P. M., Meisenbach, R., Remke, R., Liu, M., Bowers, V., & Conn, C. (2005). The good working mother: Managerial women’s sense making and feelings about work-family issues. Communication Studies. 56, 261-285.

Everingham, C., Stevenson, D., & Warner-Smith, P. (2007). Things are getting better all the time? Challenging the narrative of women’s progress from a generational perspective. Sociology, 41, 419-437.

Table of Contents

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Executive summaryaˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦aˆ¦ii

Single mothers versus stay at home mothers 1

Portia Jackson 1

Operations Manager 1

Freddie Mac 1

Ireon Robinson 1

Team Leader 1

Freddie Mac 1

Executive summary
Introduction

The main debate that is on today is on what type of mothers are the best. Will it be the home mothers who do spend their days while taking care of the home and the kids or working mothers who spend their entire day, earning a salary in order to take care of the children? Most people claim that the debate is irrelevant as both parents whether hired or not are working mothers. Children are an integral population in the community thus lenders the debate imperative. Also the debate poses a problem because it pits a set of mothers against others as there can be no logical distinct relationship between profession and parenting.

This report aims at contrasting both set of mothers and giving limelight to some of the problems they both go through. It also aims at giving patent differences between the children of these two sets of parents. As much as some women would want to make a choice of whether to work or not to, most mothers do not have a choice. In order for stay at home mothers and the working mothers to get completely along, they should come to a consensus on some things. Just because some have decided to work, it does not mean they are neglecting their children and choosing their career instead. There is nobody who actually knows the family’s financial status and their reason to choose their professions apart from them. In fact what is right for one person may not be right to others. The report focuses on the analysis of the interview conducted about the whole subject and proposes a literature review on women’s view on the topic, and the problems they undergo as working and staying at home mothers.

2.0. Background

During the past generations, women had only one major role as far as the society is concerned; to stay at home and care for their children. As mothers, they were required by the traditions to stay at home and ensure that all the domestic life did run smoothly for the families. Gone are those days. However, there have been numerous frustrations of actually trying to work continuously full time and at the same time raise a family. Therefore, most women consider the staying at home option. Economists allege that the stay at home parents who refute a career can lose approximately $ 1million over years (Dunleavey, 2010). By some women just choosing to stay at home they limit the future prospects as far as income is concerned and the children might be at risk of not being fully provided for.

Most stay at home mothers have been known to criticize the working mothers claiming that they have gone ahead to choose career over their kids. Working mothers also have retorted saying that just because they do work it does not necessarily mean they do not care about their children’s welfare. The working mothers also do criticize the stay at home mothers alleging that they have no dreams and ambitions. Since the year 1970, the gravest changes among the American families are the amplified employment of the mothers outside their homes. According to ‘the children of America- working parents and child care’ article, the range of children with one parent who worked full time in 2002, increased to 80 % from 70% in 1980. For the children who live with two parents, 89% of them had one parent who worked as compared to 1980 when it was 80%.

Despite the amplifying number of women in the labor force since the year 1994, the number of all the children who are from the two families who had a stay at home mothers and working fathers have grown. In the year 2002, almost eleven million kids who were under 15 years had full time staying at home mothers. Some of the problems faced by the working mothers are trying to balance their work as well as get effectual time to spend with their kids. They also have difficulties in getting adequate childcare for their kids and they are sometimes unable to stay home when their kids get sick. The stay at home mothers on the other hand have some problems like attending appointments issues where the mother is too preoccupied at home and has no helper thus cancels lots of meetings. Also, there are unexpected money issues that may arise with time and with nothing to fall back too, it can be hectic. There are numerous problems that they face and those are just few. The major difference between the two sets of mothers are that working mothers do bring home regular pay check and have very little spending time.

2.1 Assumptions and implications

Most people assume that the working mothers have neglected their families thus they criticize them. They usually think that the working mothers have chosen their professions over their children. On the other hand, mothers who decide to stay at home are always considered to have taken the easy way out and seen as people who have no dreams and ambitions to follow. The issue is that most of the mothers who always work wish they can stay at home and cater for their children and are usually guilty but circumstances force them to work. The stay at home mothers always wish they can have time to go for appointments as well as work.

Explanations of new system

Most of the women today are in the workforce. According to U.S Census Bureau, In the year 2008 according to United States Department of Labor, 68 million women who are employed and 75% of all the employed women worked full time and 25% worked part-time. Most of the women now are hiring caretakers to take care of their children as they go to job. The system according to most people is not appropriate as the caretakers are not effective and can introduce the children into some unfavorable behaviors. Still, the system leads the mothers to feel guilty as they hardly have time for their children thus they grow aloof and more comfortable with the caretakers than the mother.

General requirements

There is a need for the problem to be solved on a rational base. It should be understood that criticism is not the answer but support is. Whether it is working mothers or staying at home mothers, both are working and should be respected. It should also be understood that there is no mother who is better than the other as they are all striving to care for their families whether directly or indirectly. Children of both sets of mothers should be catered for to enable them to succeed irrespective of their mother’s financial and professional status. The gap between the two mothers should be narrowed down for effective communication to take place.

Statement of the need

Working mothers do seem to get more criticism for being neglectful. In real essence, working women suffer from stress, overload and other problems. Staying at home mothers also get criticized for apparent luxury and indolence. There is a need for empowerment of women. As most people would assume that working women do not make it in marriage, it is not so. In fact, divorce rates have been on the fall for the last decades, while the female labor force rate has been rising (Zvika et al, 2006). The organization needs to focus on the research as it has its bases on children who are the future leaders of tomorrow.

Project description

The project aims at contrasting and comparing working mothers versus staying at home mothers and the differences between their children. It also does examine whether or not working mothers are better than staying at home mothers and the differences that does arise in their children.

4.1 Explanation of the problem

Single mothers in the professions and managerial occupations face numerous problems. They have difficulties as far as child care is concerned, overload of work and role conflict (Susan & Marilyn, 2001). They face financial strain, minimal support, and more work load than the mothers who have partners (Susan & Marilyn, 2001). Women in the paid employment who basically appear vulnerable to stress based diseases acquire dual role in both workplace and the domestic work. Working women suffer from stress that is induced by both home and work interface (Susan & Marilyn, 2001). Most people also do assume that staying at home mothers are the best mothers as compared to working mothers thus creating controversy between the two. Staying at home mothers do face financial crisis though they give maximum attention to their children. There are also conflicts between families where women are working and men are not. Though use of organizational programs that are work life related are shown to minimize family conflicts and improve satisfaction and the well being, the availability of some extensive as well as generous policies do not result in utilization of the employees (Paula et al, 2005). Attention is highly needed to curb this problem as the children are integral people in the society. The mothers need counseling, consulting and coaching in order to cope with the stress that is prevailing (James et al, 1999).

4.2 Statement of the objectives

To examine whether working mothers are better mothers than staying at home mothers and also to find out the problems experienced by both mothers in the workplace and as far as society is concerned. There is also a need to explore on the differences of children raised by working mothers and stay at home mothers as far as attitudes and performance is concerned

4.3 Methodology

Research design

The research is a case study on working women versus staying at home women and studying how they differ as far as their children are concerned as well as the problems they face.

Population and sample

The population of this study is both men and women in Hawaii. The study used a systematic random method to choose the sample. Stratification was based on gender and status quo as far as workforce is concerned. 50 households were chosen as the sample.

Data collection

I used primary and secondary data. I used interviews and questionnaires as primary methods. The data collected included number of households, problems they faced and how their children differ. Data collection from peer reviewed articles and general research was also used.

4.4 Data analysis and findings

Data analysis was carried out using Statistical Package for Social Sciences (S.P.S.S). Performance in school represented the independent variable while the parents represented dependent variables. Data collected regarding the problems of both sets of women were also independent variables. The analysis showed that both sets of women faced numerous problems including criticism and stress. Children from women staying at home were likely to become more independent on their parents than the working mother’s children. Both the children of the working and non working mothers had similar performance since most working mothers alleged that they had time with their children in the evening and helped them with their class work.

Budget

Given that all my resources are actually available, there isn’t much costs associated with performing this research. The major costs are photocopying articles, printing the report, and a laptop that will enable me do the research.

5.1 Conclusion and recommendation

It is evident that both women whether working or staying at home mothers have diverse problems. They both suffer from stress and other patent problems. There is a need to be aware on how these women should be empowered and exactly how their problems should be solved since they are the backbone of the children who need full support.

In general, society considers the elderly as persons above the ages of sixty or sixty-five. This is usually the beginning of old age as a person becomes less active in political, social and economic affairs. Though there are elderly persons who are in good health and active members of their communities, majority are the ones whose physical and mental functions are on the decline. Since they are not able to get along on their own, majority of the elderly persons require attention and care from their loved ones as well as friends. Consequently, psychologists use the term elderly care to refer to the personal as well as medical attention that this group of the population receives.

