toptermpaper.com

What are the advantages and disadvantages of viewing behaviour through a lifespan perspective for social work practice?

This assignment will look at the advantages and disadvantages a social worker viewing behaviour through a lifespan perspective may encounter. It will look at developmental theories that relate to the chosen service user group, and how, as a social worker, this knowledge would increase understanding of the service user and how this in turn may affect the role of a social worker in practice. The service users age group being explored in this assignment will be older adults aged from 65+.

Lifespan development starts from conception and finishes with the death of each individual. During each individual’s lifespan there are constant changes and developments taking place, the majority of stages and life changes each individual passes through are due to their common psychological and biological heritage as humans and are shared by all people. Culture and social class, and the individual’s environment are all factors that help shape the course of development (Niven. N.1989). There are five main theoretical approaches for lifespan development; these are biological, cognitive, humanist, behaviourist and the psychodynamic approach.

Ageing in late life is shaped by the accumulation of life events and the proximity of death; a misperception about ageing is that disability and poor health in later adult life are inevitable (Davies, M, 2002). During each individual’s lifespan, they will experience a series of crises and life transitions. Throughout the lifespan there are certain periods or stages where each individual will face a transition from one state to another. These periods have been referred to as life crises by some psychologists, each crisis needing to be resolved in order to progress to the next stage. Each individual proceeds through the stages of development, and the way in which they deal with each crisis in each stage of development shapes their personality (Niven, N, 1989). Other approaches agree that there are certain stages in development that have significance for each individual, but they state that there are also other events that can also shape development – these being experienced by some individuals but not all.

Retirement is just one of a number of changes that need to be adjusted to in late adulthood, among the others are declining health and physical strength along with physical and sensory impairment which can result in increased dependency on others in late adulthood (Beckett.C.2002).

Several physical and cognitive changes also take place in old age (Bee & Mitchell, 1984) cited in (Sugarman. L. 1990. Pg 53). The bodily changes that are associated with ageing are summarized in five words- slower, weaker, lesser, fewer and smaller. As ageing occurs experience gained throughout the lifespan helps the individual and they learn to compensate for the many gradual declines that accompany old age. (Corse 1975) cited in (Sugarman. L. 1990. Pg 53) concludes that experience, intelligence, and education can help maintain normal perceptual and sensory functioning.

Many changes in appearance take place in old age. Outward appearances begin to show ageing, older people’s skin begins to lose elasticity, which causes lines and wrinkles to appear, hair loss and grey hair may be one of the first signs of ageing, and hearing and eye sight now begin to deteriorate (Windmill.V.1987). Internally the kidneys, lungs, heart and intestinal tract all begin to function less and there may be deterioration of muscles which can literally cause old people to shrink. The reduction of calcium in the bones makes the old person more prone to fractures and brittleness of the bones is also a problem in the older population. Arthritis is one of the more serious health problems affecting older people and for most people these changes may be gradual (Windmill.V.1987).

A social worker needs the basic insight of childhood studies, as without them it would be difficult to assess adults on adulthood theories alone.

Freud is credited with beginning the psychoanalytic approach. The central assumption of this approach is that behaviour is governed by the unconscious as well as the conscious processes; some are present at birth while others develop over time. (Beckett.C.2002) The second assumption of the psychoanalytic theory is that our personalities have a structure that develops over time. Freud proposed three parts of the personality- the id, the ego, and the superego. Freud’s key assumptions were that adult’s personalities depend on childhood experiences; he assumed children go through five psychosexual stages. The first being the oral stage, the second the anal stage, and the remaining stages being the phallic stage, the latency period and the genital stage. (Beckett.C.2002).

When looking at human lifespan development, Erik Erikson’s theories can be of use to a social worker. Erikson was a student of Freud; however he had some very different ideas. He thought development was psychosocial and due partly to maturation and partly due to society. Erikson also thought that personality development continued across the lifespan, unlike Freud, who suggest personality development finished in adolescence. Erikson (1980) cited in (Niven, N, 1989, pg 155) proposed eight stages of development which he called ‘developmental crises’, these being viewed more as a period of difficulty or dilemma. They are times when individuals face a turning point or transition in their lives often involving a degree of stress associated with having to resolve each dilemma. Not only do these transitions of change affect the individual’s behaviour they also affect their family and friends. Erikson’s stages are phrased in terms of an opposition between two characteristics and each individual must successfully negotiate the task or stage in order to be able to move on to the next one. Eriksson’s eighth stage (late adulthood) is integrity vs despair; this suggests if the individual has managed to negotiate the previous stages, then the individual will have developed a sense of integrity. This refers to the acceptance of the limitations of life, with the sense of being a part of a larger whole which includes previous generations. It enables the individual to approach death without fear, if one looks back on one’s life and sees it as unsatisfactory, despair occurs and a feeling of ‘what if’ prevails. Erikson suggests that at each transition individuals may need to revisit unresolved issues from previous stages. The main strength of Erikson’s theory is that it offers a framework for explaining changes in childhood and adulthood. His work has been criticised in that it represents a set of assumptions instead of precise descriptions of relationships and causes. A disadvantage here is the lack of empirical evidence- this is also another criticism of Erikson’s work. The advantages for a social worker using Erikson’s theory is that it provides markers for those events in a service user’s life that may be proving difficult and in using this approach, social workers can highlight the problems that are likely to affect people during specific stages of their life. (Niven. N. 1989).

An area of life course development most associated with older adults relates to end of life issues. In the later stages of adulthood the end of life is expected. Death is the end of biological and physical functioning of the body. Factors to be taken in to account for social workers working with service users who have suffered a loss, are gender and cultural differences, as these can affect a social worker’s understanding of what may count as a loss and what in turn can be done about it (Currer. C 2007). Each individual’s reaction to grief and emotional trauma is as unique as a fingerprint. When thinking about bereavement and loss it is useful to look at attachment theory, Bowlby’s (1946) cited in (Davies, M, 2002), major work was Attachment and Loss; sadly it is the case for many individuals in later adulthood that there is a price to pay for the benefits of forming attachments. According to Bowlby’s attachment theory adults, who as children had secure attachments with their carers, are able to form satisfactory relationships in adult life and this will help them to cope with the pain of bereavement in later life. Bowlby’s aim of this originally was to explain the consequences for personality development and how severe disruption of attachments between infant and mother could have negative effects on development. (Butterworth. H. & Harris. M. 2002). Adults who did not have secure attachments as children can be identified, according to Howe (1995) cited in (Davies, M, 2002), who suggests that avoidant individuals are the ones who show self reliance. They may display delayed reactions to grief, they attempt to be emotionally self reliant and are wary of forming relationships. This means the loss of someone who is close to them usually triggers defence mechanisms- they may not cry or appear to be upset but are vulnerable to future losses. Exaggerated reactions to grief can be accounted for when the individual has not adjusted or come to terms with earlier loss of an important attachment relationship. On the other hand ambivalently attached individuals may experience self-blame and guilt when their partner dies. Where there has been an insecure attachment in childhood (an attachment that does not meet the child’s needs- the need for safety and security etc) Bowlby (1998) cited in (Beckett. C. 2006) suggests the anxious child will try to protect themselves against anxious situations. The child uses a variety of psychological manoeuvres and this results in what Bowlby called a faulty working model of themselves and of other relationships. To maintain this model the child will use defensive exclusion to avoid feelings that may threaten the child’s already precarious stability. Attachment theory is backed up by empirical evidence. This is beneficial as it can help social workers identify causes from an individual’s past and this helps to provide explanations for present behaviours and their ability to deal with change (Beckett. C.2006). Each individual’s reaction to grief and emotional trauma are as unique as a fingerprint.

When looking at loss it is important to remember that older people may lose friends, abilities, connections and many other things that are important to them. The significance of grief and loss in old age is dismissed by the ageist stereotype that older people will be used to loss because they are at an age where they have experienced lots of it. However the reality is that loss can be cumulative at this age and this results in negative experiences for those whose loss or grief is not recognized or addressed (Thompson.N. et al. 2008).

It is important that social workers take a holistic approach to understanding life course development in older adults, as life course is central to any understanding of ageing. A social worker should be aware that an individual’s life experiences and life course developments are affected by several factors- these include economic and social aspects, historical, cultural, psychological, and cognitive and physiological influences. (Crawford, K, & Walker, J, 2007). All transitions expected or unexpected, sudden and unplanned, present opportunities and challenges for the individual’s development and growth.

Each individual will have different experiences of transitions even when the life event is common to many in society, each person will respond and adapt to that change in a unique way. (Crawford, K, & Walker, J, 2007). There are disadvantages for social workers when viewing individuals through a lifespan perspective as most of the theories being used are Euro centric (European studies) and cannot be applied to all cultures.

As a social worker care must be taken when using any of the behavioural approaches as they raise the issues concerning the use of power and oppression. The social worker should not focus too much on narrow behavioural issues at the expense of the larger picture (Beckett.C.2006).

It is in a social worker’s interest not to oppress or discriminate service users but to treat them with unconditional positive regard, not forgetting to treat each service user as an individual with their own opinions and values. The theories used do have limitations as not all individuals or cultures fit the suggested norms and each person develops at a different rate. As a social worker knowing about the different viewpoints from theorists and their suggested viewpoints may enable a better understanding of what problems a service user may be experiencing. When working with service users from any age range, it is important that the social worker does not influence these transitions with their own life experiences.

References

Beckett.C.(2006).Essential Theory for Social Work Practice. Sage Publications Ltd. London.

Beckett.C. (2002). Human Growth & Development. Sage Publications Ltd. London.

Bee.H. & Boyd. H. (2003) 3rd Ed. Lifespan development. Pearson Education Inc. Boston. USA

Butterworth. G. and Harris. M. (2002). Developmental Psychology. A Students Handbook. Psychology Press Ltd. Hove. East Sussex.

Crawford. K. & Walker. J. (2007) 2nd Ed, Social Work and Human Development. Learning Matters Ltd. Exeter.

Currer. C. (2007). Loss and Social Work. Learning Matters Ltd. Exeter.

Davies. M. (2002) 2nd Ed. The Blackwell Companion to Social Work. Blackwell Publishing Ltd.Oxford.

Niven. N. (1989) Health Psychology. An Introduction for Nurses & other Health Care Professionals. Churchill Livingstone.

Sugarman. L. (1990). Lifespan development. Concepts, Theories and Interventions. Routledge. London.

Thompson.N.& Thompson. S. (2008) The Social work Companion. Palgrave Macmillan. Basingstoke.

Windmill.V. (1987). Human Growth & Development. Hodder and Stoughton Ltd. Kent.

Victims of a Serial Killer
Vangerlena Smith

Violent crimes happen to certain individuals or groups every day. Sometimes the victims have the same characteristics, and sometimes there is no trace of recidivism pertaining to the victims at all. Some of those characteristics may include sex, gender roles, age, ethnicity, economic status, goals, education level, area of residence, stature or body type, etc. There is one particular case where the victims had similar characteristics. The case is that of Jeffrey Dahmer, a famous serial killer who lured, killed, and dismembered all of his victims’ body. All of Dahmer victims were male, mostly African American. According to the research I have done majority of Jeffrey Dahmer’s victims were hitchhikers, travelers, homosexuals, in some type of desperate need, or in the areas where Dahmer resided. He never went out of his way to go and find his victims; they just of sort of came to him. They were all also obviously young because he would meet them in clubs, bars, or at parties. The ages of the victims are listed as follow: 14, 16, 18, 19, 20, 22, 23, 24, 25, 26, 27, 31, 33, and 36. Dahmer also had victims who had a chance at living. Before he became the serial killer that he is known as today, Dahmer was arrested multiple times for fondling and molesting younger boys in public plays; such as, fairs, carnival, etc.

In the following paper the nature(s) of the crime that Dahmer committed will be addressed. How to deal with the victims and their families on a micro, mezzo, and macro level will also be explained. Also, as any human being, social workers have personal values and ethics that sometimes conflict with those of their professional values and ethics.

Nature of the Crime

The violent gruesome acts of what Dahmer did to his victims could fit many natures of crime. Dahmer’s first victim was a nineteen year old hitchhiker whom he just picked up. Later the two got drunk and engaged in sexual activities, and the victim simply wanted to leave afterwards. Dahmer did not want him to so he killed him, dismembered his body, and disposed of him. This is where the pattern started. The previous information shows that one of the natures is obviously control. It was said that Dahmer never really had any friends, so he was a loner. He obviously got the victim drunk so he would become totally vulnerable to the situation, so that he could take advantage of the victim. The victim deciding to leave was totally out of Dahmer’s control, so he made it where he was in control; he hit the victim over the head with a dumb bell where he then proceeded to kill him. It’s debatable that Dahmer’s first murder was unplanned, so the sense of control that he felt afterward his first murder, he wanted to continue to feel. This is the starting point of his recidivism.