It is evident that elderly care takes a variety of forms, ranging from personal care such as feeding and dressing, to medical attention. In addition, the care that a family chooses for its elderly persons will depend on their needs. This is because some of the elderly persons may still be in good health while others may be frail. Consequently, some of them may require home-based care while others may need specialized attention in a nursing home or in a hospital. Whatever the case, the elderly do need some form of care.

In this study, I shall focus on the American culture and the Asian culture, and make comparisons between the two, in relation to the aspect of caring for the elderly. For the Asian culture, I shall examine the Japanese. In both United States of America and Japan, the number of elderly persons is on the increase. This means that both governments have to consider and put in place the best mechanisms to cater for this group of the population. Different communities accord the elderly different forms of care, depending on how their cultures dictate. The way a community perceives old age will therefore affect the manner in which it treats the elderly.

The responsibility of caring for the elderly in Caucasian and Japanese cultures lies mainly with the woman, because these societies consider her as an innate caregiver due to her maternal abilities and instincts. However, this is also due to the fact that, over the years, the woman has fewer opportunities in the economic scene, and as a result, she remains at home most of the time to take care of her children and the elderly. On the other hand, when the woman is able to access the labor market, she finds herself in positions where she has to provide care for others. Most nurses, school and hospital matrons are women. However, in the above cultures, children also participate in elderly care, as a form of compensation for the nurture their parents gave them when they were young.

The American society places a lot of emphasis on staying young. Consequently, as Samovar et. al. (2009) notes “we find a culture that prefers youth to old age.” (p.71). This negative perception of old age makes the young people avoid staying together with the elderly and caring for them. The older adult population rather than the young adults are the ones taking care of the elderly. This explains why some families in the United States give over their old relatives to nursing homes. This does not however mean that the young cut all their links with their elderly relatives. They do provide support and maintain contact with them. The nursing homes are an option for the elderly people who have no family or relatives to look after them at home. This is especially the case for those who are physically handicapped and require the help of another person to take care of them.

Though the nursing homes have become the choice for most families with elderly relatives, they do have their limitations. Some of these institutions for the elderly have become money-making ventures, therefore reducing their emphasis on the needs of the elderly. Poor hygiene and lack of trained medical personnel and quality treatment as well as poor feeding programs are some of the problems the elderly face in these nursing homes. Moreover, placing the elderly in nursing homes limits their freedoms as they have to follow the stipulated program. They cannot choose when to feed, sleep, interact with their fellow housemates and cannot keep their belongings. However, nursing homes for the elderly still remain the option for most American families, as there has not been much success with home-based care.

On a positive note, the elderly persons in American society have more groups of friends and neighbors whom they can go to for support, than the aged people in Japanese society. This means that the American elderly are likely to receive care from their friends and neighbors, apart from their immediate family members. However, the Americans usually tend to give special care to their elderly only after they learn that the latter are facing a medical problem.

However, since the family is still the main caregiver for the elderly, some of the American families employ professional nurses to take care of their old at home, instead of sending them away to nursing homes. Another reason for this is that, institutions for taking care of the elderly are expensive, and some of these families are not able to afford them. Moreover, some families opt to take their elderly to day nursing institutions, where they receive care throughout the day and then return home in the evening. This is suitable for those people who are working and cannot stay with the elderly relatives during the day as they have to report to work. It is also convenient for working adults who cannot afford specialized care for their elderly ones, either at home or in a nursing institution.

In some instances, the elderly person may be able to live in his or her own house, and may be strong enough not to require specialized attention and care. In such cases, the family members of such an elderly person find a house near other aged people, in areas where the amenities they need on a day-to-day basis are readily available. This form of elderly care appeals to the community and involves them in taking responsibility for this group of the population.

On the economic front, some of the big corporate organizations have introduced benefit schemes for their employees, in order to help them in caring for their elderly relatives. This is because most companies want to avoid losses in production, due to having employees who have to work while at the same time take care of their elderly relatives. Some companies also provide home-based care services for the elderly, but as a profit-making venture. This however, has a negative side to it as these privatized services are costly and not many families are able to afford them.

On the other hand, Asian culture of the Japanese has a positive perception of the elderly. It teaches the children to respect and care for the elderly. The Japanese consider the family as the prime caregiver for their elderly, and in this case, it is usually a female member of the family who carries out this duty. This is because the Japanese believe that it is not in order to take the elderly to a nursing home as this is equivalent to neglecting one’s responsibility of taking care of one’s parents. This also makes the Japanese families give the required care to their elderly relatives throughout their old age, rather than only when they are facing a health problem.

In the case of aged people who are not related to the family, Japanese wives or their daughters are the ones who tend to give their elderly friends the care they need. Sometimes, the daughters-in-law also give care to the elderly, especially if the patient is female. However, if other friends and non relatives are living under the same roof with the elderly persons, they may provide the necessary care to the latter. This is in contrast to the case of the American elderly who receive care from their family as well as friends and neighbors.

In Japan, the activity of giving care to the elderly is mainly as an act of duty, rather than voluntary will. The caregiver considers this act as one that he or she has to give, and in most cases, the Japanese wife will provide the elderly attention at her husband’s request. The dependence of the Japanese elderly on their immediate family is also evident in the fact that most of them rely on their spouses and their children for financial support. Since the Japanese believe that giving the elderly care is a woman’s job, the men usually leave this task to their wives. However, though the Japanese men are away from home most of the time, they also contribute to elderly care by giving their spouses financial as well as emotional assistance. Again, by participating in looking after their children, they allow their wives to find time to take care of the elderly members of the family.

Elderly care in Japan still remains largely in the hands of the family, especially for those who are not sickly and in need of specialized medical attention. However, caring for the elderly at home is no longer the only option, and families have begun taking the old to nursing homes. This is due to a number of reasons such as the aging of the family members providing the care as well as the increasing involvement of the Japanese women in formal training and employment. Moreover, Japanese families are not living in large numbers as they did in the past.

However, the number of nursing homes for the elderly and professional caregivers is on the decrease because of the Japanese belief that it is the immediate family which bears the responsibility of taking care of their elderly relatives. The elderly who are in need of very little personal and health care remain at home, but get visits from personnel who attend to them. This happens either a few times a week or every day depending on the needs of the elderly person. Due to the rising demand for health caregivers for the elderly, Japan has sought the help of care personnel from the Philippines. These caregivers are more experienced and are willing to work at a low pay.

Due to the increase in the elderly population, financial resources have not been enough to allow families to put their relatives under specialized care at home and in nursing institutions. It is due to this situation that hospitals in Japan have offered to accommodate the elderly who are in need of both personal as well as medical attention. This way, the elderly in Japan can access long-term care. Though on a small-scale, the Japanese elderly engage in volunteering programs where they offer services to the community and in turn, they receive personal as well as medical care.

There are however some similarities in the aspects of elderly care in American and Japanese cultures. Care for the elderly is still one of the concerns of both the United States and Japanese governments, though they differ in their policies. America gives priority to provision of medical attention, pension for retirees and shelter, while the Japanese government came up with policies to put in place insurance for every citizen including the elderly, for a long-term period. In both countries, the increase in aging members of the population has put a lot of pressure on the medical as well as retirement schemes. However, technological advances in medicine have increased and they are being used to improve the life-expectancy levels of the American and Japanese aging populations. Again, since women are increasingly going into formal employment, the men in both countries are also becoming more and more involved in elderly care.

In conclusion, due to lifestyle changes, many people have started living in smaller groups and families, and are also located far from each other. Consequently, caring for the elderly can no longer be the responsibility of the immediate family alone, but has to be a prerogative of governments, non governmental organizations as well as private institutions.

Case management is the process of helping patients with lives that are not productive or satisfactory as a result of a number of problems among them drug and substance abuse.

Case management in social work is whereby a social worker professionally assesses the needs of the client and their respective families (Ballew & Mink 1997). The social worker then coordinates, monitors, evaluates, arranges and advocates an effective service package to meet the client’s or patient’s needs. Case management differs from managed care whereby the former is designed to obtain the most appropriate and perhaps best treatment for patients while the latter is designed to avoid hospitalization or initiate shorter hospital stays thereby reducing costs incurred.

Case managers’ professional credentials will comprise broadly of the following:

A masters graduate accredited by the council on social work education

Have a current state or national social work certificate or license

At least two years work experience at the masters level relating to bio-psych – social needs

Practicing in line with federal and state regulations and laws

An adherent to the social work code of ethics (National Association of Social Workers – NASW)

Case management constitutes psychological and clinical components. As a pre- requisite therefore, a case manager should be able to address a variety of matters some of which may include:

Crisis intervention: where the patient’s state or situation signifies a crisis needing urgent attention

Resource brokerage: This involves marshalling of the necessary resources to commence treatment.