According to:

“Sadism, a term introduced by Krafft-Ebing (1898) late in the nineteenth century, originally referred to sexual pleasure derived through inflicting pain and suffering on others. Over time, the term was expanded to include nonsexual enjoyment derived from sadistic acts” (Marten & Kahn, 2011)

Dahmer acts also could be labeled as perversion. For some of the victims they did not willing have sex with the offender. Also, some sexual acts were also done to some of victims’ corpse after death. Dahmer, in his teen years had struggled with his homosexual desires; combined with his years of being a loner, he decided to just take actions and deal with those desires. Lastly, the nature of Dahmer’s crime could be labeled as revenge. As stated earlier, Dahmer was a loner growing up. Yes, he had sexual desires like any other human being, but no one wanted to engage with him in any type of way because he was seen as an outcast. It could be possible that Dahmer’s act on his victims could have been one of revenge from earlier stages of his life.

Micro, Mezzo, and Macro Levels

Assessing the victims, families, community, and nation on the level of micro, mezzo, and macro scales is a critical level in evidenced-base practice. According to Hull & Ashman (2012): “Practice with individuals is considered as micro practice, practice with families as micro/mezzo practice, practice with group as mezzo practice, and practice with larger systems, including organizations and communities, as macro practice” (Ashman & Hull, 2010).

Dealing With the Situation on a Micro Level

On the smallest level, the micro level, for this case it is much easier to start with the live victims of molestation and fondling. This level could be used to work with the individuals to get some understanding on how they are coping with what had happened to him and also throw out suggestions. I’m sure at this level it’s easier to find out what each of the young men are probably wondering why did this happen to them, and what did they do to deserve it. On this level, it’s easier for a social worker to handle because they get to work with the individual one on one. In a mezzo group setting the victim may be ashamed to open up about what happened to them, and in return never get the proper help they need for moving on or coping. Some victims who has had things done to them and never told or got properly treated sometimes become the perpetrator of that same crime later on in life.

According to Davis (1991): Dahmer’s probation officer noted that, “When Jeffrey was eight, his father said, a neighborhood boy had sexually molested him. Perhaps this may be the reason why Jeffrey has sexuality issues” (Davis, 1991).

So Dahmer’s actions are a product of child molestation, and what could possibly happen if one stays quiet.

It is also important to work with the individual family because family support when dealing with these types of things is vital. The social worker could encourage the family to do things such as, not help the victim stay the victim. They can do this by not treating the victim like something’s always wrong. Of course it’s a given that they will probably never forget the incident, but the reminder of it does not help them cope. For those who lost their lives as victims of Dahmer, families could be assessed individually on a micro level as well. Everyone has a different experience when it comes to death of a loved one, so they cope in different ways. It would be very inaccurate to marginalized them all into one category and help them to all cope in one way. It isn’t possible. Also, close friends, neighbors, teachers, classmates, could all be assessed on an individual level; depending on the level of closeness to the victim.

According to Social Work License Map (2012):

“Micro practice is the most common kind of social work, and is how most people imagine social workers providing services. In micro social work, the social worker engages with individuals or families to solve problems. Common examples include helping individuals to find appropriate housing, health care and social services. Family therapy and individual counseling would also fall under the auspices of micro practice, as would the medical care of an individual or family, and the treatment of people suffering from a mental health condition or substance abuse problem. Micro-practice may even include military social work, where the social worker helps military service members cope with the challenges accompanying military life and access the benefits entitled to them by their service. Many social workers engage in micro and mezzo practice simultaneously. Even the most ambitious macro-level interventions have their roots in the conversations between a single social worker and a single client” (Social Work License Map, 2012).

Dealing With the Situation on a Mezzo Level

Mezzo is the level of assessment dealing with group settings. Pertaining to the victims of Jeffrey Dahmer; this is where a social work could get all the molested victims in one room, and maybe have them share their experience and how it affected them. There is such a thing called self-help groups and in these groups the individuals all have something in common. Within these groups they help one another cope with the particular problem. They sometimes do this by expressing their feelings. If these victims could come together and talk about how Dahmer affected them, they may just be able to move on. Also, on this level the victims along with their families could be assessed. Once assessed on a micro level, if the individual could open up about how they were affected to their families, then maybe the family would know how to assist them in helping them cope. “Those skills used in working with individuals provide the foundation for work with larger groups, organizations, and communities” (Ashman & Hull, 2010). One victim may not want the family to baby them because of what happened to them; where on the other hand, another victim may need that extra attention from their parents, siblings, etc. For the deceased victims, their families could also be assessed together. They need to know how one another feel, to emotionally support each other about the loss of their loved one. For instance, if a couple’s child was one of Dahmer’s victims they may deal with it differently. The husband may keep it boggled all in and the wife may cry all the time. Well they need to know how to communicate with those different feelings to help one another maintain emotional stability. The husband could comfort the wife during her times where she feels as if she wants to cry. On the other hand, the wife could encourage the husband to talk about his feelings more often, or at least let him know she’s there if he ever feels the need to talk about the loss.

According to Social Work License Map(2012):

“Mezzo social work practice deals with small-to-medium-sized groups, such as neighborhoods, schools or other local organizations. Examples of mezzo social work include community organizing, management of a social work organization or focus on institutional or cultural change rather than individual clients. Social workers engaged in mezzo practice are often also engaged in micro and/or macro social work. This ensures the needs and challenges of individual clients are understood and addressed in tandem with larger social issues” (Social Work License Map, 2012).

Dealing With the Situation on a Macro Level

On the Macro level, a social worker deals with the community which consists of the families, individual victims, close friends, etc. In the community where Dahmer did all his murdering, could rise up a scare amongst some people and be of a shock to others. On this level, a social worker could be effective by going to meet with parents and plan ways that they could make the community a safer place where their children could live, play, etc. Setting up a neighborhood watch team, parents making sure they know where there children are going when they leave home, and making sure that the children be alert of strangers are all ways in solving some of the problems in a community of uproar. As for the community of Dahmer’s victims who didn’t survive, a social worker could advocate for more police security in that area, just to watch for things of suspicion. Because not only were those communities afraid of Dahmer, but they were afraid that there were more killer out there like him. This is where the macro level gets broader. What Jeffrey Dahmer did to his victims become known nationally. This created worry all over the United States. How would social workers address the issue to a community as broad as the whole nation? First, they could brainstorm ideas for the nation to keep themselves self. For example, they could encourage people not to hitchhike at night. They could also warn that all hitchhikers should not be picked up as well. As stated before, another safety precaution is that parents know where their children are at all times. For those who are of age, encouragement to not leave from clubs, bars, parties, etc. with strangers would be a great gesture. A killer who has the intent to kill cannot be dissuaded to kill, but those who could possibly fall victim could set up precautions for their safety to prevent the incidents that happened to Dahmer’s victims from happening to them.

According to Social Work License Map (2012):

“The practice of macro social work is the effort to help clients by intervening in large systems. Examples include lobbying to change a health care law, organizing a state-wide activist group or advocating for large-scale social policy change. Macro practice is one of the key distinctions between social work and other helping professions, such as psychiatric therapy. Macro social work generally addresses issues experienced in mezzo or micro social work practice, as well as social work research. Macro practice empowers clients by involving them in systemic change” (Social Work License Map, 2012).

All in all, every victim, their family, their friends, etc. could be assessed on either a micro, mezzo, or macro level. Not all people are going to deal with every crisis the same way, so they should not be expected to cope the same way. Some don’t mind speaking in group settings where others may want to talk on a more individual basis. In the Dahmer’s case the level of macro got as broad as the United States, but in some cases the issue on a macro level could become global.

Ethical Issues/Values Conflict

As a social worker I would personally be all for the victim, not matter the evidence behind what Dahmer did. For example, Dahmer had some psychological issues so that calls for the need of treatment. As far as professional value goes, it’s clear after a psychological evaluation was done that Dahmer needed help; however, my own personal values says that he was not right for taking the lives of innocent people, therefore he should spend the rest of his life in prison. For the same reason, I would also want him to spend his life in prison because some of those victims were teenagers. Also, not only did he kill all of his victims but he removed the flesh from their bones, he cut some of their hearts out, crushed their bones, had sex with the corpses; that is completely inhumane.

According to O’meara (2009): “Dahmer drilled holes in his living victims’ heads; poured in chemicals to “zombify” them, had sex with the corpses’ viscera, and kept some body parts in his refrigerator, occasionally eating them” (O’Meara, 2009).

As for the victims, I think it would be unethical, so to speak, of me to say that they could have prevented things from happening to them; such as, not leaving the club with Dahmer, not leaving with a stranger period, not getting drunk and falling into a stupor, etc. However, every social work knows or should know that it’s never the victim’s fault about what happened to them (Gough & Spencer, 2014). Also, they would not only be some ethical issues and values conflict when it comes to the social worker, but also everyone engaged in Dahmer’s case. Once the prosecutor present all the evidence without thinking some, not all, or the jury will want in him jail; some would even vote death penalty because of their values.

Policy Issues

Policy issues on the Jeffrey Dahmer case would definitely be his sentencing. It is obvious in my research that Jeffrey Dahmer was psychologically ill, and need major help. However, the argument was that Dahmer disposed of the bodies, which means he was afraid of consequences. If he didn’t dispose the body he probably could have got sent to get some type of treatment.

The Jeffrey Dahmer case is rare out of many. As stated before violent crimes happen to certain individuals or groups every day around the world. Murders sometimes just go on a random killing spree, but in Jeffrey Dahmer’s case all of his victims have common characteristics and trait. All of his victims were male, majority of them being black for some odd reason. They all were also of young ages. Some of those characteristics of Dahmer’s victims were their sex, gender roles, age, ethnicity, economic status, goals, education level, area of residence, stature or body type, etc. He mostly picked up hitchhikers, drunken people, or people who just needed a couple of bucks and were willing to do anything. Jeffrey Dahmer’s criminal acts started with the molestation of younger boys. The above content discusses how to help the victims who survived and the loved ones of the victims whose lives were lost cope on a micro, mezzo, and macro level. On the micro level each individual victim is assessed for counseling. The micro level gives the individual more space to be open about what happened without being judged in any kind of way, or with being afraid. The micro level is a vital step to the mezzo and macro levels. On the mezzo level the victim could then be assessed in a group setting with people such as, their families, other victims, their friends, and so forth. The macro level is the largest level of all. On this level, communities, neighborhoods, and even the nation are included. It just depends on how broad the crime is and in Dahmer’s case the murders made national news, frightening many parents out there with young male children.

References

(2012, July 20). Retrieved November 12, 2014, from Social Work License Map: http://socialworklicensemap.com/macro-mezzo-and-micro-social-work/

Ashman, K., & Hull, G. (2010). Understanding Generalist Practice. Stamford: Cengage Learning.

Davis, D. (1991). The Jeffrey Dahmer Story: An American Nightmare. New York City: St. Martin’s Paperback Press.

Gough, J., & Spencer, E. (2014). Ethics in Action: An Exploratory Survey of Social Worker’s Ethical Decision Making and Value Conflicts. Journal of Social Work Values & Ethics, Vol. 11 Issue 2, p23-40. 18p.

Marten, W., & Kahn, W. (2011). Sadism linked to loneliness: psychodynamic dimensions of the sadistic serial killer Jeffrey Dahmer. Psychoanalytic Review, Vol. 98 (4), pp. 493-514.

O’Meara, G. J. (2009). He Speaks Not, Yet He Says Everything; What of That?: Text, Context, and Pretext in State v. Jeffrey Dahmer.. Denver University Law Review, Vol. 87 Issue 1, p97-137, 41p.

When working in health and social care, there are certain laws and policies which we have to follow. Some of them are the policies and procedures made by our organizations while some are rules and regulations set up by the government. Principle of practice means abiding by all of the rules; policies and procedures so as to fulfil the requirements which we need to follow in order to be an ideal professional in health and social care.

VALUES OF HEALTH AND SOCIAL CARE

In health and social care, values are the beliefs and ideas that guide us about the way we are supposed to care for others.

Examples from experience

We can understand and learn more about the values in health and social care working as a care worker in different roles and settings. It is not mandatory that an individual should only be cared for in a nursing home or a residential home. It can even be his/her home. Different types of care settings are as follows:

Primary care

When someone notices the early symptoms of health disorder then they often visit the GPs. If the GPs find out that the case is rather more serious then the GP suggests that person to go to a specialist. However the individual can return to the GP for follow up care and monitoring of his disorder. Nursing treatments, physiotherapy, radiography and other specialist care may be undertaken at the GP’s surgery.

Hospital care

Sometimes when the patients reach the later stages of a disease or if they need intensive care then they might be subjected to hospitals.