Teamwork collaboration: The bringing together of all the stakeholders involved in the treatment plan

Client / family education: Provision of all the necessary information and education related to the condition and treatment procedure.

Client / family advocacy: Advocate for patient or client where society or family puts forth a set of demands (Halley, Kopp & Austin 1997)

Psychological assessment and diagnostic procedures

Results and evaluation: Interpretation of patient assessment results.

Client / family counseling: Initiate patient / family counseling sessions.

Most importantly the case manager initiates a team oriented approach to case management. Generally case management procedures offered by organizations are effected based on a screening procedure outcome. This screening criteria will pinpoint all collaborative services through coordination of high quality care services. The coordination is meant to reduce any service fragmentation. The ultimate goal of this process would be to identify patients:

With costly illness or injury

With terminal condition

With chronic illness or illness in an acute stage

The coordination of the case services during screening is aimed at enhancing the quality of life and appropriate usage of health care resources. Client screening should cover the following aspects:

Financial

Environmental

Physical

Psychological

Cultural / spiritual

Vocational

Client psychological screening is achieved through an assessment process which may include among other components:

Patient’s personal data

Patient’s health status and age

Patient’s emotional and financial status

Patient’s vocational and functional status including spirituality

Cognitive functioning focusing on the client

The case management process exploits a number of intervention options. The case manager assists clients / patients and family members to establish a suitable treatment plan. The plan pinpoints the patient’s strengths and supportive systems. These are employed during the implementation.

Alternatively the case manager may monitor a patient from community to an inpatient facility and back to the community setting. The manager then adapts a treatment plan suited to the patient’s needs in each of the set ups. Collaboration as an option can also be used where the case manager collaboratively and collectively involves the patient’s family and others concerning the implementation of the treatment plan. The parties are continuously updated about the progress, goals, obstacles and any variations to the initial treatment plan. The Patrician movement most likely adopts this kind of approach or practice based on the fact that this movement considers the family as a basic societal unit that can be directly involved in the treatment and prevention of substance and drug abuse (The Patrician Movement 2010).

An important aspect concerning any process is the documentation process. In the case management process the manager develops suitable case management plans which are documented in the patient’s record. These documentation should be accessible by all relevant and authorized team involved in the treatment plan of the patient in question. The documentation contains vital information based on the current or proposed treatment plan. Accordingly all medical documentation should be kept confidential and treated as so. The case management process must have an established measurement of outcomes. The plan’s outcome indicators should include observed and measured goals for every problem, the progress being periodically measured by the case manager along with the supportive team. The measurement indicators will include:

Resolution of the problem: This will include the patient care plans connoting the percentages met, partially met or not yet met. The patient’s level of dedication to treatment estimated by measuring the attendance frequencies for the assigned treatment sessions. A decrease in procedures and treatments that was unplanned for.

Service costs, reconciled service levels and utilization of resources

The patient’s or client’s satisfaction which can be derived by the use of tools such as questionnaires the likes of DUKE, Darmouth Co-op or SF- 36. Levels of patient satisfaction can also be demonstrated through contract renewal by the client usually an indicator of insurance company satisfaction.

The patrician movement was founded at St Patrick Parish on the Eastern side of San Antonio in Texas in the late 1950’s as a church based drug and substance abuse prevention and treatment facility. Initially founded as a haven from multi racial violence within the neighborhood, patrician movement founders realized the need to address the substance abuse that was clearly evident among the various gang members who came to seek shelter at the parish. The movement has largely evolved into a fully fledged facility today offering prevention and treatment services from a holistic point of view (The Patrician Movement 2010). The treatment program is largely inclined on a self assessment journey making every case unique in its own sense. The core concept embraced by the patrician movement points to the fact that each individual is unique and has a right to develop maximum potential. The family is emphasized as the basic unit of society and education as paramount for human development and treatment. The prevention and treatment services at the patrician movement are somewhat unique. This is due to the fact that prevention and treatment process are family oriented and managed. Case managers are basically from within the community and a conservative approach to rehabilitation process is followed. Among the case managers are those with special skills, others are former clients of the patrician movement whereas some are family members (Ballew & Mink 1997)

The patrician movement is concerned with the whole person and serves the San Antonio population basically. However the entire Texas state also benefits from the services of this movement. This movement having started at community level and as a community initiative is thus strongly San Antonio based. While involving the family in case management; patrician movement is helping to build stronger rehabilitation programs with effective accountability and follow up. The age bracket covered by the services offered at Patrician movement ranging from 18 to 65 years ensures a wider population is catered for. Patrician movement runs a brief strategic family therapy (BSFT) to cater for youngsters exhibiting early substance abuse and delinquency. By focusing on the family as a base of contact and rehabilitation Patrician movement ensures full community involvement in the programs thereby making them quite effective. Established in a mixed race society, Patrician movement cross racial approach to treatment and prevention continues to elicit community support from people of mixed race. Posted statistics are indicative of the fact that as at 2003 over 2500 families had been served with over 2200 adults as well. Proportionally this implies almost one adult per family. This means drug and substance abuse rate in San Antonio is high. A perusal of the testimonials from the Patrician movement website indicates a community full of gratitude to the services offered at the movement. The GED diploma program is among the unique service offered at Patrician movement meant to empower the population intellectually.

By focusing on the whole person the Patrician movement boasts a higher level of success in rehabilitation unlike the common approaches that will mainly focus on the resolution of the problem. In developing and involving the family and therefore the community as a fundamental part of the rehabilitation process, Patrician movement is ensuring lower chances of relapse due to the fact that all other underlying factors are looked at and addressed.

Due to the fact that the San Antonio population is mixed race, the Patrician movement believes in intellectually empowering the community as part of its prevention and treatment strategy. The administration of GED program ensures that those without the basic intellectual skills are equipped and in so doing the general public is able to receive and act on general public information without misinterpretation or misunderstanding.

Promporn Dokphutsa

Task 1

Explanation of Te Tiriti O Waitangi and its application in the social services

Te Triti O Waitangi was signed on 6th February 1840 at Waitangi. It significant to maintain the benefits of Maori people who living in New Zealand. It is concluded 4 important principles which are partnership, protection, participation and permission. These 4 principles are the basic necessary needs for Maori in term of living and culture. Therefore, while Maori people get engage into any social services, it is responsible for social workers to be aware and make sure that Maori clients have been treated with appropriate services.

Firstly, partnership refers to working together for agreed outcomes. A a social service organisations must ensure providing policies that the needs of Maori are taken into description when cooperating with Maori client and their family/ whanau. By building trust and rapport with Maori clients and their family/ whanau is the first thing to consider introducing yourself and getting to know more detail of clients by making friendship. As well as involve clients in every processes of care plan such as let them sign the contract to ensure health & safety support and fully inform need to be used.

Secondly, protection focuses on client’s privacy and safety. The social workers may following the Code of Rights and Code of Conducts to maintain client’s confidentiality while attending social service. As well as respect the right of Maori to enjoy their taonga in social service settings. To be able to make important decisions those are in their best interests.

Thirdly, participation is focused on service accessibility for Maori to make sure that their needs are met by asking or allowing them to participate in their care plan until discharge from residential care. Also family/ whanau engagement at all levels of service is another way to practice participation principle.

Lastly, permission is important for social workers to be considered while engaging to social service. Maori clients must be free to speak Te Reo Maori and participate in any Maori spiritual or culture practices.

To sum up, 4 principles of Te Tiriti O Waitangi are using to maintain and promote Maori’s physical and mental well-being and safety. Therefore, social workers have to provide as much as possible resources for Maori clients to make sure they needs are met and bi-cultural perspective by following Te Tiriti.

Task 2

Manage the intake process of a person discharged from residential care.

Context setting

Residential support to Adult(18-65yrs) with an intellectual disability

Individual

Group

Summary of reason residential care was required

SH

Adult (23)

A Maori lady is being discharged from a residential care after she has completed to 6 months stay. SH had diagnosed with Perthes Syndrome (Childhood disease of hip joint) since she was born. But when she is growing up she started showing challenging behaviour included physical and verbal aggression such as throwing, hitting, kicking, spitting, swearing and pinching. Therefore, her family/ whanau suggested transferring her to stay in the residential care facility to develop social skills and to be independent in her environment.

Contribution to managing intake process

Date

Notes/ key of information provided to the person

01/03/14

Receiving and collecting information of SH.

Receiving and recording referrals for a meeting.

Contacted SH family/ whanau and other key people and gave them access to the information for the meeting.

02/03/14

Service co-ordinator, house leader, CSW, Mother, GP, caregiver and healthcare professional have a meeting regarding to the improvement of SH.

03/03/14

All parties were agreeable that SH is ready to go back to the community.

Summary of information provided to the person regarding the role, function, services and legal responsibilities of the social worker and social service provider.