Domiciliary care

There is often a negative belief among the elderly people that they might not return home if they are sent to a care home or a hospital. In these cases, they want care to be provided in their own homes. When the care worker provides care by travelling to the client’s home then it is called domiciliary care. Agencies that provide home care workers should be obliged under the 1973 Act and should make sure that the staffs have undergone proper training and should provide them with necessary equipments. A good agency will have a different department for recruitment and training of staffs and a different one for client enquiries. Domiciliary care can be a problematic process especially when a single care worker has to attend many clients.

Residential care

In the further stages of a disease, a patient needs to be under care 24 hours a day. Such people need to be sent to a residential care home where they can be looked after by a team of staffs. People with dementia, Alzheimer’s disease or arthritis need advanced care and hence they can be admitted to a nursing home. It is not necessary that every client in a residential care home is suffering from a disease. When families and relatives are unable to look after the elderly people in their home due to their busy schedules then also they may trust residential care homes to keep the elderly people. According to best care home awards, Morton Grange is Britain’s best residential care home in 2009.

Requirements

The requirements for maintaining the values of health and social care are as follows:

Equality

Different people have different needs. It is essential that the same principle of fairness is used to meet their needs. Therefore, the definition of equality is not only equal treatment of all the individuals but it the similar treatment of individuals in similar conditions. Let us suppose that in a hospital, there are a number of patients with a particular type of brain tumour. In this situation, they should be offered the same option for treatment even if their choices may differ based on a range of factors. Equal opportunities should always be available for everyone.

Diversity

The word diversity refers to the variations found in the characteristics and nature present among the individuals within a population. When we look at a population then we can notice that people are different from one another in their own ways. We can feel the differences in the language, religion, race, tradition, norms and values of people. For instance, According to National Statistics Online 2007, UK population consists of 71.7 % Christians, 3.1% Muslims, 1.1% Hindus, 0.6% Sikhs, 0.3% Jewish and 0.3% Buddhists. This statistics shows the diversity in religion of the UK population in 2007. As a care worker, it is important to realize the social context in order to understand our service users and accept diversity with all our hearts.

Dignity

According to the Social Care Institute for Excellence (2006), dignity refers to the state, quality or manner worthy of esteem or respect; and (by extension) self-respect. In the field of health and social care, one should not forget that every person has his own individuality. Being a care worker, one should intend to promote the self esteem of the service users and we should have a sense of respect for everybody regardless of any sort of differences in order to express that we value their dignity. Let us put forward the example of old people who tend to find happiness in small things such as the weather and flowers and try to maintain their dignity and self respect by remembering their past achievements. Listening to them and giving them priority can really help to enhance their dignity.

Protect

The values of health and social care are likely to be disturbed in some cases. The steps to be considered in order to protect the values in health and social care are:

Taking account of limitations

We have got our own sets of rights but this sometimes while using our rights we might forget what our limits are. If we forget our limits then we may be successful in hurting other people’s feelings and also violate their rights. Suppose somebody is a popular author. He has the right to express his views, ideas and creativity through his works. However, this does not necessarily mean that he can write negative things about people of a particular group or culture. He cannot mix something like racism in his writings and hurt others. That is not his right. Hence, we should take account of our limitations.

Use relationships to promote rights

Gilchrist (1992) suggests a number of ways to ensure that discrimination does not exists in our society, they are:

Recognise prejudice and discriminatory practice that it can lead to;

Value diversity;

Understand a need to find ways to empower others;

Combat discrimination and encourage others to combat discrimination;

Reflect on the organisation and the policies, procedures, practices and facilities which might support anti discriminatory practices.

Impact of discrimination on others

The unequal treatment and attitude that we show to others is known as an act of discrimination. People can discriminate on the basis of sex, religion, social class, ethnicity, race, etc. We have to abide by the anti-discriminatory acts such as sex discrimination act, Race Relations Act, etc. because discrimination can have only negative impact on the following aspects:

Identity

When someone is discriminated then he/she may start losing the honour which should possess regarding their identities. For example, when someone is discriminated on the basis of his religion then he may adapt some other religion just to be accepted by others.

Self-esteem and confidence

Discriminatory acts hinder one’s dignity and decrease one’s willingness to participate in social activities. For example, due to the sexual discrimination faced by gays, lesbians and transgendered people, they grow up feeling isolated and conscious about difference between them and others. According to www.citizenship.ahsonline.co.uk, over 70% of transsexuals have contemplated suicide in their lives.

Colleen Rothwell-Murray. Commissioning domiciliary care: a practical guide to purchasing services. 2000. Oxon: Radcliffe Medical Press Ltd.

Sue Cuthbert, Jan Quallington, Values for care practice. 2008. Devon: Reflect Press Ltd.

www.pressdispensary.co.uk

Values and EthicsThe Value base of Social Work and the Development of my own Values

This essay will firstly discuss what values are and the value base of Social Work. It will then proceed to analyse the origin and evolution of my own values. Followed by reflection on them and how they relate to the value base of social work. I will summarise by identifying areas of my personal values that I think require further development.

It makes sense to start off by exploring what is meant by the word ‘value’. It is a somewhat vague term, most people would claim to have values but struggle to elaborate when asked what their values are. Banks makes a good analysis, ‘ ‘values’ is often used to refer to one or all of religious, moral, political or ideological principles, beliefs or attitudes.’ (cited in Thompson 2005, p108) Values can vary greatly from one culture to another, from family to family and differ between each individual. Values and what they mean to each person in my opinion are unique for everyone. As Thompson suggests ‘….a value is something we hold dear, something we see as important and worthy of safeguarding.’ (2005, p109)

The British Association of Social Workers, (BASW), promote a Code of Ethics, that they expect each and every social worker to adhere to. The key principles of these are human dignity and worth, social justice, service to humanity, integrity and competence (1999). Each of these principles contains core values that are imperative for good social work practice. Examples of such values are ‘Respect for human dignity and for individual and cultural diversity’, ‘Value for every human being, their beliefs, goals, preferences and needs’, also ‘Respect for human rights and self-determination’. When I first read the code of ethics, at the very beginning of studying social work, it appeared very simple. I asked myself “Surely it can’t be complicated to follow these basic values?”. Nevertheless, through the teaching I’ve had so far and the questions it has raised, I realise that social workers must keep a constant check on themselves, reflecting regularly so as their service users receive a consistent quality of service.

Biestek (1961 cited in Dominelli 2004) put together seven points that he felt formed the traditional social work values. These are, Individualisation of the client, treating each service user as an individual. Purposeful expression of feelings, allowing service users to talk about and express the feeling they have. Controlled emotional environment, obtaining the right balance of emotions. Unconditional acceptance, accepting that person for who they are. Non-judgemental attitude, not judging a person on the way they choose to live their life or the decisions they have made. Client self-determination, similar to empowerment, playing a part in helping a service user realise their goals. Lastly, Confidentiality, respecting that everything discussed with a client is personal to them and they may not want others to know their private business. Although Biestek defined these values as important nearly fifty years ago, they still remain significant and can be applied to social work today.

With this is in mind a common traditional value to explore would be respect. This is a value held by many different cultures and religions, mostly seen as respect towards elders and also towards people in authority. In the General Social Care Council’s Codes of practice, respect is referred to throughout, one instance being ‘Respecting and maintaining the dignity and privacy of service users’ (2002).

This value although stemming from good intentions is open to exploitation, for instance when the older individual or person in authority abuses the power that respect gives them. It is widely agreed that one should have unquestionable respect for anyone older than them or toward a person in a position of authority, whether that respect is deserved is often not open for discussion.

So how do values apply to social work? Values are something people make use of in their lives everyday, probably without even realising so. However values also form a significant part of social work practice, as Trevithick points out, ‘Social work is not unique in its values perspective, but other professions may not have given this issue the same importance…’ (2005, p4). For instance, if a social worker cannot empathise with a service user it is going to be very difficult to understand how best to assist that person. As Thompson suggests ‘(empathy)…is a very skilful activity, as it involves having a degree of control over our own feelings while remaining open and sensitive to the other person’s feelings.’ (2005, p119). This is an area of my values I can detect require improvement. I will need to ensure I achieve the appropriate balance of caring without becoming so emotionally involved that I find myself in a position where I am unable to support the individual.

My own values stem from my upbringing. We hold very strong family values, encouraging each other completely in whatever we are undertaking. If a member of the family has a decision to make, we will share our views and opinions, but ultimately always support and respect the final choice made. I benefited from this support immensely when I became a mother at just eighteen years old, I received an incredible amount of assistance and encouragement from my family. I am in no doubt this made a huge difference to how confident I was as a mother.

However, I was unable understand my partner’s family values. Within their family they lead much more separate, independent lives. At eighteen I couldn’t fathom this way of thinking, I thought, naively, that all families shared my family’s values. My Mother-in-law expressed her disappointment that her son was becoming a young father. I perceived this as a rejection. I deliberated for a long time as to why we didn’t share the same outlook, identifying it as a disapproval of her son’s choice of partner. After many years, and several heated confrontations, I came to realise that it wasn’t a personal attack against me. It is simply that my in-laws hold different family values to myself and I can now appreciate and understand this.

It was growing more mature that enabled me to distinguish that other peoples’ values are different to my own. It was not my place to judge my mother-in-law and I can now recognise my over-sensitivity. I believe this was all part of a process that inspired me to form a non-judgemental attitude. I accept others for who they are and do not judge them on how they choose to live their life and the decisions they make. This is a quality that, I hope, will contribute positively towards my social work career.

Another value I was raised with is respect; I mentioned this nearer the beginning of my essay and feel that it is an area of my values that has developed. As a child I was expected to show total courtesy to all adults, it was inconceivable that I could question an adult. Although secure that I was completely loved, I was a child and couldn’t possibly argue with an elder. An adult would certainly not say sorry to a child, fundamentally this was not a reciprocal value. One occasion I can recall is my mother thinking I had stolen a cake from the kitchen cupboard, my brother had in fact taken it. Even though she was made aware of the truth, I was never apologised to.

The concept was that adults, and more so parents, were never wrong. I like to think that now, as an adult myself, I still strongly hold this value of respect and encourage my children to show regard and consideration toward others. Although, for me personally, the value has evolved. I foster the belief that respect should be shown toward all persons, young and old. I aim to show equal respect to children and adults alike and I feel with my own children that, if I have made a mistake in any way, I should always apologise to them.

It is vital when interacting with a service user I am aware of the values I hold, as Dominelli points out, ‘…. the social and knowledge contexts within which values are embedded impact upon their use,….’ (2004, p65). For example, I am against abortion once the pregnancy has gone past the twelve week stage, but I am fully aware that if a service user was in this situation, it would be totally unprofessional for me to allow the client become aware of my personal opinion. It is certainly not my position to impact upon any decision the service user may make.

I am also attentive to the fact that there are other areas of my personal values that require further development. One aspect that I am conscious I will need to work on is showing respect to persons that have committed certain offences, for example, a paedophile that has molested or murdered children. Having young children myself I find this sensitive issue quite upsetting. Still, I am aware that even though an individual has chosen to carry out this act it doesn’t mean that they are not entitled to services. It would be my job to offer that person the services they hold a right to receive and, as before with my views on abortion, I must exercise the non-judgemental area of my values to effectively provide this.

To conclude this essay I believe that I am able to recognise the values that I possess and I aspire to remain attentive to these and the areas that require further strengthening. I also feel the values I hold relate to social work practice and I hope they will contribute toward my career, in a positive manner, for many years to come.

Theory is every systematic collection of ideas that relate to a specific subject. Observations that can be explained by a structure designed to analyze them is called a theory. It can also be a series of principles applying to something and describing a set of phenomena. A theory should be able to identify this set of phenomena and make allegation about the reality of a coherent collection of ideas. Theories are supposed to be practical and they are never considered right or wrong. They are supported only by observations and there is some significant truth in every one of them but no single one of all these theories says it all.

On every field, practitioners make decisions and give advice based on principles, theories. A good practitioner needs to predict the effects of action and if he’s not able to do that he is hardly responsible or professional. Each career theory should describe the important features of the situation and find proof of what really happens. Theory asks “why does it happen this way?” and tries to give a reason based on the evidence. Understanding the causes and the results means that a practitioner can work out “what would happen if…” By doing this the practitioner can see how outcomes change if interventions are different. This is where theory and practice communicate with each other.

Theories have a great impact on a practitioner’s way of work and in order to give advice, information and counseling he should be able to apply these theories based on the situation. Being capable to do that gives him the confidence to make the best of his skills to help the client. By doing that he increases his range of skills, self awareness and the opportunity to give and get support. Meeting the desirable outcome means that the practitioner has been tested and proved his effectiveness and knowledge on the subject. It’s a way to evaluate his skills, challenge his self and reflect on his action. Having the knowledge to adapt theories to the client’s needs improves his performance, gives him guidelines and provides him with a target for practice. The practitioner is developing his skills by interacting with people and learning from them. He’s being changed by the individuals and his ability to approach and understand the needs of the client.