The intake process helps to identify and assess a client’s current situation, issues and needs as well as to determine the most appropriate and effective means of helping the client. Social workers and social service provider have to concern about client’s safety and wellbeing first before making any decisions during the process of discharged. Therefore, gathering data (qualitative e.g. interview/ quantitative e.g. number) to get personal information of client is necessary. It could come from the client, family’ whanau, friends, health care professional or other keys people who relevant to the care plan. Also physical and mental wellness of client is important to make sure the client is ready to go back to the community independently. Intake and Assessment is a reverential, organized process of gathering personal information of either clients or clients’ caregivers in order to facilitate service providers as well as clients to make informed decisions about the provision of the programme and/ or services. Social service organisation should make sure that they have progress their own timeline for intake and assessment that suits their programmes which lead in safe environment and suitable for the client/client’s caregiver.

Notes/ key points of how you completed intake procedures according to the discharge plan, legislation, ethical practice and in accordance with your workplace standards/ requirements.
Roles and responsibilities
As a social worker will need to create suitable and focused on working together with clients, taking into account individual differences and the cultural and social context of the client’s situation such as understands the concepts of culture, class, race, ethnicity, spirituality, sex, age and disability.
Allow client to participate in the processes by motivates and encourages participation.
Assists clients to gain their self-determination over their own environments. Provides choices for the client, gives accurate information by which the client can best decide.
In working with clients, the social worker uses her/his personal characteristics appropriately. May attends supervision to develop best practice.
Written policy and procedure
Admission criteria.
Intake and Assessment procedures.
Documents to be completed and retained.
Procedures to follow when a client cannot be assisted /referring on.
Information to be provided to clients.
Legislation relevant to the organisation.
Others notes/ reflections on the intake process.

Client’s safety and wellbeing must be the first consideration of the social service provider before completed intake procedures according to the discharge plan.

Task 3

Contributions to assisting the person to manage the transition from residence to the community

Date

Notes/ key points of any meeting or other communication details of actions related to assisting the person.

05/03/14

SH’s family/ whanau was consulted about the discharge from residential care facility.

06/03/14

Discuss with SH about her interests and goals.

08/03/14

Support SH in term of decision-making in her interests and being independence.

How did the assistance you provided encourage self-determination and discourage dependency on the social service worker or social service provider?

Respect the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. As well as giving an opportunity for clients to request and ask for their interests or needs, but always have to be considered about safety and wellbeing of client and people around. Social workers should use clear and fully inform clients of the purpose of the services, risks, limits to services, relevant costs, reasonable alternatives, clients’ right to refuse or withdraw consent, and the time frame covered by the agreement. Then, social service worker or social service provider has to be responsible to follow and review of client’s self-improvement after discharge from the residential care.

What people did liaise with in the community and how did this assist parties to the plan to contribute to the person’s resettlement?

Disability service agency is responsible to provide resources that suitable to the clients by following client’s needs and requests. Also assisting connects the client with plans and resources in order to help them cope. However, relevant factors may include client’s abilities, her resources, her needs, client’s goals, and identify what is important to the client, also any risk factors.

What resources did you manage, and what arrangements needed to be made for the transition from residence to community?

-Safety is the most important and first consideration for the social service provider to be aware and ensure client’s physical and mental is safe.

-As a social service provider has to be aware of “client’s cultural needs” to practice as a Maori. As well as promoting spiritual practice to maintain client’s customs and beliefs. Additional, cultural assistance should be provided to avoid of cultural conflicts.

-Disability needs of client is another factor to be considered. To ensure client is living in safety and friendly environment with her disability. And maintain physical comfort in her daily routine.

-Health needs for client may assist by regular visited of health care professionals and assist her with medication needs.

-Language and communication should be clear and understandable to client and her family/ whanau. Additional, interpreter may provide if needed.

Other notes/ reflections on the transition to community

As a social service provider makes sure the client is living in safe environment and surrounding with positive people and activities. Therefore, it may help client to improve her social skills and being independence in community.

Task 4

Assist the person to resettle in the community following residential care

Date

Notes/ key points of any meetings or other communication details of actions related to the person

09/03/14

Provide choices and opportunities for SH in term of her interests.

10/03/14

Allow SH to make her decisions by ensure respectful and confidentiality.

11/03/14

Fully inform to SH family/ whanau regarding to her decisions. Then discuss how to provide service and make her needs to be met.

How did you encourage self-determination and discourage dependency on the social service worker or social service provider?

Encouraging self-determination:

-Outlined agency’s objectives and appropriate legislations, backing up agency orders/kaupapa.

Provided information and fully informed SH of the limitations and possibility of the meeting, and allowed her to define the best options and which issues I could help her with.

Discouraging dependency on social services:

-Allow SH to express her possible solutions and choose her own best options.

-Where possible the agency would step away, so that SH could step up.

-Allowed SH to figure out so called “emergencies”.

How did you assist the person to identify requirements for life in the community, i.e. set aims and objectives?

Organised first meeting to provide intake assessment and referral accepted.

Then second meeting had set up to interview with SH to discuss her particular needs at this point in time. Ensure effective communication is being used and document her needs and prioritise what need to be done first into an action plan.

Lastly, arrange the key persons who would be responsible to action each of the itemised needs.

How did you assist the person to evaluate their participation in the community against their aims and objectives?

Identify progress against plan and review. Then asked scaling questions as to where SH felt she was in agreement to her hopes and her interests.

How did you assist the person to establish a community lifestyle that focused on both their safety and the safety of others?

-We established community supports before her transition such as 24/7 emergencies call if need any help.

-Educate basic skills to her family/whanau how to deal with her aggressive behaviour while she is living in the community.

-We discussed goals that will motivate her to gain her social skills and make more friends.

What progress against the discharge plan was achieved?

Her mental health status was unstable, according to the Epilepsy. Therefore, her seizures are managed by medications and need to be observed by health care professionals at all time if possible.

What further options (if any) were identified?

It is important to note that staffs have to be familiar and consistent with client when giving her social services to avoid of challenging behaviour and accident that may happen.

Other notes/ reflections on the re-setting of the person

Avoid confrontations with client and do not say “NO” to her. Do not say “Don’t do that” try to say “First you do… (Something she may not like to do), Then you can do… (Something she like to do)”.

Task 5

Application of social service theory

Maori Model of Practice

-Maori model of practice within utilised social work practise research and validated to provide best practise.

-Maori models of practise have holistic approach

-Wellness of whakapapa focus opposed to individual focus.

For example -Te whare Tapa Wha (four cornerstones of Maori health) including:

i.)Taha tinana (physical health): healthy eating, sleep, physical activities, safety awareness and proper hygine.

ii.)Taha wairua (spiritual health): beliefs, culture religion.

iii.)Taha hinengaro (mental health): positive thinking, positive behaviour and healthy lifestyle.

iv.)Taha whanau (family health): emotional support, financial and responsibilities.

Social work knowledge, skills and values (Te Kaiawhina Ahumahi 2000) was a useful resource for the social workers to be used as a guideline to work in appropriate way and proper practice while giving services to the clients.
Social policy theory involves the study of the social relations necessary to promote human wellbeing and things that affect the kinds of life. It can be love and safety, a job and money.

References:

http://www.polity.co.uk/shortintroductions/samples/dean-sample.pdf
http://workplacewellbeing.org.nz/mana-mahi-resource/workplace-wellbeing-guide-6-working-with-te-tiriti-o-waitangi/
http://www.hdc.org.nz/education/presentations/the-health-and-disability-commissioner-act-and-the-code-of-rights-and-methadone-treatment

Early motherhood has been an issue in the U.K. for a while now and data from the Social Exclusion Unit (1999a) explained by Chase et al.(2009) shows that the UK has one of the highest numbers of young mums in Europe.

A group of students including myself carried out a research to find out whether the needs of young mothers in one of the boroughs in London are being met and whether their needs fit into the different approaches surrounding the concept of need.

In this essay I will be describing the rationale and the nature of the research carried out by our group. I will evaluate the strengths and limitations of our research including methodological and ethical issues.

I will be discussing different approaches in literature to defining the concept of need and then relating our findings to the concept. Finally I will consider the implications of our research for social work policy or practice then I will conclude.

The rationale behind the decision to explore this question was that the issue of young parenthood is relevant to the field of social work. This is because the young mums sometimes encounter difficulties which make them fall back on the social services for support. According to Chase et al(2009) the young mothers seem to have the notion that instead of receiving the necessary support that they require, the Social Services rather intrude upon, regulate and scrutinise their lives.

We therefore wanted to find out what the professionals in the field and the young mums identified as their needs, what kind of support was available to them and if there were any gaps in the services provided for young mothers. We also wanted to know what enables or prevents them from getting the kind of support they need.

Furthermore tackling teenage pregnancy has also been on the government’s agenda for a long time and we wanted to know whether the strategies put in place to tackle it were working.

We wanted to broaden our awareness and knowledge base because most of us had limited personal and professional knowledge in this area.

We wanted to explore issues surrounding social exclusion, discrimination and oppression issues and see if we could come up with any recommendations for practice.

We chose the southeastern area because it made it easy to for us to access resources like the service provider, service user group and previous research material.

Our group brainstormed and came up with young mothers as a topic. We developed this into a question as to whether their needs were being met then we worked out a plan with various deadlines to accomplish different tasks.

We asked for ethical approval from the Goldsmiths ethics committee, in which with reference to the ESRC Research Ethics Framework and the NASW code of ethics we stated our independence and impartiality.

We addressed non malevolence by assuring them of their safety and asking them to bring someone along with them if they felt they needed support. We also addressed how we were going to tackle issues regarding voluntary participation, informed consent and the integrity and quality of the research. We also addressed ethical data management and confidentiality of research participants. We also wrote out a consent form which addressed our objectives and consequences of participation.

We chose a qualitative approach explained by Whittaker (2009) as a method which seeks to explore ways in which individuals understand their worlds. This was because we needed a deeper understanding of the issues affecting the young mothers and the reasons behind why and how they felt disadvantaged.

We also used a quantitative approach when comparing previous statistics on young mothers. This is what Whittaker (2009) explains as a method which tends to emphasise quantification and measurement to establish relationship between variables.

Our research was a Participatory action research which Alston and Bowles (1998) explain in Whittaker (2009) as a form of research that is committed to the involvement of those affected most. We also undertook a literature review where we looked at journals, books, official and legal publications which were relevant to young mothers.

To recruit the professionals, we used purposeful sampling which Whittaker (2009) explains as a method where one chooses participants who are likely to yield useful information based on their knowledge, experience or role.

To select our young mums we used snowball sampling which Whittaker (2009) explains as a situation where a small number of participants (which in our case were the professionals) are asked to recommend other suitable people who would be willing to participate.

We used semi structured interviews where we had an interview schedule with flexibility during the interview. The main components of the interview with the professionals were job roles, services offered to young mothers, views about funding due to change in government, needs of young mums, hindrances and gaps in service.

The main components of the interview with the young mothers were access to services, education and employment, community and service user involvement.

In analysing our data we used thematic analysis which Whittaker (2009) explains as a method for identifying, analysing and reporting patterns (themes) within a set of data.

In all we interviewed 14 women who became young mothers at ages ranging from 14 to 21 years and 4 professionals.

The strength of our Participatory action research method as Whittaker (2009) explains, shows that the method challenged the traditional power imbalance which would have made us look like experts and the young mothers passive subjects. This method was helpful because it was highly compatible with anti-discriminatory and anti-oppressive practice.

Due to the limited time that we had, this method was the most suitable way of gaining a lot of information in a short period of time as compared to observational methods.

The qualitative approach also allowed us to bring our backgrounds and our identities into our research. This is explained by Maxwell (1996) in Whittaker (2009) through the concept of reflexivity, which acknowledges that we bring our thoughts, values and beliefs to our research. This was helpful because being a mother myself I could identify with what some of the young mothers were saying.

The interviews were helpful because as Whitaker (2009) explains, interviews are good at examining complex issues and enable participants to discuss sensitive issues in the open without committing themselves in writing. This brought out complex and rich data which drew upon the feelings of the teenage mums.

We recorded the interviews and this helped us to give the young mothers our full attention rather than dividing it between writing and listening.

We had some limitations in the form of the transcripts of the interviews which were time consuming and the data very complex to analyse. Due to the number of young mums we interviewed the findings could not be generalised.

The presence of some of the professionals during our interview was a limitation because the young mums could not really express their honest opinions.

Our sample was chosen for us therefore we could only speak to participants thought to be suitable by the service provider. Opinions from the focus group could also be limited to those with the strongest opinions or the loudest voices. Our research also lacked the opinions of young mothers who did not use the service providers we used.

To fit the answers we got from our findings in to the concept of need is complex because one cannot come up with universal definitions that would fit different notions on need.

A number of key theorists have come up with different approaches on the concept of need. Abraham Maslow pointed out in Hartley (2010) a hierarchy of needs with the ultimate goal being the need for self actualisation. According to Maslow the first stage was to satisfy what he called physiological needs which included food, shelter, clothing and sleep.

The next stage was to satisfy safety needs which included security, stability, dependency, protection, freedom from fear, anger and chaos.

Maslow identified the next stage which is to satisfy belonging needs. These include giving and receiving affection and love, contact, intimacy and belongingness. After this stage comes esteem needs which include a stable and high evaluation of self which can be achieved through strength, achievement, mastery, competence, confidence, independence and freedom. Under esteem needs Maslow still put prestige (esteem from others), status, fame, attention, recognition, importance and appreciation.

The final stage on his hierarchy is what Maslow called the self actualisation stage where. Maslow emphasises the essential goodness, wholeness and potentials of humans.

Sheppard (2006) criticises Maslow by pointing out that his theories do not consider that people can consciously take decisions without following the hierarchy.

Midgely (1984) in Sheppard (2006) also criticises Maslow’s theory by saying that the theory hardly covers situations where choice is unavoidable. The pursuit of one goal leads to the abandonment of another. For instance a single mum would love to nurture her baby but has to work and pay bills instead. She fulfils esteem needs which include independence and freedom but forgoes the previous stage of satisfying belonging needs which include giving and receiving affection.

Another approach from Doyal and Gough (1991) also explain that all human beings have needs which are objective and universal. These needs can be said to be goals which humans need to achieve to avoid serious harm. Serious harm is being fundamentally handicapped in the pursuit of one’s vision of the good.

Doyal and Gough (1991) grouped these needs into basic needs and intermediate needs where basic needs are a necessity for successful social participation in a society in which a person lives.

Under basic needs they emphasised physical health and autonomy because physical health is central to the capacity for people to direct their lives and carry out decisions.

Doyal and Gough (1991) explain that autonomy is necessary in order for people to be self directing because one aspect of autonomy is freedom from hindrance or constraints. Therefore one is unable to act under ones own direction if there are constraints. Hence autonomy is not possible when mental health, cognitive skills and opportunities to engage in social participation are missing.

Having explained basic needs, Doyal and Gough (1991) went on to explain that intermediate needs defined how the basic needs can be fulfilled. These included adequate nutritional food and water, adequate protective housing, a safe environment for working, a safe physical environment and appropriate health care. Further included were the need for security in childhood, significant primary relationship with others, physical and economic security, safe birth control and child bearing, appropriate basic and cross cultural education. Therefore to be able to satisfy basic needs one needs a range of satisfiers (intermediate needs) which will be culturally specific.

Robinson and Elkan (1996) explain that the theory underpins theories which emphasise the importance of citizenship and ability to participate within the community.

In the limitations, Doyal and Gough point out in Robinson and Elkan (1996) that the theory does not account for what standard of need satisfaction should be set in order to be able to calculate shortfalls in the actual level of need achieved.

According to them a solution to this, is to set a basic minimum standards such as a poverty line of need, below which people are prevented from participating within the society.

Another limitation which Robinson and Elkan (1996) point out is the problem of who to decide whether or not a given policy is meeting basic or intermediate need.

Another approach from Bradshaw in Hardy (1981) identified four separate definitions. There is normative need which is explained by Hartley (2010) as needs which are determined by expert judgement of policy makers or professionals. The limitation to this approach, as explained by Hothersall and Maas-Lowit (2010) is that there may be different conflicting standards which could contradict how need is identified.

Bradshaw also identified felt need which Hartley (2010) explained as need which is subjectively experienced by an individual or inter subjectively experienced by a group; it is what people feel they want.

Hothersall and Maas-Lowit (2010) point out that there is a danger that peoples’ answers are influenced by what they already know about a service.

Bradshaw went on further to identify expressed need which Hartley (2010) explained as felt need turned into action for instance demanding a service. Hothersall and Maas-Lowit (2010) explains that the theory does not take into account the fact that people may be ignorant or unwilling to ask for a service.

Bradshaw identified comparative need in which people compare what they have to what other people have which is measured by studying the characteristics of those receiving the service or service evaluation.

Hothersall and Maas-Lowit (2010) point out that the theory fails to take account of the variety of ways in which needs might be different, since it makes no attempt to compare different areas.

From the perspectives of the young mothers we interviewed, they identified housing as a need because some of them had been granted temporary accommodation because they were unemployed. Comparatively it was better for them to stay unemployed since wages from unskilled labour was not enough to cover their rent so they are stuck.

Maslow identified housing as a need which needed to be satisfied before other needs can follow. Housing and economic security are also explained by Doyal and Gough (1991) as intermediate needs which have to be fulfilled for basic needs to be met. This is also hindering them from attaining their goals. Doyal and Gough may call this serious harm.