Counseling is a way of helping people overcome problems and achieving their goals. The clients should have the resources needed to deal with any difficulty they have and this is what they should try to gain from a meeting with a career practitioner. After the meeting they should be able to make well informed realistic decisions, resolve their problems and reflect on their selves. In order to achieve what they desire, they should explore their choices, increase their understanding of the situation and make effective plans. These can be achieved if the client trusts the practitioner and understands that he has the best interest at heart and his role is to make him more responsible on his decision making and his future planning.

Using the case study provided offer justification as to how the theories studied can contribute to our understanding of the client and the issues that the case study presents. Evaluate the implications these insights have for the practice of career guidance.

As we can see from the case study Dee is a person easily influenced by everyone around her. She didn’t go to college or sixth form after she finished school because of her parents, who seem to have the final word on her life’s path. She found a job to contribute to the family income and she got married very young because her parents believed that is important to settle down with a husband and children. She left others guide her life decisions but now she seems ready to take her life on her hands. Dee has been through every major transition in her life and I can see that she managed to overcome many obstacles to finally decide she wants more of her life. Her new-found confidence and ambitions brought the end of her marriage but she seems to be able to make her decisions without the influence of her family.

As her practitioner I would use the occupational choice theories and the transition theories to understand Dee and the issues she presents at the meeting. Transition theory provides a description of ways in which people may cope with change and draw insights on hoe people make decisions. If the client understands the process of transition it would be easier for her to engage and participate in the process.

Most of the transitions in Dee’s life were involuntary and a number of conditions appear to disable her from taking the next step, finding a new job or going to the university. She has no economic security, high commitments as a woman divorced with two children and no one to support her. She is a person who experienced multiple transitions in her life, marriage, parenthood, divorce and from school to work. All these events in her life are possible vehicles for maturity and personal development.

As practitioner we should have in mind that each of us cope differently with transitions and the more aware a person becomes of these aspects of himself, the better equipped he will be to control the change effectively and to be benefited from the transition. Adams, Hayes and Hopson signify that a cycle of feelings and reactions are expected in every type of transition. The cycle has seven stages and a person must go through them in order to move on. The first phase of the transition is immobilization. The person feels overwhelmed, frozen and unable to do anything about the situation. Then comes the phase of minimization. At this point the person is in denial or feels euphoric. Denial is sometimes a positive reaction and a necessary way to adjust. The third phase of the cycle is depression. People are fully aware of the situation and feel powerless. Not being able to get control of their life they often get depressed, angry and have an intense feeling of hopelessness. As people start to face the reality they manage to move to the fourth phase. They begin the process of unhooking from the situation and letting go. At the fifth phase people turn out to be more active, adopt new behaviours and life styles to deal with this big change in their lives. At the next phase people try to find a reason for the things that are different now and what this means for their lives. Finally, at the seventh phase of transition people acknowledge the reality, have a better understanding of their selves and test their behaviour based on their experiences through the transition.

A person who is already experiencing a divorce and a career change is possible to be more upset and have a more powerful transition. To be able to give advice and guide a person like Dee means exploring all of the aspects of her life, how she arrived at this point and how she made all these decisions that brought her today to this office to get career guidance. Being familiar with the occupational choice theory gives as a better understanding on how Dee decided to change her career and what obstacles she may face during this process.

Part 1: Indicate two sociological theories that can be used to help your understanding of the service users’ situation

In taking the time to observe how sociological and psychological influences may impact on a service user or client group, the social worker can remain mindful of the wider context of a situation and not just take what she sees at face value. This knowledge allows the social worker to remain objective and to make informed decisions in order to maintain professionalism in her work. By applying Sociological and Psychological theory to the ‘Bertram’s’ case study I aim to explore the wider social context, outside influence and psychological implications from the past and present. Through this exploration I will uncover the varying viewpoints and sometimes contradictory nature of these theories. To gain a Sociological perspective on the case study I will be applying Functionalist and Feminist theories. I will be able to scrutinise the Bertram’s current situation and apply the theory in order to gain a wider understanding of the social context. In order to maintain a balanced viewpoint, Psychodynamic theory and Maslow’s hierarchy will enable me to consider the psychological impact with a focus on human and emotional development.

By examining a situation from a Sociological perspective we can take into account how various aspects such as class, social structure, religion, disability can impact people from a wider social context. This is essential in gaining a holistic picture the situation.

Functionalism

By applying a Macro theory to the case scenario it allows us to look at the large scale features of society and how individual actions affect society as a whole and vice versa. Functionalism will enable me to contemplate the structure of society and how the Bertram’s fit within that structure. Functionalist theorists regard society as a system with interlocking parts. It is believed that each part needs to function effectively in order for society, as a system, to work as a whole. It is often rationalised using biological analogy. The social role of individuals is an integral part of the theory. Each person is thought to have their individual role to play within society. From a functionalist perspective it is very clear that Mrs Bertram is not fulfilling her role as a wife. Due to her alzemers she is unable to carry out the duties that would have been expected of her. Durkheim believed that everyone had their place, and a woman’s place was in the home. In the context of the 40’s, 50’s when Functionalism was at its peak, this viewpoint would not have been uncommon, if a little out-dated by today’s standards. None the less, it is not through choice that she has become dysfunctional within society. She has legitimate claim for not being able to carry out her societal role and Functionalism would automatically see her take on the ‘sick role’. This would enable her to function again within the system under a different guise.

It could also be observed that Mr Bertram is a dysfunctional member of society. With his reckless behaviour, his outrageous spending, and the lack of care for his wife’s basic needs he is no longer fulfilling his role of husband. A main proponent of Functionalism was Emile Durkheim (1858-1917). He saw marital vows as obligations. “When I perform my duties as a brother, a husband or a citizen and carry out the commitments I have entered into, I fulfil obligations which are defined in law and custom which are external to myself and my actions” (Durkheim, 1982). He believed that if a member of society was deemed as dysfunctional, then he was considered to be a deviant member of society. Deviance occurs when people are not functioning correctly, according to the ‘norm’. This could be through crime, or anything which affects their ability to carry out their societal role. Deviance needs to be controlled or managed. If it was established that Mr Bertram was in fact deviant then he may need some persuading that by providing the care and attention that his wife needs his wife would not be removed from the situation. Through this resolution, therefore, they would both be able to function appropriately.

It could be observed that Mr Bertram had an alcohol dependency. If this was established then Mr Bertram too may take on the ‘sick role’. In which case a different method for resolving the issues within the house would need to be adopted. Talcott Parsons (1902-1979) believed that sickness was a social concept rather than a biological concept. So being ill meant acting in different, deviant ways to the norm. Being sick was therefore a form of social role (Haralambos and Holborn, 2004). Parsons believed the rights of a sick person to be exemption from normal social obligations, the right to be looked after and blamed for their social deviance as long as they were genuinely sick. Obligations of a person playing the ‘sick role’ would be to understand that they have to ‘get well’ as soon as possible in order to continue their normal function and in order to do this they must receive professional help. Mr Bertram’s condition would need to be treated or managed in order to enable him to function again. In that case Mr and Mrs Bertram would be able to stay at home under treatment and the issues about care could be dealt with accordingly. He would no longer be considered deviant member of society. A criticism of the ‘sick role’ would be that it is very difficult to apply to long term illness like that of Mrs Bertram. It is built on the assumption that the person gain help in order to gain function. This would not be possible for Mrs Bertram.

Feminism

From a Radical Feminist perspective it could be observed that Mrs Bertram has been oppressed by her husband. Through her devotion and his dominance she has succumb to subordination. Radical Feminists use the patriarchal social system as a concept to explain gender inequality. Patriarchy is the dominance of men over women in society. They view men as responsible for the exploitation of women from which they benefit greatly, through free domestic labour, sexual duties and so on. The case study describes how Mrs Bertram was swept off of her feet and totally devoted to Mr Bertram. In their current situation, Mrs Bertram is at home in squalled conditions and desperately in need of help. Mr Bertram is avoiding the situation by using diversionary tactic, selfishly seeking social activity and pleasure through drink. This further increases her oppression as she is fully dependent on her husband to provide the care and attention which she is desperately in need of.

“Shulamith Firestone, an early radical feminist writer argues that men control women’s roles in re-production and child bearing. Because women are biologically able to give birth to children, they become more dependent materially on men for protection and livelihood” (Giddens, 2006). Feminists could argue that for this reason Mrs Bertram has become vulnerable within her setting and just accepts this way of life. Jessie Bernard argued that “Men need marriage more than women” (pg 208 Gender). Perhaps this reliance on the domestic labour, comfort and sexual duties of a wife, which has been lost my Mr Bertram through his wife’s condition is attributing to his behaviour. Mrs Bertram is no longer fulfilling her duties as a wife and this could be disrupting his routine. It would appear that Mr Bertram has never had to control the household, take care of his wife or finances, and may lack the ability or may simply consider it beneath him. It could affect his masculinity to have to carry out such chores and duties believed to be part of a woman’s role. This may also be the reason why he is reluctant to accept help with the situation. He may feel he is being barraged and dictated to by his step daughters which may be resulting in a greater defiance. It is not clear from the case study, the nature of their relationship either. He may feel that family and professionals are undermining his authority as head of the household. Mr Bertram may be compensating for his lack of masculinity at home, by using his social appearance, bravado, drinking and defiance. This time away from the house for him may reaffirm his role as a dominant male within society whilst his dominant role as a man disappears at home. He no longer has command over his wife, no longer gets respect, adoration that he was once used to. Men are considered to have more influence within society; Mr Bertram has no influence over this situation or over his wife.

Part 2: Using the scenario describe two psychological theories that can be used to help your understanding of the service users’ situation
Humanistic theory – Maslow’s hierarchy of needs

Humanistic psychologist Abraham Maslow (1908 – 1970) argued that humans throughout life not only want to have their basic survival needs met they strive for more in terms of personal growth. He believed that once basic needs for survival had been met that human development progressed toward higher psychological needs. He argued that “people are motivated by the conscious desire for personal growth” (Rathus, 2004). Maslow believed what separated us from our so-called lower animals was our capacity for self-actualisation (Rathus,2004). He believed that this self- actualisation was as important as basic needs but could not be met unless other stages of human needs were completed. He organised these stages into the hierarchy of needs, often presented in pyramid format. Each stage must be satisfied in order to progress to the next. At the bottom of the hierarchy are physiological needs. These are the basic human needs we all have in order to survive, like food, water, shelter, oxygen. Once the first basic need has been satisfied, the following stage is safety needs, the need for security. The following stage in the hierarchy is love and belonging; the need to give and receive love, to overcome loneliness and achieve a sense of belonging in life. The fourth stage is ‘Esteem needs’; to feel self-confident, respected and not to feel inferior. Self-actualisation is the final stage in the hierarchy and can only be reached when all foregoing needs are satisfied and the person feels he has achieved everything he wants to in life and is the best that he can be.

In the case of the Bertram’s it is clear that Mrs Bertram is currently not even meeting the bottom of Maslow’s hierarchy of needs. It is noted that their flat is in an appalling state, she is unable to feed herself and left on her own for most of the day. You would expect most of her needs to be met within the context of her marriage to Mr Bertram; however, since he has neglected his role as a husband, he has placed her in a position of significant danger. Since not even her basic physiological needs are being met in the current situation then at present there would not be an opportunity to progress through the hierarchy of needs.

If Mrs Bertram was placed in residential care then her physiological needs would be met. She would have food, water and care of her basic needs. She could then perhaps progress to the following stage of safety. She would no longer be at risk of hurting herself and she would be in a more secure environment. Although it could be argued that for an advance Alzheimer’s sufferer, the unfamiliar setting would disorientate her and she might not actually feel secure there. Because of her diagnosis, Mrs Bertram is unlikely to meet the third stage of ‘love and belongingness’. Her advanced Alzheimer’s may mean that she fails to recognise her husband, family members and have a declining ability to communicate. Mrs Bertram would never reach self-actualisation. The best that could be achieved would be basic survival and safety needs, whether this was achieved at home with the compliance of her husband, or in residential care. Although it could be debated that residential care would not be the best option. As the GP states in the case scenario, “a move to residential care might well kill Mrs Bertram”.

It would appear from the case scenario that Mr Bertram’s basic needs are being fulfilled. However it is uncertain as to whether his s safety and security needs are being met. He certainly would not get a sense of love and belonging from his wife, in the latter stages of sever dementia. I would observe, however, there is some attempt from Mr Bertram to achieve a sense of self-esteem, since he spends the majority of his time with his compatriots at the golf club. It is clear that in this relationship and the current situation faced by the Bertram’s that he too has no way of reaching self-actualisation. Maslow observes that it is mainly social factors that hinder the personal growth of humans. Potentially at least the first two stages of Maslow’s hierarchy could be reached within the context of their marriage, with the right services in place.

Psychodynamic theory

Through the Psychodynamic theory of personality we could speculate about Mr Bertram’s past and how that has influence on his behaviour in the present. It would be difficult to achieve a comprehensive result in regards to Mrs Bertram because of her Alzheimer’s. Since her behaviour is wholly attributed to her condition.

Studying Sigmund Freud’s (1856 – 1939) theories, with a focus on psychosexual development, would be the most relevant to apply to the case scenario. Psychodynamic theory had been developed and evolved over the years. Freud’s idea of Psychodynamic theory depicted humans as largely driven by unconscious motives and desires. He proclaimed that humans come into conflict when their basic instincts come up against social pressure to follow, laws or moral codes. “At first this conflict is external, but as we develop it becomes internalised” (Rathus, 2004). Freud explains the conflict of personality using psychic structures. The id, which Freud believed is present at birth and located in the unconscious mind, and revolves around our basic biological drives and instincts. It operates on what Freud called the ‘pleasure principle’. It demands instant gratification regardless of laws or moral rules. Another feature in the structure of personality is the ego. Formed from the id, developed through learning and experience. This is the part where conscious thought takes place (Beckett and Taylor, 2010). The ego operates on the ‘reality principle’. This takes into consideration what is practical and possible in gratifying needs (Rathus, 2004). When the ego senses improper impulses arsing it can sometimes deploy a number of defence mechanisms. The third psychic structure is the superego. This is formed throughout early childhood and is developed through standards, values, parenting and moral standards. “Psychodynamic theory emphasises the way in which the mind stimulates behavior, and both mind and behavior influence and are influenced by the person’s social environment” (Payne, 2005)

Freud believed there were four stages in psychosexual development. The first stage took place during the first year of a child’s life. This is known as the ‘oral’ stage. Much of the child’s development is explored by putting things into the mouth and sucking, biting chewing. Freud believed it was possible to have arrested development through trauma. And be fixated on one of the stages. From the case study we could surmise that Mr Bertram is fixated on the oral stage of psychosexual development through his ‘drinking’. We could speculate that he may have had a significant trauma at that stage which has left him with a possible alcohol dependency, thus fixated on the oral stage.

It could perhaps be identified that Mr Bertram is using psychological defence mechanisms in order to avoid the situation that he is currently facing.

Part 3: Reflect on your own background describe it and indicate 1 sociological and 1 psychological theory that can be applied to you, giving examples

The relationship I have with my father has often been fraught, difficult and tense. As a sufferer of a severe mental disorder, my father has often displayed irrational, delusional, paranoid and sometimes violent behaviour. Throughout his life he has had frequent hospitalisation. For me this is something I have grown up with and am used to dealing with on a day to day basis. I am acutely aware of how our relationship differs to that of my friends for example. I have as close a relationship as possible with him, and to that end I usually bear the brunt of his paranoia and aggression when he is unwell. I have witnessed first-hand the stigma attached to mental illness. I find it extremely difficult to trust anyone enough to tell them about the situation, and I strongly feel I shouldn’t have to tell everyone that meets him, this only leads to labelling him as mentally ill, thus changing the way in which they treat him; which only compounds his paranoia.

Some Sociological theorists believe that mental illness is a social construction in order to rationalise bizarre or irrational behaviour that cannot be in any other way explained. This is known as labelling theory. Scheff (1966) argued that people are labelled as mentally ill because their behaviour does not make sense to others. “Scheff points out that labelling of a person as mentally ill is facilitated by stereotyped imagery learned in early childhood and continually reaffirmed, inadvertently, in ordinary social interaction and through the mass media. Thus, when a person’s violation of social norms or deviance becomes a public issue, the traditional stereotype of “crazy person” is readily adopted both by those reacting to the deviant person and, often, by the deviant person as well” (Lamb. 2002). Erving Goffman suggests that when someone is labelled as mentally ill then they are treated differently. When an interaction takes place with that person it is with this knowledge of the mental illness, therefore creating what Goffman called a spurious interaction (Haralambos and Holborn, 2004).

From a behaviourist view, Schizophrenia could be viewed as a kind of learned behaviour. “From this perspective, people engage in schizophrenic behaviour when it is more likely to be reinforced than normal behaviour (Rathus, 2004). This could be the result of being raised in an unrewarding or punitive situation. It could also be observed that this kind of behaviour is reinforced within the hospital setting, where the schizophrenic behaviour is reinforced through attention from professionals within that setting. Cognitive theory argues that behavior is affected by perception or interpretation of the environment during the process of learning. “Apparently inappropriate behavior must therefore arise from misinterpretation. Therapy tries to correct the misunderstanding, so that our behavior reacts appropriately to the environment” (Payne, 2006)

I believe the experiences I have had with my father give me the ability to understand mental illness without stigmatising. It also helps me empathise with the sufferer and the family. An empathetic approach to someone who was hearing voices for example, would be to understand that to the person affect, they are very real. I fully understand the importance of having the right services in place in order for that person to thrive. My experience allows me to observe the wider context of a situation and realise that it is not only the primary sufferer of the condition that is affected. The wider family needs to be considered as they have a huge role to play in the well-being of the person concerned.

Introduction

This report will look at service users who suffer with schizophrenia, it will highlight what schizophrenia is. The needs of service users who suffer from schizophrenia will be identified including; personal, interpersonal, social, educational, accommodation and medication needs. The services available to service users which meet these needs will also be identified.

What is Schizophrenia

Schizophrenia is a complex disorder with a number of variants, although the prognosis is well understood by specialists. It is a neuropsychiatric disorder where a number of factors may have impacted upon the central nervous system and which results in a cluster of symptoms that are classified as schizophrenia. It is commonly thought, incorrectly, by the general public to be associated with dangerous and extreme madness and thus carries a stigma which other diagnoses do not (Eldergill 1997).

About one in 100 people will have one episode of schizophrenia, and two thirds of these will go on to have further episodes. Schizophrenia usually starts in the late teens or early 20s, but can also affect older people for the first time. The causes are unknown but episodes of schizophrenia appear to be associated with changes in some brain chemicals. Stressful experiences and some recreational drugs can also trigger an episode in vulnerable people. (www.mentalhealth.org)

Needs of service users with schizophrenia
Personal needs

An individual’s personal needs include;

Good basic personal hygiene; this may include assistance to wash and brush their teeth or the individual may need prompting/reminding do so.

Having clean fitting clothing; help or prompting again may be needed to assist the individual to get dressed.

Food and drink supplies; individuals may need assistance shopping or making meals, to ensure good diet and physical health.

Interpersonal needs

It is important that individuals gain support from their family, friends and professionals.

Awareness of the individual’s illness and needs is also paramount.

It would also be useful to the individual if their family and friends have an idea of what causes their episodes and ways of defusing the situation or a point of contact when these situations arise.

Social needs

It is important that the individual does not feel excluded from society because of their illness.

To be able to carry out social activities on a regular basis

Meet other people with the same illness; this can provide an understanding of their illness as well as peer support.

Educational needs

Education about their illness and also education for their family and friends.

What to do or who to contact when experiencing the onset of a psychotic episode.

Education on ways to prevent or control the psychotic episodes.

Accommodation

Stable adequate housing.

Depending on the severity or their illness; supported living or residential accommodation.

Medication

It is important that the service user understands what medication they are taking, if any.

What the medication does.

Side effects of the medication.

Services

The National Service Framework for adult mental health has seven standards;

Standard one covers mental health promotion and aspects of discrimination and social exclusion that is associated with mental health problems.

Standards two and three cover primary care services for people who have mental health problems and include 24-hour crisis services.

Standards four and five highlight what is needed to provide effective services for people with mental health problems. This includes being familiar with the care programme approach and its relation to care management.

Standard six relates to the individuals who care for people with mental health problems, with social service departments being given the lead responsibility in ensuring that all carers’ needs are assessed and that they receive their own written care plans.

Standard seven sets out what is needed to achieve a reduction in suicides. This will potentially involve all social workers in a range of settings. (Golightley 2009)

Social services

Social services are put in place to assist people who are experiencing a crisis or are in need of ongoing support. The adult mental health services would be the provider of this service to individuals with schizophrenia. Golightley (2009) highlights the role of social workers working with sufferers of a mental illness to be;

Educating service users and their families about their illness.

Helping to arrange appropriate low stress accommodation.

Networking with the service user to provide community support.

The use of behavioural techniques to modify behaviours.

Encouraging compliance with medication.

Acting as an advocate for the service user where appropriate.

It is important that social workers are able to identify whether the service user is a risk to either themselves or others. If so it is important to identify the risk and a way to manage it.

General practitioner

MIND the mental health charity state that General practitioners are usually the first point of contact for individuals who believe that they are experiencing the onset of a mental illness. GP’s can offer advice and referral to other specialised mental health services and treatments. It is also possible for them to prescribe anti-psychotic medication once assessing an individual’s situation and they feel the individual would benefit from it.

After diagnosis GP’s still play an important role in individuals’ aftercare and physical health. The GP will be able to provide advice about the medication, what it does and its side effects. “According to the Government, GPs play a central role in the care and treatment of people with mental illness.” (Department of health 2001)

Community mental health teams

Community mental health teams are put in place to assist and treat service users who suffer from mental disorders which primary care teams cannot treat including schizophrenia. Community mental health teams usually consist of professionals such as;

Psychologists

Psychiatrists

Nurses

Social workers

Occupational therapists

Support workers

(www.mind.org.uk 2012)

All of these professionals work alongside each other as part of a multidisciplinary team. They create individual care plans for each service user and assist them to either maintain their disorder or work towards full recovery depending on the severity of their disorder.

To access the services of the community mental health team service users would need to be referred by their general practitioner, social worker or health visitor. These professionals will only refer individuals to this service if they believe that it would be appropriate and their patient would benefit from the services they have to offer. Once the service user has been referred, they will receive an assessment from the community mental health team which will determine the next steps for them to take towards recovery. The assessment will give the service user a diagnosis .Depending on the outcome of the assessment their next steps may include; advice, treatment or ongoing support from the team and in some cases referral to another service which specialises in their disorder. (www.mind.org.uk 2012)

Early intervention service

There is some evidence that early intervention can prevent psychosis and can help to prevent some of the worse consequences of psychosis, such as periods of unemployment, misuse of drugs or alcohol, getting into trouble with the police or becoming depressed. (Care services improvement partnership and national institute of mental health England 2006)

The early intervention team is part of the wider community mental health team framework. This service is specially designed for sufferers of schizophrenia and associated psychotic illnesses. This service aims to assist people who are at risk of experiencing their first episode of psychosis or are in the early stages of a psychotic illness. The early intervention team consists of;

Psychologists

Psychiatrists

Community psychiatric nurses

Social workers

Support workers

They aim to improve the effectiveness of short and long term treatment by; providing prevention strategies, detection of illness, support and treatment in the early stages of psychosis (www.mind.org.uk 2012).

Crisis resolution and Home treatment

To access this service, service users are usually referred by a community mental health team, general practitioner, social worker or health visitor, although it is possible for service users to refer themselves

The team is staffed by mental health professionals including; Psychiatrists

Mental health nurses

Social workers

Occupational therapists

They provide intensive and rapid support for people aged 16-65 years old who are experiencing a mental health crisis and who, without the team’s help, would be admitted to a psychiatric hospital. Sometimes the CRT can support people in their own homes, shortening their stay in a psychiatric hospital. For people in the community, CRTs arrive quickly – ideally within an hour. The team is then available 24 hours a day, seven days a week. Support continues for as long as it is needed or until the person transfers to another service (www.mind.org.uk 2012).

Burton (2009) describes the crisis resolution and home treatment team as the gatekeeper to other mental health services, prompt assessment of an individual suffering a crisis, community based care, remain involved throughout the crisis, undertake crisis prevention planning and work in partnership with the sufferer, family and carers.

Residential care

If service users feel they are not ready to live in the community independently or supported, residential care may be the next step for them to take. Residential care services provide service users with rehabilitation and support if they are suffering with a severe long term mental illness. This service provides 24-hour care by residential social workers, nurses and mental health support workers. Care homes are for people who need a high level of care and find it hard to manage in their own home (www.mind.org.uk 2012).

This service can be accessed by having a community care assessment, service users may have to pay for this service as it is means tested.

Service user groups

Service user groups are put in place to assist service users of all types. Each group is tailored to suite specific service user groups. Service user groups that specialize in assisting individuals with personality disorders, emotional or behavioural difficulties would benefit sufferers of schizophrenia. These specific groups aim to make service users feel; supported, empowered, included and a part of something. New coping strategies are provided which can lead to service users experiencing fewer crises.