Going by Bradshaw’s concept, the normative judgment of the professionals we interviewed explained that housing was a need but they could only account for housing needs which have been expressed. Many of these young mums lack life skills to be able to express this need to the appropriate agency.

Lack of appropriate childcare was another expressed need according to the young mothers because most of the child minders were not willing to make the hours more flexible. This was preventing them from going back to college or seeking employment.

This according to Doyal and Gough produces serious harm because they are fundamentally disabled in the pursuit of their goals.

There was one service user’s perspective I found intriguing. She got employment which fits into the esteem needs on Maslow’s hierarchy (independence from welfare and freedom from poverty). According to the normative judgment of the professionals because she is working now, she has no need for benefits. She has rent arrears for six weeks, her wages are way below minimum wage and child care hours are not flexible preventing her from working more to fill the gap. She wants to quit because from her perspective she used to earn more on benefits therefore she is better off unemployed. Then again economic security is an intermediate need which Doyal and Gough explain as necessary to be able to satisfy basic needs. Further more she is fundamentally disabled in achieving her goal. This according to Doyal and Gough would produce serious harm.

I do not think that all the recent policies and programmes provide simple and straightforward solutions to all the circumstances which the young mothers face.

In 1999 The National Teenage Pregnancy Strategy was launched in England. The strategy aimed to improve the health of the nation, increase education, employment opportunities and to tackle social exclusion by preventing unwanted pregnancies. It also aimed at assisting and supporting young parents back into education employment or training.

Chase et. al (2009) explains that this goal was to be achieved through a national campaign with clear and improved messages about sex and pregnancy. There was to be greater assistance for young parents through the provision of support services like housing, child care supervision and housing.

Furthermore some of the key elements of Every Child Matters agenda included young people to enjoy make a positive contribution and enjoy economic well being.

The strategy does not seem to be achieving its full potential because most of the young mothers and professionals I interviewed have expressed accommodation, housing and childcare as a need which is preventing them to make a positive contribution and enjoy economic well being.

Therefore policy recommendations will be related to those family friendly policies that are specific to the individual housing and childcare needs of teenagers, in order to enable them to maximise their full potential and parent successfully.

In pointing out issues surrounding stigma, some service users recounted how they are looked down upon and treated unfairly because they are young mums.

As to whether young motherhood should be viewed negatively, depends on the comparison between the life of a young mother prior to childbirth and whether her opportunities in life became limited after that. For some it helped them to settle down and become more focused than was possible owing to their previously chaotic lifestyle.

There is provision in Government strategies like Youth Matters, Young people and maternity services, which addresses sex and relationship education, access to contraceptives and guidance on benefits.

This addresses part of the issue but does not address issues like experiences of abuse and neglect, feeling unloved and rejected and a sense of belonging to a family which make the prospects of being a young mum more inviting.

My recommendations would be for policies that would tackle emotional difficulties of teenagers on an individual basis and encourage acceptance of teenage mums in the community.

With recommendations to practice, Parton 1994a and Walker 2001 point out in Sherpard( 2006) that there has been a shift from an emphasis in response to need to a response to risk. Therefore for social workers to be able to identify need they must be able to recognise it and use their statutory powers creatively.

In my experience with service users I realise that I have overlooked some needs based on assumptions or simply because I did not get the message.

Therefore Walker (2007) urges social workers to listen actively, engage appropriately and understand accurately the view points of service users. We must also overcome personal prejudices to be able to respond appropriately to a range of complex personal and interpersonal situations.

In my opinion if inter agency work is encouraged, there are new opportunities for professionals to listen and learn from the young mothers. This will steer working with the mothers into a direction which is likely to keep them engaged and able to benefit from available services. Social workers can in this way build on their own strengths and develop further the good work currently going on.

At the end of this essay, I have written about at the rationale to explore the needs of young mothers as a topic due to its relevance to Social work. I have also written about what motivated us and our reasons for our choices.

I have also written of our ethical considerations and our methodology. I have explained why the qualitative research method was suitable for our research.

I have evaluated the strengths explaining that the Participatory action method was highly compatible with anti-discriminatory and anti oppressive practice. Furthermore the concept of reflexivity which is a component of qualitative research made it possible for us to locate ourselves in our research.

I have looked at the limitations of our research which included inability to express honest views due to the presence of professionals during the interview and our inability to generalize findings.

I have looked at different approaches from Maslow, Bradshaw, Doyal and Gough in defining the concept of need and their limitations.

I have also looked at the service users need for housing, child care, finance and other needs and related it to the different concepts of need.

I have also written about some recommendations for policy and practice which if properly resourced would emphasize the good work currently going on.

In society, some groups are more vulnerable than others – the poor, the disabled, battered women, etc. NGOs working at the grassroots levels are best suited to deal with the vulnerable groups. However, NGOs and the Government can join hands to find the most suitable strategies to use, to empower those who are potentially weak in the social structure. The Government of Mauritius has put in place an NGO Trust fund to help these people to lead a decent life.

Community empowerment can genuinely benefit the community. However, along the way community organisations encounter several obstacles which hamper the empowerment process. This called for a review of the community empowerment strategies.

Most of the limitations of empowerment strategies occurred due to the lack of training in leadership development and lack of capacity building skills. On the other hand, NGOs were found to be limited in their actions due to the lack of resources and dependence on the Government. Moreover, the Government sometimes attributes more importance to the needs of stakeholders, rather than the needs of the community – thus failing the whole purpose of community empowerment.

So, to increase community involvement, organisations have altered their way of doing things. Some examples are : strengthening relationships with the community by developing a deep understanding of community issues, undergoing training, implementing creative strategies to encourage participation, among others.

1
What is community empowerment?

‘Community empowerment is the local government’s core business’ (cdz & changes, 2008).

Community empowerment enables people to play an active role in the decisions that affect their environment (cdx & changes, 2008). According to Rappaport (1987), empowerment is meant to enhance the possibilities for people to control their own lives. Cochran (1986) believes that people understand their own needs far better than anyone else and as a result should have the power both to define and act upon them (John at al, 1993).

Community empowerment refers to the process of aiding communities to gain control over their lives. Communities consist of groups of people sharing common interests, concerns or identities. Through empowerment, people are able to control the factors and decisions that define their lives. By increasing their assets and building their capacities, they can therefore broaden their networks. People cannot be empowered by others as such, but by themselves (WHO, 2012)

Community empowerment encompasses involvement, participation and commitment to the society. It is only possible when people feel a sense of belonging to the community and it aims mostly at social and political changes. In another words, community empowerment is a way of re-negotiating power to achieve more self-control (WHO, 2012).

Community empowerment covers the social, cultural, political and economic aspects of society. With the advent of globalisation, actions at the local level heavily impacts actions at the global level. This is why partnerships are required to finding collective solutions (WHO, 2012).

Communication is the key to successful community empowerment. It helps to raise awareness and increase knowledge of the people to encourage discussions and debates, so that people gain insight on the controlling forces acting upon their lives and initiate their own decision making process (WHO, 2012).

Empowering communities also includes empowering the individual. Empowerment at the individual level starts with defined needs and aspirations and focuses on available resources.

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It is the process of taking control, which eventually leads to fulfilling one’s potential. It comprises of certain factors; self-reliance, participation in decision making, dignity and respect, belonging and contributing to the community. The empowerment of communities involves a higher degree of individual empowerment, a strong sense of belonging to the community, participation in political activities, leadership in decision making and access to resources (WHO, 2010).

The community empowerment process is very complex and requires understanding and commitment from the part of all stakeholders. Community empowerment progresses gradually. Therefore it requires constant learning and consistent building of a community’s capacity (Donnelley, 2009)

2.1 How to empower a community?

In order to empower a community, that is to involve groups of people in engagement activities, it may be necessary to develop a campaign. However, we should bear in mind that a campaign based on other motivational grounds besides community welfare, fails the whole purpose of community empowerment. Community engagement involves the active participation of individuals and community representatives in all aspects of the campaign. It is very important for the community to be active participants, instead of passive ones (Kirklees Partnership Involving Communities Framework, n.d).

Empowering people is not an easy task. Individuals often do not have the time, energy, resources, expertise to develop and implement such campaigns. Community engagement demands certain criteria, namely resources to enable empowerment – such as political and legal rights, funding and the social capacity to create mobilisation networks, opportunities – such as those provided by institutional arrangements and finally motivations for people to exert their rights (Paul, 2010).

Social workers, both voluntary and professional, are assets to the success of these campaigns. Since human nature is complex, the staff leading the campaigns should let go of aspects that

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may threaten the purpose of the campaign. Instead volunteers, community organisations and partner agencies should participate in the design and implementation process. Here empowering social workers might be another important aspect of community empowerment (Kirklees Partnership Involving Communities Framework, n.d).