‘Self-help and peer-support groups enable people to meet and share information, friendship and support. They often bring together people with a similar mental health issue, on a short- or long-term basis.’ (www.mind.org.uk 2012)

Talking therapies

Talking therapies, such as psychotherapy, counselling and cognitive behaviour therapy (CBT), can help to manage and treat schizophrenia. Talking treatments help individuals to identify the things they have issues with, explore them and discuss strategies or solutions. They can allow individuals to explore the significance of their symptoms, and so to defeat them. (www.mind.org 2012)

Cognitive behaviour therapy can be accessed through the NHS service users can access these service through their GP. Many voluntary associations including MIND offer these services at no cost.

Benefits

There is financial help available to those who cannot work due to a mental illness. These benefits can help towards care, rent and other commitments.

Disability living allowance

Service users who suffer from a mental disability such as schizophrenia may be eligible to claim this benefit whether they are working or not. Disability living allowance is a tax free benefit put in place to help with extra costs you have because of your disability.

To apply for this benefit service users must first apply through the jobcentre plus, their social worker or support worker would be able to assist them with this process. The claimant may then need to undergo a medical examination in order to receive the benefit. Receiving this benefit could increase the amount of other benefits the service user is entitled to. (www.direct.gov.uk)

Housing benefit

Housing benefit can provide individuals on a low income with financial support to pay their rent. How much each individual receives depends on their circumstances. Housing benefit depending on the service users’ income can pay all or part of their rent. Individuals are eligible to apply whether they are working or not, they can apply through their local council or jobcentre plus by filling in a housing benefit form.(www.direct.gov.uk)

Council tax benefit

Service users can apply for council tax benefit through their local council. Depending on individual circumstances service users may be eligible to get all or part of their council tax bill paid. Individuals can get a council tax benefit claim form from their local council.

Summary

http://www.rbwm.gov.uk/web/social_mental-health.htm

http://www.smhp.nhs.uk/OurServices/MentalHealth/CommunityServices/Communitymentalhealthservices/tabid/2538/Default.aspx

www.mentalhealth.org.uk

http://www.nice.org.uk/usingguidance/commissioningguides/schizophrenia/specifying.jsp

http://www.cwp.nhs.uk/OurServices/adult/CrisisResolutionHomeTreatment/Pages/default.aspx

http://suite101.com/article/what-is-a-crisis-resolution-team-a204890

http://www.mayoclinic.com/health/schizophrenia/DS00196/DSECTION=symptoms

http://www.nhs.uk/Conditions/Psychosis/Pages/Introduction.aspx

https://www.gov.uk/housing-benefit

http://www.nao.org.uk/publications/0708/helping_people_through_mental.aspx

http://www.rethink.org/how_we_can_help/our_services/nursing_and_resident.html

http://www.mind.org.uk/help/diagnoses_and_conditions/schizophrenia

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/schizophrenia/

Department of Health (DH), 2001, The Mental Health Policy Implementation Guide, London: DH.

More foster carers are needed in the UK today. Official statistics from the Fostering Network indicate that over 10,000 foster families are needed. Another research by Fostering Network found 82% of local authorities saw a rise in the number of children coming into care and needing foster homes in 2009-10. Family foster care provides substitute planned family care for children who cannot be adequately cared at the own home due to various reasons.

4.1 Foster children:

The number of children coming into foster care has become overwhelming over the years. But the fact is that it has become very difficult to find the families who are ready to meet the challenges of increasing complex behavioural, emotional needs these children experience.

SHORTAGE OF FOSTER HOMES

England: 8,200

Scotland: 1,700

Wales: 750

Region

Shortage

England

8200

Scotland

1700

Wales

750

Source: Fostering Network Website

Chart 1a: National Breakdown: Shortage of Foster Homes in England, Scotland and Wales

SHORTAGE OF FOSTER HOMES IN ENGLAND

North West: 1700

North East: 1300

East: 650

South West: 600

South East: 850

London: 2000

West Midlands: 650

East Midlands: 450

Region

Shortage

North Wales

1700

North East

1300

East

650

South West

600

South East

850

London

2000

West Midlands

650

East Midlands

450

Source: Fostering Network Website

Chart 1b: Regional Breakdown: Shortage of Foster Homes in England

4.2 Motivations for foster carers:

Much research has been conducted on this issue as what motivates people to foster. It is very important to understand this key component because this may help to understand their needs and can be used as a tool in the marketing mix to recruit more carer. In 1996, Denby & Rindfleisch conducted a research on children and youth services. The research was conducted in order to understand what motivates a person to become a foster carer. Some of the findings were, “fulfilling the need for foster homes in the community, enjoying and wanting to help children, providing a companion for an only child and for oneself, increasing family size, obtaining substitute for a child who has died or who has grown and left home, religious reasons and supplementing family income” (Denby & Rindfleisch, 1996). Based on the findings of this research it is very clear that there are various factors that are involved for a person to become a foster parent.

4.3 Foster carer recruitment:

In the recent years, there has been a decline in the number of families able to provide foster care. When a child is identified in need of foster care, the problem of finding placement homes still remains very high. Some of the factors that are related to the shortage of foster carers may be due to the following reasons:

Greater difficulty in meeting the increasing complexity needs to become a foster carer

Lack of public awareness

The poor public image of faster carer.

With these issues, it has become difficult to recruit foster carer and has become an important and yet a challenging task. Recruitment of quality foster carer in an on-going demand for the agency.

4.4 Productive approaches 2008 – till date:

For the past 2 years, the enquiries generated by fostering solutions using the current marketing strategy have increased. Fostering solutions uses different methods of advertising to attract potential carers. These include bill board, bus, community care, exhibition, flyer, internet, job centre, jobs fair, local community booklet, national magazine, newspaper advertisement, passed office, post office, radio, tv, recruitment event, taxi, website, word of mouth, yallow pages etc (Fostering solutions).

Over the past few years, the recruitment focus was on the following factors:

To recruit carers through using fees, and other allowances.

Using messages such as “show you care” to reach the carers.

4.5 Recruitment outcome:
Table 3: FOSTER CARE RECRUITMENT ENQUIRIES – SOURCE OF INTEREST BETWEEN 01/09/2009 AND 04/08/2010
SOURCE
TOTAL ENQUIRIES
Advan
4
Fostering Network
2
Banner
1
Bill board
1
Bus
38
Current carer
8
Flyer
41
Internet
10
Job centre
3
Jobs fair
1
Local community booklet
30
National magazine
2
Newspaper Advertisement
761
Not specified
1
Passed office
78
Radio/TV
28
Recommended
156
Recruitment event
419
Recruitment poster
102
SMS
13
Van
1
Website
1071
Word of mouth
494
Yellow pages
22
TOTAL
3289

Source: FSDocument

Out of these, the most successful advertisement medium for fostering solutions has been website with a total of 1071 enquiries followed by newspaper advertisement with a total enquiry of 761, followed by word of mouth with 494 enquiries between 01/09/2209 and 31/08/2010.

From the above table it is evident that the total number of enquiries during the period 2009-2010 is 3289, but the no. Of approval are only 126 out of 3289 enquiries. This is just 3.82% of the total enquiry. It is evident that 3289 people are interested to know about the fostering care. But the approval rate is very low.

Table 4: FOSTER CARE RECRUITMENT ENQUIRIES – SOURCE OF INTEREST BETWEEN 01/09/2008 AND 31/08/2009
SOURCE
TOTAL ENQUIRIES
Fostering Network
3
Bill board
4
Current carer
1
E-invite
1
Flyer
19
Internet
1
Local community booklet
47
Newspaper Advertisement
591
Not specified
13
Passed office
108
Radio/TV
32
Recommended
173
Recruitment event
168
Recruitment poster
130
Taxi
1
Van
4
Website
1347
Word of mouth
535
Yellow pages
106
TOTAL
3284

Source: FS document

The total no. Approval between 01/09/2008 and 31/08.2009 was 163 and total enquiries received during that period was 3284. When Comparing the current year enquiries and approval rate with the previous year (i.e.) recruitment enquiry between 2008 – 2009 which was 4.96% of the total enquiry, it is clearly evident that there is a decrease in the approval rate when compared with that of the previous year. But we just cannot come to a conclusion that there is a decrease in the approval rate because some of the enquiries may still be in the approval process.

Table 5: Conversion rate

Year
Enquiries
Approved
Conversion Rate %
2008-2009
3284
163
4.96
2009-2010
3289
126
3.83

Source: FS Document

Over the past two years, the conversion rate is found to be reasonably constant with

4.96% in the year 2008-2009 and 3.83% in the 2009-2010.

Chart 2: Enquiries in different region

From the above chart it can be seen that the number of enquiries received from each region varies to a greater extent. For example the highest number of enquiries was received from the midlands with a total of 396 enquiries. Where as on the contradictory there were lower enquiries from various other regions. The reason for so many enquiries in the midlands is because of the strong advertisement campaign with additional newspaper advertisement. Fostering solutions should focus on all the regions equally. This will help to increase the enquiry from different region.

The major problem which is to be considered right now is that the approval rate is very low despite there was 3289 enquiries between 2009-2010. This may be due to various reasons.

Advertisement ? Enquiries ? ROI ? Approval

With reference to the above given table, when an advertisement is made and when it is able to attract 3343 enquirers who have even the slightest idea of fostering has enquired the agency, it is clear that people are interested to know more about fostering. But somewhere as they move further in the process (i.e.) from enquiry to the next stage, the number gets reduced to a greater extent. This can be viewed as a result due to 2 reasons.

There may be a problem in the process from the enquiry stage until the next stage which is the registration of interest. Or

The agency is not targeting the right people.

In order to identify the problem in the process from the enquiry stage until the ROI, a study maybe conducted as what is going wrong in that process. It is very important to focus on this issue right now because the time and cost involved in marketing is very high. Considering that fact, the marketing strategy maybe of good type, but due to some bottleneck in the process, the marketing strategy may seem to be unsuccessful.

4.6 STRATEGY
Objectives:

To successfully recruit the carers, the following objectives must be considered to meet the challenges that are associated with the recruitment activities. They are,

To recruit carers for different age group

To recruit carers for children with disability

To recruit a diverse range of carers to place the children to meet their best needs.

Recruit carers based on categories – long, medium and short term carers.

In addition to these objectives to recruit the carer, the fostering solutions should be the best choice for carers. In order to achieve such a position, the following factors plays important role

Benefit packages for carer- what fostering solutions can offer for both carer and young people.

Competitor awareness versus brand awareness of the agency.

Services provided before and after approval.

Raising awareness through advertisement – that carers are still needed , that fostering solutions values the carers, and to create a sense of feeling that they have made the right decision in selecting fostering solutions.

4.6.1 Plan of action:

In order to reach both regional and national audiences, the agency should continue to advertise a multi-layered approach of marketing. The message which the agency tends to convey to its audience must be clear and focused. The agency may use tools ranging from traditional to establishing its own marketing strategy through various opportunities that are available to raise the awareness of the people.

The traditional method includes the regular media advertising which the agency is currently involved and it has delivered results. It is now the right time to think of new opportunities of marketing through using the internet media such as web tools like Linked-in, Facebook, twitter, etc.

By using both the traditional and new methods, the agency can reach and cover a wide range of people from different regions, which will help to educate the people about the basic awareness and understanding about the need for fostering. This also helps to reach the target audience by giving them the information which they require.

4.6.2 Factors influencing the decision making:

There are several factors that influence the decision making of the marketing strategy. These factors help the agency to be alert by keeping them informed about the decisions of the potential carer and the way they react to the recruitment strategies and approaches that are used by the agency. A research maybe conducted in this area so as to find out the following:

What ultimately actuated the potential carer to pick up the phone and enquire about the services that are offered by the agency. This can be done through introducing marketing questions in the initial home visits.

Checking closely the effectiveness of all the resources that are used in marketing and making sure it is being efficient.

Look into the key areas where the potential carers drop out of the process. It is very important to understand this because, this will give an idea as the reasons why they drop out. This will in turn help to influence the potential carers to identify the drop out points. Through identifying the drop out points time and cost that are involved in retaining the potential carers can be kept under good control.

4.6.3 A change in the current communication tools

The information that are offered by the current communication tools are limited. That is the current communication tools which is paper based (information pack) gives idea from where the information is obtained.

Chart 3 : communication route

Enquiry

Information

Follow Up

Resultant

Website

Phone

Information Pack

Phone Call & Postcards

Drop Out

Proceed

This is the normal route through which the information flows from the agency to the prospective carers. This route does not offer flexibility for the carer. Which means the carers contact type preference, individual decision process are not considered in this route. Moreover, the person making a call to the agency maybe quite intimidating.

There should be a change in the current communication routes and channels whereby the routes are open up through which the prospective carer can gather information and be informed about the follow-up and the application process right from registration of interest until the approval.

Information Search

Enquiry

Informed Decision

Follow up

Resultant

Recruitment Stands

Newspaper

Word of mouth

Flyer

Website

Face to Face contact at event

Phone

Website

Information Pack

(Delayed decision) Direct phone and postcard

Drop Out

Proceed

Un-persuaded

Un-persuaded

Prospecting

Proceed or Informed Influencer

Participants or Informed Influencer

4.6.4 ENGAGING THE COMMUNITIES:

To target the right carer, I suggest increasing the chances of finding successful foster carer through designing a planned strategy to engage the communities in foster care. By involving with the community there is more scope to create awareness and recruit many carers. To come up with such a strategy, it is very important to know the agency’s needs and lay down its priorities, thumb rules on how to come up with a specific message for the general public. By engaging with the communities, it helps to inform the public and the potential foster carers about the need for foster care.

The ultimate goal of the agency is to increase the number of qualified foster carers.

In any business concept, designing an effective marketing strategy is a means of trial and error. For a strategy to be successful, it has to be analyzed from various perspectives before it can be implemented. In such a way, before reaching a community for help in recruiting the foster carer, we have to know in particular the needs of the agency and the ways in which the public might be of help to the agency. By needs of the agency here refers to the big question “who is our target customer?”. To kick start this process of finding the target customer the following assessment maybe done by the agency.

Identifying the foster care population in a community

How many foster children are there in the community?

Their age group

Age group under one year

No. Of children (between 1-12)

No. Of teenager (between 13-18)

No. Of youngsters (over 18)

Based on the agencies past experience say for example previous 2-3 years, how many children does the agency expect will require foster care during the next year?

The racial composition

White

Mixed race

Asian

Black

Other

Identifying the foster carer population in a community

How many qualified foster carers are there in the community

Identifying the children in the community

Up to what extent the following elements contributed to placement of children in foster care

LOW

Moderate

HIGH

Substance abuse

Poverty

Mental illness of parent(s)

Poor parenting skills

Incarceration of parents

Children’s emotional or behavioral

health needs

Knowing the needs:

After the above mentioned needs assessment is reviewed by the staff, the agency can come to a specific needs conclusion. The next step may be to rank the needs. The rankings should be based on their priorities as shown below

Example needs

Ranks

To provide more adequate support for foster families.

3

To recruit foster parents for teenagers.

1

To provide better training for foster parents so they can handle

children’s special needs.

To recruit foster parents for teenagers.

2

To educate the public about the impact of welfare reform on children

in foster care.

Once the needs are prioritized, the next step is to develop a community action plan. This can be done through the following ways

4.6.5 Engaging the wider public :

At the national level, the foster care fortnight event is conducted by the Fostering networks helps to engage the wider public and to spread the awareness about the need for fostering and the young people at care. However, this may help to engage the wider public, the major drawbacks in these kinds of events is that the agency does not get the chance to engage directly with the wider public on the assumptions and views to inform how we move ahead to spread the awareness. In order to overcome this problem the agency may preferably engage with the residents from the communities to inform them about the messages and the promotional approaches of the agency through which the awareness of the need for foster care can be increased.

This can be done through engaging services in a county wide arts and photography competition. This helps the agency to find out more ways to engage with the communities and encourage them to take part in fostering. The photography competition can be conducted through collecting pictures from different age group categories – young people in care, people who have experienced foster care. The competition must be judged by the agency; the winning photography must tour around the county and be visible in libraries and other common places for short period. A separate budget maybe required for this competition.

4.6.6 Working with the mass media:

Mass media is the most common and effective medium of advertising. However, for an advertisement to be effective through mass media, it is very essential for the agency to know what kind of information or message should be conveyed to the public. For example in the case of targeted recruitment, the focus is on the families where they can accommodate children and teens with specific needs. In this case community based recruitment would be very effective rather than a general media campaign. However, media campaign may be very effective and most suitable for general outreach.

Strategies for getting the message out to the public and spurring the community to take action.

4.6.7 Invite community leaders to help you get the message out:

Engaging with community leaders to spread the awareness is one of the best ways to reach the people in a particular community. This is due to the fact that the leaders may approach the public with a message which would be very effective rather than the agency conveying the message by itself. The community leaders may not have the special knowledge about the system of foster care as that of a social worker. However, what they do have is the ability to attract the public and press. It is very advantageous for the agency to form a link of network with the community leaders for they be very sympathetic the cause and would come forward to help the agency. These leaders may be invited to speak at the campaign events and they may be requested to mention about Fostering Solutions in their own events. In such a way the community becomes aware and lot of people might come forward to foster. The main advantage is that a minimal support from one community councillor or a child advocate can quickly raise the status of the issue.

4.6.8 Using the help of current foster parents:

The most effective means of advertising is to get help from the current foster carers to recruit more new foster carers. Gratified foster care parents are the better tool for recruitment and retention. The advantage of Working in with foster parents to increase recruitment will help to improve the retention as well. Foster parents can be of great help in the following ways:

Through sharing their personal experiences, the current foster carer may help the new foster carers to explain as what takes to be a good foster carer. This will also give an opportunity for the new foster carers to meet the children in care even before they get placed with a child.

The current foster care parents may help the new carers to complete the applications by way of providing pre-service anf training in collaboration with the agency.

The current foster carer may act as a middle man between the agency and the prospective foster carer by way of following-up with a phone call or a personal visit.

Through engaging with the current foster carers, the new carers may get individualized mentoring and it may in turn be a great motivation for both the new and the current foster carers.

4.6.9 Carer benefit package:

Carer benefit package may help to attract more carers. It is great way to communication through which the awareness can be increased. A detailed list of benefits and opportunities maybe listed, this will in turn help the prospective foster carers to take up fostering. The fact is that the more we offer and promote ourselves as the agency, the satisfied and happier will be our carers and are more likely to stay with us. This maybe one of the retention strategy. This strategy helps to gain competitive advantage over the competing agencies because, the carers are very happy with the benefit package. Regardless of whether the benefits are being used by the foster carers or not, the list of available benefits on the website maybe seem real and more tangible.

4.7 Resources

In order to implement the above mentioned strategies effectively, resources are very important keys.

4.7.1 Human Resources:

In the current organizational structure, the marketing department is very centralized. With the ambition of developing the marketing strategies for both the national and regional level, it is very important to increase the hierarchy level as shown in the above chart. In order to strengthen the regional marketing strategy a new post namely marketing assistant may be appointed region wise. The main work of this job will be to spread the awareness of fostering in their region and attract more carers. They will be reporting directly to the Marketing and public relations manager. The main reason to implement this change in the organization structure is because just having a marketing department at the head office will not work. Division of work is very essential in such cases. But for time being with limited resources, the main challenge is to stay focused in the priorities of the service that are provided by the agency.

Chart 4: Organizational Structure – Marketing Department.

4.7.2 Financial Resources:

To corroborate the current level of enquiries and conversion, it is essential to continue to invest funds in recruiting advertising. A sustainable budget allocation will help the agency to be efficient and effectively plan the time and resources which are very valuable. This will also help to improve response rate, and to reach all communities as well as effectively plan the response resources.

For long term planning, a planned annual budgeting will help to place the agency in a better position to cope up with the increasing preferential rates and spends of the promotional activity. There is also a need for the agency to invest in high profiled activities such as web advertising, website development and so on in order to maintain the profile of Fostering Solutions as the agency of choice for the carers.

Currently, Fostering solutions uses all feasible media which will enable the agency to touch the hearts and minds of many potential carers and make them aware about the need for fostering. More funds should be invested in the areas of community publications, editorial media and recruitment campaigns.

4.8 Recommendations:
Considering the above discussed strategies the following maybe summarized as the strategic recommendations
4.8.1 Short term recommendations:

– Maintain year round awareness for the need foster carers across England, Scotland, Wales and in communities.

– As discussed in the strategy using the current carers and their positive stories of children will help to attract more carers and it also helps to retain the existing carers.(refer 4.6.8)

-Work with the community leaders to spread the awareness(refer 4.6.7)

– With reference to the conversion rate issue raised in this report, it is essential for the agency to conduct a study on the effective procedures that are implemented by the agency in the process of responding to enquiries and registration of interest with prospective foster carers. Because, this is where lot of people drop out. So it is essential for the agency to conduct a research and find out the reasons as why the conversion rate is very low. (refer table 5)

– As discussed in the resources, it is essential for the agency to have dedicated marketing staff at each regional office to make advertising more effective.(refer 4.7.1)

– With the help of the demographic information and analysis of the community assessment by the agency a better targeting of recruitment and advertising can be achieved.

4.8.2 Long term recommendations:

– As discussed in the short term recommendations, statistical data on foster carers maybe collected using the community assessment in order to make better recruitment decisions. This will help the agency to have a continued sustainable investment at national and regional level in the recruitment of foster carers.

– Have ongoing high quality campaigns across England, Scotland and Wales on both national and local level to attract more foster carers which will help to maintain enough carers to meet changing demands

– The agency should put as much effort in order to retain the foster carers as in recruitment. The agency should work on the factors such as carer benefit package, and other benefits that can improve the retention of foster carers. (refer 4.6.9)

– Develop a comprehensive foster care recruitment website to promote awareness and interest in fostering and permanent care

-Focus should be to improve local capacity through working in close relation with the communities in order to recruit locally

I will discuss both the personal and professional values that influence social work practice and discuss a particularly challenging experience I had with two service users who came for counselling where myself and a qualified social worker was to assist the service user. The names of the service users have been changed to ensure confidentiality.

An important thing to recognise regarding values in social work practice, according to the Central Council for Education and Training in Social Work (CCETSW) is that “values are integral to rather than separate from competent practice. Therefore there can be no such thing as value free social work practice. Such is the influence of values in social work practice that CCETSW set out six core values, that the student must demonstrate competence in, before she/he can be awarded the Diploma in Social Work. The first of these values is: “to identify and question their own values and prejudices, and there implications for practice”.

It is not easy to recognise your own values, as often they are unconscious ideas or views, which can only be challenged or changed, when brought to the conscious level.

Personal, societal, political and cultural experiences influence the values that an individual develops, so it is important to become aware of these influences. The values people hold affect the way they act and treat other people, without an awareness of this people can unconsciously act in what may be perceived as an oppressive and discriminatory way.

Another of the core value requirements of CCETSW 1995, and one, which highlights one of the dilemmas faced by Social Workers, is: “Promote people’s rights to choice, privacy, confidentiality and protection, while recognising and addressing the complexities of competing rights and demands”. (CCETSW 1995). To illustrate this difficulty what follows is a description of a challenging practice I have experienced, during a counselling session I had with a women whom I shall call Jane. Jane came for counselling because she was in a violent relationship. She described how her husband both physically and mentally abused her, and that she had a history of abuse from controlling men. She had returned to London from Pakistan where she and her husband lived, after he had once again abused her whilst she was in the process of deciding whether to stay in Wales or return to her husband in Pakistan. Her husband has two children from a previous relationship, for which he has custody, although this was not a particular concern for Jane, for me there could be a conflict of competing rights. Jane had a right to privacy and confidentiality, but the children had a right to protection. Confidentiality in instances such as this “…may be breached, where it is demonstrably in the client’s interest or where there is an overriding concern for the rights of other people, when for example the behaviour of the client may endanger others”. (Social Care Association 1988).

Had my role in this been that of a Child and Family Social Worker the rights of the Children would have been paramount. As I worked with Jane I became aware of my own values which were urging me to protect her, and wanting to encourage her to remain in London . Only by reflecting on my practice did I become aware, I could have become another controlling male figure and missed the opportunity to enable her to take control for herself.

Jane made her decision to return to her husband in Pakistan, I did not hear from her again for one months, after which time she made another appointment to see me – this time with her husband who I shall call Bill.

When they came to see me and my colleague I was aware that I had seen Jane on her own previously and was careful to ensure the things she had talked about were kept confidential, and that I did not accidentally disclose these to Bill . Jane had told me her story from which I had developed my own picture of Bill, before even meeting him. Bill was a large man, very loud and appeared aggressive at first, I was a little concerned about the safety of Jane, myself and my colleague, in that first meeting. When writing my notes after the session, and analysing what went on, one of the questions I had of my practice was: What had Bill done to make me feel threatened? He did not verbally or physically attack me, or make any threats, after reflection, I felt it could have been because he was different. Bill was from a different culture of Pakistani Pataan descent, he was tall and a heavily build, and his way of communicating was to shout as that is how he got attention. If I were to work positively and constructively with Bill, I needed to act in an anti oppressive and anti discriminatory way, to ensure that he received the same respect that all clients have a right to, and that I treated him as a unique individual.

According to Egan (1990) respect means prizing the individuality of service users, supporting each service user in his or her search for self, and personalizing the helping process to the needs, capabilities, and resources of this client. Effective helpers do not try to make service users over in their own image and likeness. On the other hand, respect does not mean encouraging service users to develop or maintain a kind of individualism that is self destructive or destructive of others. Egan (1990 pp65)

Having recognised my own personal prejudices, I was able to identify more clearly the strengths Bill had and to build on them. This had quite an impact on future counselling sessions. Bill valued being listened to and respected, his voice level lowered and he stopped to listen to Jane which gave her the opportunity to tell him how she felt. As we progressed the counselling relationship became more of a partnership, we looked at the different ways they communicated, Bill began to ‘own’ the violence he had previously denied and Jane grew in confidence, and was able to express her own needs and expectations. We agreed to set tasks and goals each week that enabled them to check their progress, which further empowered them.