The Government should include the community at all stages of development projects to increase community engagement and community participation. Capacity building – strengthening skills, potential and abilities of people in developing societies so that they can step out of their misery, and community participation – actively engaged in designing, implementing and evaluating strategies to address a particular problem are essential to community empowerment (Debra, 2002).

Both NGOs and the Government understand the need for community empowerment in Mauritius. Here are some examples of how the community is empowered:

The Government has proposed to introduce a Community Empowerment Programme (CEP) with the objective of facilitating the community to make use of ICT to fully participate in the socio-economic development of the country.

The CEP in line with the Government encourages the development of local content and creativity.

The purpose of this initiative is to democratize access to information, provide comprehensive information about the country, namely its economic and social structure and stimulate the development and production of local content on the internet.

This will enable Mauritians to use the internet more effectively and find solutions to the challenges in the community. It will provide a common platform for sharing local knowledge, a marketplace for project proposals, and discussion forums. People will also formulate and implement their own development projects by collaborating with other stakeholders (NCB, n.d).

Another example would be the Work done by the Bel Ombre Foundation for Empowerment, which was founded in 2008. Their vision is to create an enabling

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environment where each individual can realize his potential. This organisation aims at empowering the inhabitants of Bel Ombre to catch the development pace by investing in training, entrepreneurship and social integration. Ongoing projects include adult literacy programmes, supporting the local artisans and the fight against poverty (Bel Ombre Foundation for Empowerment, n.d).

People should feel free to act upon their own ideas for the benefit of the community, so that they can be more creative and productive in their endeavours. For instance educating people

is one initiative of community empowerment, which can be understood as aiding the individual to better understand his/her needs as well as society’s needs, and find proactive measures to the challenges that society faces, without controlling the latter. At the same time, they feel a sense of belonging to the community.

2.2 Whom to empower?

It is true that we are all part of society, and that we have needs, but there are other people who are in precarious situations and need a boost. However, it does not mean that they deserve better treatment than the common man. They should just be given a hand. For example; poor people, battered women, minority groups, the disabled and so on.

Empowerment is also about sensitizing people who are in vulnerable positions or who are potentially weak in the social structure. As mentioned earlier, community empowerment sometimes necessitates campaigns to reach the target audience. However, there are sensitive issues that touch a large group of people and are not often discussed openly. E.g. Battered women.

Hence, both the Government and NGOs focus on preventive measures. Due to the division of labour and stereotypes, women often occupy an inferior position in society and are victims of injustices by man. So, one initiative of the Government was to empower women.

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Empower women

According to reports from all over the world, women constitute a majority among activists in the community and a minority in leadership in the community (Sadan, 1997).

The Ministry of Gender Equality, Child Development and Family Welfare insists on the reinforcement of capacity building of women, which can be achieved through education and training. The Government also provides the necessary support for women to launch businesses (Ministry of Gender Equality, Child Development and Family Welfare, 2010).

The Ministry has organised workshops for women under the National Women Entrepreneur Council to enable them to develop their managerial skills and provide support to potential women entrepreneurs wishing to launch their own enterprise (Ministry of Gender Equality, Child Development and Family Welfare, 2010).

The Women Entrepreneurship Development Programme has been launched in several regions of Mauritius, namely in Quartier Militaire, Triolet, Le Morne, Terre Rouge, Camp Thorel, Lallmatie, Ernest Florent and Pont Lardier and some 1800 women have benefitted from the programme (Ministry of Gender Equality, Child Development and Family Welfare, 2010).

Empower the poor

Since NGOs work at the grassroots level with the poor, they have been able to establish reciprocity, mutual understanding and build trust. The Government of Mauritius works in hand with NGOs to combat poverty. All stakeholders have come to realize that actions at the local level can be a first step to a national solution (Hurbungs, n.d).

One of the first conditions for getting people out of the poverty trap is to make them take full responsibility for their lives. They should also be included in all stages of community projects, so that they feel valued and gain confidence. Another initiative adopted by the Government of Mauritius is developing actions based on the aspirations of the poor. For instance the poor prefer receiving aid to send their children to school with all the necessities

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instead of receiving financial support to feed their hungry stomachs (Hurbungs, n.d).

NGOs should help the poor become aware of their current realities and empower them to make their own choices about the future, initiate actions for their development and adopt a healthy lifestyle (Hurbungs, n.d).

2.3 Benefits of empowering a community

When a community is empowered, people feel free to act within the society and at the same time associate a sense of belonging to it. Through community participation and capacity-building, they rediscover their own potential and gain confidence. They also feel worthy of the community, for the help they are providing – to make a change.

Community empowerment can initiate actions at individual level, which can reach community or even national levels. For example, someone victim of an accident, can gather a group of people – it can be close friends, family, or even strangers who have joined for a good cause – and help to sensitise others on road safety measures (Dr. Glenn, 2009).

Development of small groups can initiate collective actions. It is also a means for practitioners to gain community service skills, leadership skills for some, management skills, develop empathy, broaden networks, form partnerships and bring about social cohesion (Dr Glenn, 2009).

Community organisations offer the means to resolve societal problems. They include young groups, faith groups, community councils and associations. They have the power to mobilise resources. They development of community organisations requires some form of leadership and those who serve the community have better chances of developing community capacity – and can become future leaders (Dr Glenn, 2009).

Empowered individuals are able to influence the direction and implementation of a programme through their participation. They progress from a personal action to the point that

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they are collectively involved. This can lead to gaining the power to influence economic, political and social action. They can therefore help others to empower themselves and gear them towards capacity building (Dr Glenn, 2009).

2.4 The role of the Government and NGOs in community empowerment

The Government of Mauritius has the responsibility of catering for the people and has formulated laws to protect them and safeguard their rights. The Government acts as an authority figure. The political and administrative environment of a community directly affects the empowerment process (Phil, 2007)

The environment includes a series of factors such as the laws, rules and regulations and practices of the civil society. The environment also covers the policies and practices of relevant Non-Governmental Organisations (Phil, 2007)

In this regard, their task is to encourage community activities that enable the community to develop itself – to be empowered. They should also help the community to initiate actions towards self-reliance, community empowerment and eradication of poverty (Phil, 2007).

The Government should be able to modify Ministry regulations, modify legislative policies, support legislative committees responsible for legislative reform, provide guidelines and empower NGOs active in the related sectors, raise awareness through conferences, workshops, competitions and so on and pass relevant information through public media – posters, radio, local TV, newspapers, and advertisements (Phil, 2007).

NGOs are increasingly involved in capacity development. They lean towards developing skills and tools to strengthen the society. NGOs can have a significant impact on community development. However not all NGOs are in good terms with the Government and very often they lack resources and face many obstacles and unless they become partners with the Government, capacity building initiatives will continue to fail (Inger, 2009).

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The Government should also offer training to practitioners so that they are well equipped at all phases of the process. More importantly the Government should provide support to NGOs which can lead to consistency and integration with each other. Support could be of financial and technical assistance for meetings, working committees and campaigns.

According to the Mrs Sheila Bappoo ( Minister of Social Security, National Solidarity and Senior Citizens Welfare & Reform Institutions), the Mauritian Government fully acknowledges the role of NGOs in community development. The Government has put in place an NGO Trust Fund which has the objective of helping vulnerable groups of the society so that they can lead a decent life.

The Government provides support to numerous organisations who are actively involved in community empowerment. One such example is the the Youth Empowerment Programme which was implemented by a group of students from the University of Mauritius and the Force Vive des Quartier Reunies.

The project had the objectives of developing leadership skills among children and at the same time encouraging community service by University students (MEF, 2011).

The Government is actively involved in many such initiatives, and as we can see community empowerment begins with the common man. All we need is an idea and the will to bring about change.

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3.0 Community empowerment strategies

Community empowerment strategies include community development, community engagement, community participation and capacity building (Peter, 1996).

Community development helps people to recognise and develop their abilities and potential and organise themselves to respond to problems and needs which they commonly share. It supports communities that control and use assets to promote social justice and help to improve the quality of community life (SCDC, n.d).

In Maritius, the Community Development and Poverty Alleviation Project has been implemented by the Government and its budget extends to approximately 4 million Rupees. Community development requires the knowledge of people, their values and culture. People should be empowered to generate their own knowledge and use it to improve the quality of life. Therefore participation is necessary for community empowerment. Community development walks in hand with management. Community Services Management is a relatively new approach and it aims at empowering community workers and stakeholders to better assess and implement community based projects efficiently and cost effectively. Community Development also requires General Organisational Skills – including financial skills. The emergence of professional management in such organisations denotes power. Community practitioners should be aware of the structure of the organisation to develop the required skills to effectively achieve its objectives. Finally, we cannot ignore the concept of Sustainable Development when speaking about development in Mauritius. The Government, NGOs, and the private sector recognise recognize that the environment, the economy and equity are irrevocably linked (Community Development and Poverty Alleviation Project, 2005).

Community engagement is the process of involving people in decisions that affect them. This can mean involving communities in the planning, development and management of services. Moreover it consists of empowering the community to make decisions and to implement and manage change (DSE, 2011).

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The Government envisioned the creation of a sustainable society with the implementation of the project Maurice Ile Durable (MID). In this regard, the Government encourages community members to initiate partnerships with multiple stakeholders and facilitates community engagement that supports people to express their vision for the community and initiate shared responsibility (Anneleos at al, n.d).

Community participation refers to active engagement in designing, implementing and evaluating strategies to address a particular problem (Debra, 2002).

The Government stresses upon the integration and participation of the youth in many aspects of the society. The Government also provides the opportunity for youngsters to engage in voluntary activities. One such programme is the National Youth Award which was launched in Mauritius in 1996. It is a sort of training programme which encourages personal delivery and growth, self-reliance, perseverance, responsibility to themselves and the community (Ministry of youth and sports, 2012).

This programme under the Ministry of youth and sports supervised numerous activities which involved the participation of many national projects, namely ”Jeux de L’avenir”, Jeux de L’espoir”, Environmental Projects, Community Services and special vacances (Ministry of youth and sports, 2012).

Capacity building involves strengthening the skills, potential and abilities of people in developing societies so that they can get out of their misery.

Capacity-building programmes were established in Mauritius in view of poverty reduction. Since 2000, the IFAD (Funded Rural Diversification Programme) has been reaching out to more the 15 000 poor people. The programme has helped the poor to diversify their incomes and improve their standard of living. Under the Community Development and Poverty Alleviation Project, the Government adopts an approach to help the poor to get out of their own misery, by providing them with opportunities to generate their own income – by empowering them (Community Development and Poverty Alleviation Project, 2005).

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3.1 Limitations of community empowerment strategies

Community empowerment strategies encompass several areas and require the participation, involvement, and commitment of various stakeholders. Implementing empowerment strategies also demands much time and effort. However they are good initiatives to empower the community, as explained previously. Community empowerment strategies have brought about numerous improvements in sectors such as poverty, health, environment, and society in general.

The major obstacle to successful community empowerment is the lack of training in leadership development and organisational capacity building (Peter, 1996).

NGOs

NGOs have the possibilities to pass on information either by directly providing them to the public or helping the community to acquire access to information sources. NGOs can improve organisational assets by establishing new community organisations or improve on existing ones. They can also help people to get financial aid and material assets based on their needs and rights. Moreover, they do a great job in sensitizing and gathering people through health and education activities – community engagement. Finally, since NGOs work at the grassroots level, they are more experienced and have genuine knowledge of the difficulties people find themselves in (Selibu, 2006).

However, very often many obstacles hamper the empowerment process. Limitations to empowerment activities of NGOs arise from many sources. To start with, NGOs are constrained by the fact that they have little access to resources and less influence on policies and the law. Another factor would be that most NGOs are dependent on the developments made by the Government. NGOs are in most cases not in good terms with the Government, and this directly impacts their actions. Moreover, NGOs are limited by local factors such as inefficient institutional frameworks, weak relationships with the community and organisational problems within themselves. Consequently, in trying to respond to donors, the Government often lose sight of genuine empowerment needs of the community and cater for other demands from stakeholders (Selibu, 2006).

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Risks factors

When implementing empowerment strategies, risk factors should be anticipated and well-managed. The risk factors include time and planning limitations, possible lack of cooperation from stakeholders, incompatibility among methods used, diminished interest from community leaders, lack of additional funding and possible lack of resources for community leaders to impart their knowledge and skills (Community Development and Poverty Alleviation Project, 2005).

Community organizations face enormous obstacles to repairing the social fabric of their communities, especially if society faces serious issues (e.g. high crime rate). This limitation is due in part to organizations’ inability to develop strategies and due to lack of resources (Peter, 1996).

Moreover it is quite difficult to foster community participation and engagement, because people are not always free to participate in activities even if they can benefit from them. The community is also reluctant to form partnerships with stakeholders due to lack of trust. The community sometimes expects too much from the Government, and therefore is left with only aspirations and dreams. People have responsibilities and other concerns and they view community engagement and participation as an added burden. It can also be that information and whereabouts of campaigns and workshops are not evenly spread, considering low-budget organisations. Sometimes community leaders themselves are not committed to the project. Very often community activities are merged with politics, and are a means to monetary gain and enhanced image. As a matter of fact, community empowerment strategies fail their very own purpose due to lack of community involvement/participation/engagement.

3.2 Alternatives to increase community engagement and participation

If an organisation wants to be truly accountable, it needs a strong system of organisational governance. Without a clear focus, it is impossible for community organisations to achieve significant impact. Hence, community organisations should be able to develop the element

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of trust with the community (ICD, 2005).

They should implement creative strategies so that the community is motivated to work with them. Both NGOs and Government organisations should address the different strategies including – capacity building, physical projects, research and information and networking (ICD, 2005). Organisations should also display reliability, leadership and transparency. Empowerment programmes are not always easy to achieve. This is why organisations should review their own strategies.

Participation and continuity

It is necessary to work with the community in bringing awareness of the proposed activities and their benefits. It is also of significant importance to maximise community participation in planning, design, and implementation stages so that people develop sustained interest and ensure continuity of the particular project (Community Development and Poverty Alleviation Project, 2005).

Management, supervision and monitoring

The success of the projects will depend on proper management, supervision and monitoring. Practitioners should be given appropriate training in the field of project management. Progress should be monitored, to ensure that objectives are being fully achieved (Community Development and Poverty Alleviation Project, 2005).

Engagement

Community engagement is achieved if projects bear better outcomes. It is also very important to strengthen the relationship with the community. Community organisations should project the reputation of the organisation through their actions. Moreover they should develop increased understanding of community issues to form partnerships and broaden their networks (DSE, 2011).

Leadership training

Social workers and staff should possess the right skills to be able to reach the audience. Some practitioners often feel a lack of motivation and discontinue their service. Dealing with

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people can be exhausting and frustrating. Therefore the Government should provide access to training sessions, information and networks. More than 20 training centres have been successful in teaching community organizations the skills needed to develop leaders and build strong community organizations in the US (Peter, 1996).

Target vulnerable groups

The Government should display involvement in the community. It should tackle issues that are of concern to the community – education, emancipation of women, poverty, etc, and provide support by empowering them. E.g. Implementing poverty alleviation strategies. The Community organisations should also work with those who are potentially weak in the social structure. For example by educating the illiterates, providing economic support to vulnerable women, reduce vulnerability to HIV/AIDs and other health issues, and by collaborating with other organisations (SEM, 2012).

Community organisations should themselves be empowered to adopt the best suitable approach to deal with people. The Government should promote community access to technology and information and also allocate a budget for community organisations to implement community empowerment programmes, for sensitization campaigns, workshops and working committees. Moreover, since media plays an important role in conveying information, media coverage of community initiatives should be improved. The common man should also be empowered to initiate action on a small basis and eventually be monitored for potential innovative ideas. It is also primordial to promote laws and regulations that give communities a voice (Peter, 1996).

The Government of Mauritius has implemented the National Empowerment Foundation in this regard and has extended support and empowered numerous people. Some examples include; The Integrated Social Development programme setting up housing units at La Valette Bambous accounting to a total cost of Rs. 205 million and benefitted 200 families ;

around Rs 1.1 billion allocated for programmes which include facilities for unemployed women, Integrated Social Development, circular migration, technical assistance to Small and Medium Enterprises (SMEs) (NEF, 2009).

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4.0 Critical Analysis

Community empowerment strategies are effective measures to empower a community. Through community engagement, community participation, community development and capacity building, people are able to identify their potential and discover their abilities, participate in group discussion and activities, engage in implementation of important projects and can empower themselves so that they can overcome difficult social situations.

As mentioned in the previous sections, community empowerment can benefit the community on a small basis as well as nationally. Community empowerment enables people to initiate actions based on their day-to-day experiences. It also creates a chain where the empowered individual in turn helps others to empower themselves by sharing experiences and forming partnerships. Community empowerment is a means for the community to broaden their networks and meet new and influential people. An empowered community can influence the social and economic aspects of a country to seek their rights. Moreover, when working with others for a collective cause, individuals acquire a sense of worthiness. Those actively involved in community work and community service can eventually become tomorrow’s leaders.

Since community empowerment strategies deal with people, unforeseen events may arise. It is true that community empowerment is beneficial to the individual and the community, however people are not always free to engage in community activities. Moreover people are reluctant to indulge in community activities due to lack of trust, because very often activities are based on selfish grounds. For example; political parties showing interest in social activities for the sole purpose of enhancing the image of the Government. Other limitations of empowerment strategies include lack of cooperation from stakeholders, lack of funding and diminished interest from community leaders themselves. Finally, NGOs are limited in their actions due to lack of resources and dependence on the Gover