Empowerment is a term widely used, and often misunderstood as giving your power to someone else; there are several definitions but this one, I think, describes it well:

It is commonly assumed by many that empowerment involves taking away the worker’s power, However, if this is done, it will of course make him or her less effective and therefore of less value or use. Empowerment is a matter of helping people gain greater control over their lives, helping them to become better equipped to deal with the problems and challenges they face – especially those that involve seeking to counter or overcome discrimination and oppression. (Thompson, 1998b, p9)

To empower is to enable people to increase control of their lives, not to control others, Bill needed to recognise that by taking control of his life, he also needed to control his behaviour not to control others. Empowering is also helpful in letting clients see their problems in the wider socio-political context as in the case of Jane.

-for example, by helping a woman who has experienced violence at the hand of her partner to become aware of the broader social problem of domestic violence and it’s links with male power in society, so that she does not see her own situation as simply an unfortunate development or, worse still, something she has brought on herself (Mullender, 1996).

Through this experience Jane found the confidence to stand up to Bill, telling him she would only return to the marriage if things changed. Bill found a more constructive way of communicating, he became more open to looking at change, and I learnt a lot more about my own personal and professional values and their influence on practice.

There are a few theories that explain the development of our own attitudes and values. Thompson (1993) developed a “PCS model”. The P level is our thoughts, feelings, actions and attitudes although an individual can also be shaped by the culture we live in. The C level is showing the interests and influence of society as reflected in the values and norms we receive during socialisation. Finally the S level is basically the structure of society we live in. Even though we have individual thoughts and attitudes, the people we share our lives with shape them and they in turn are shaped by the norms and values passed to them by society.

As I have discussed, values have a major influence on Social work practice, the personal values we have affect the way we act from birth through to old age, and our values can change as we develop, both personally and professionally and they can conflict with each other. The core values set by CCETSW underpin the work and enables Social Workers to work in an anti oppressive and anti discriminatory way and these values have changed over time and I would suggest, will continue to change when necessary in the future. It is essential that Social Workers have and awareness and knowledge of these values as they have a significant affect on the vulnerable service users they work with.

Children and young people vary enormously in their responses to the same experiences and those who suffer adversity either develop coping strategies to get through it and emerge relatively unscathed whilst others do not, in other words they sink or swim. This essay puts forward bodies of research and theories of resilience that influence thinking in social work and look at the way in which those theories inform contemporary social work to promote resilience in children and young people. It will also examine some of the ways in which issues arise which could hinder these approaches.

Frost and Hoggett (2008) say the psychological and the social elements of the child’s world cannot be understood as two parallel paradigms that influence and impact development. Holloway and Jefferson elaborate cited in Frost and Hoggett (2008),

Subjects whose inner worlds cannot be understood without knowledge of their experiences in the world, and whose experiences of the world cannot be understood without knowledge of the way in which their inner worlds allow them to experience the outer world.

It is evident that it is through a child’s psycho-social experience that they learn to make sense of the world and their place within it. Rutter (1999) informs us that for a child to be determined resilient they must have encountered an experience with the risk of psychopathology for example those who have been living with domestic violence.

There is no one universally accepted definition of resilience however Masten et al (1990) define resilience in generalised terms, as the process of, capacity for, or outcome of successful adaptation despite challenging or threatening circumstances. However an International Resilience Project, set up to study how different cultures and countries promoted resilience, adopted the following definition of resilience:

Resilience is a universal capacity which allows a person, group or community to prevent, minimize or overcome the damaging effects of adversity (Grotberg 1997, p 19).

Masten and Coatsworth (1998) identified the characteristics of resilient children as ‘good intellectual functioning, appealing, sociable, easygoing disposition, self efficacy, self- confidence, high self-esteem, talent and faith; with a close relationship to a caring parent figure and extended family network support and socio-economically advantaged’. These definitions provide useful starting points for the purposes of this essay.

Contemporary society has been described by Beck(1992) as a ‘risk society’ and early research concentrated on how children and young people responded to risk and became casualties of adversity. Ferguson (1997) points out that following the work of Foucault and the concept of ‘governmentality’ post modernist critics argue that the traditional role of social work has suffered from family case workers seeking out and working with ‘dangerous families’ and children at ‘high risk’. A study of children at risk was undertaken by Garmezy and Rutter (1983). The study of 200 children from USA appears to conclude that despite the high risk environments in which they grew up some children appear to have ‘self righting’ tendencies which allow them to develop into well adjusted young adults. It would seem that everyone has the capacity to be resilient at some times and in some circumstances depending on their mental state and level and duration of the stress in the given event.

In order to recognise resilience it is important to understand the factors that lead children and young people to succumb to adversity and to realise that resilience and vulnerability are at opposite ends of a continuum reflecting susceptibility to adverse consequences (Anthony 1987). The response to adversity and stress can be affected by one or more variables from psychological and/or social aspects.

Freud (1910) developed a psychoanalytical theory in which the unconscious is seen as a central concept on which all other aspects of mental functioning are based. The focus of his research was mainly on the individual’s personality. Social workers have to be aware that unconscious processes may conceal or distort memories or even produce responses disproportionate to the situation, giving hints of underlying issues.

Erikson (1959) differs from Freud in that he described eight stages of psychosocial development. In these stages he suggests that we encounter expectable crises which create conflict within ourselves and with significant others in everyday life. Personality and behaviour are influenced by the way in which these crises are dealt with. The people who manage to move through Freud and Erikson’s stages of development are more likely to become resilient people.

John Bowlby(1969) was a psychologist, doctor and psychoanalyst ,who specialised in working with children. He believed that attachment behaviour is a biologically originated response to anxiety and stress stimulated by physical needs such as pain or hunger, separation from or rejection by the primary caregiver or external threats such as a loud noise. He believed this response arises from the infants desire to seek security and protection through proximity to a caregiver. Aldgate(2007) surmises that an attachment relationship is part of a wider affectional relationship: that one person sees the other as stronger and wiser and someone to turn to when he or she is afraid. Through combined nature and nurture individuals begin to establish relationships and understand and begin to manage emotions. By making sense of the caregivers both psychologically and socially, (if they respond in times of need) the infant begins to see them as a dependable and reliable. Such mental models help individuals organise their expectations about other people’s availability and responsiveness (Howe 1996). When the caregiver does not respond in the way the infant expects they experience anxiety and this can lead to insecure attachments. Bowlby’s work was later built on by Ainsworth et al (1978) who through the ‘Strange Situation’ study revealed profound effects of attachment on behaviour and went on to describe patterns of attachment (secure, avoidant, ambivalent, and disorganised added later on). Trevithick (2009) confirms that over the years the work of Bowlby and others has been important within social work making links between children’s behaviour and the quality of their relationships with their parent(s) and other attachment figures. Furthermore Howe (2009) confirms that attachment theory is also playing a major role in the resurgence of relationship based social work. It is therefore of great relevance to social workers to know how parenting styles,culture, family life and the social environments have affected the child’s psychosocial development.

The notion of a secure base is of vital importance for children and young people. In a useful analogy Gilligan (2001) uses a tree putting down roots to elaborate on the idea of a secure base. It is through continuity, quality and consistency of relationships that a child may find their secure base. Relatives, friendship groups, a teacher or even a social worker may provide a secure base in an otherwise complex and chaotic world. If the child is looked after (a child who enters the care system either informally or legally) they may need to learn to develop new relationships and have the opportunity to develop a secure base.

It is not always psychological processes that shape resilience, sometimes a particular episode or situation may occur that may be problematic and have far reaching consequences. Giddens (1991) described these episodes as fateful moments, saying that these are times when events come together in such a way that an individual stands, as it were, at a crossroads in his existence; or where a person learns of information with fateful consequences. A fateful moment will have implications for the individual which may threaten their ontological security. Fateful moments however do not always result in adversity they can signal a change for the better, a potentially empowering experience, however it is the risk that things may go awry that poses the challenge. Within this context it is important that social workers assess the extent to which they make sense of society and people’s experience.

Similar to fateful moments, life events, ongoing adversities, personal stress, interpersonal problems or familial situations, can affect levels of stress or anxiety. Rutter (2000) used the example of a divorce in the family as a staged process of a life event, rather than a one off event. The divorce may be preceded by a long period of unhappiness, followed by the divorce itself and the uncertainties that accompany it such as the knowledge and burden of financial worries, possible loss of a parent, introduction of new family members, housing worries etc. Social workers working with Giddensian ideas, (that multiple choices are available to all through abstract systems) are able to help vulnerable children and young people who are on a developmental pathway to make positive choices about the direction their lives will take in their life planning. However, those who criticise Giddens say that he is too optimistic in his view of the positive capacity of individuals to understand their lives and always know why they act as they do (Ferguson 2009). There are families who work with social workers who may not have the ability to analyse their lives in this way, and social workers should be mindful of this in their work with people.

The negative impacts of poverty, lack of social and cultural capital and impact of marital discord can cause children, young people and families to be characterised as at risk according to Hoffman (2010). Poverty can have serious and possibly grave consequences for families. Nonetheless, it is important to recognise that not all poor families, or even most poor families experience these deleterious outcomes. Many impoverished families beat the odds and have stable, loving relationships ( Seccombe, 2002)

Skeggs (2001) in her study with young women revealed that they were continually making comparisons between themselves and others and were sure of what they did not want to be but were less sure of what they wanted to be, thus illustrating how the constraints of class and gender are some of the structures that inhibit who we can be and how we can behave. However this does not appear to mean that structures should be accepted per se but by accepting their existence and realising that they are given meaning through human action and interaction it is possible to work with service users and their families. Frost (2003) illustrates the harsh reality for young people stating that the

‘structural inequalities of class and poverty connect into the emotionally quite brutal lived realities of young people themselves- the power of the pecking order, popularity or unpopularity, and in-group membership or exclusion- via the conspicuous display of expensive consumer goods’.

For some young people, the friendship groups they form, sub-cultures they belong to, the styles they wear dictates the way in which they present themselves and gain a sense of who they are in society. Being part of the group increases self esteem and resilience, conversely being different in some way may attract adverse reaction and stigmatisation for example a disabled child may be affected by the negative perceptions of being different.

According to Howe (2009) social workers in the late 1980s began to feel that the service users with whom they were working were the victims of their own biographical narratives, or their place within the social structure. Service users became service users because they had problems, pathologies or weaknesses and that this defined them in some way. The social worker viewed them as a case which then depersonalised them. By introducing a method of assessment whereby they could look at the strengths of people rather than their pathology and problems it was possible for social workers to recognise the resilience and resourcefulness possessed by many people living in adversity. By being interested in and listening to the service user the social worker could begin to uncover where someone’s strengths lie. Saleebey (2002) identified some types of questions that can lead to the discovery of strengths; survival questions, exception questions, possibility questions and esteem questions. It may be difficult to tease out strengths however as many people have had years of self doubt or blame from others to carry around with them however it is on these positive elements however slim the potential for progress lies.

It is crucial to the safety of children and young people that social workers can identify risks in a child’s environment and remove or reduce such a risk. This may ultimately mean removing the risk from the child or removing the child from the risk which could, depending on the level of risk, involve the child becoming a looked after child. In this case the social worker can work with the child to prevent social isolation by maintaining or re-introducing contact with family members, if appropriate. The social worker should also ensure that a child is able to attach the correct meaning to an outcome, if for example, a looked after child has to move to a new placement the social worker must explain in clear language what has happened and why. Schofield and Beck (2005) studied risk and resilience in children in long term foster care and concluded that specific changes or single events in a child’s life such as a new attachment relationship, a change of school, a change of contact arrangements or the discovery of a child’s particular talent do have the potential to alter the direction significantly for better or worse.

Howe et al (1999) state that good quality care giving is the most potent form of self enhancement of children confirming that it is a positive building block on which resilience to build resilience. Therefore the social worker needs to ensure that a child’s caregivers are able to provide a secure attachment through their relationships to ensure that self esteem is promoted. Any relationship break-down will impact on the child’s self esteem thus reinforcing their belief that they are not loved or lovable. A child needs to experience relationships with their caregivers that promote secure attachments. If a child has had a difficult time they may display behaviour or emotions that are not what is expected or are disproportionate to the situation. Atwool (2006) confirms that attachment theory adds weight to resilience theory by clearly outlining the significance of relationships as the key to all aspects of resilience- culture, community, relationships and individual. A social worker can work with the caregivers to explain the child’s behaviour using a theoretical framework and their knowledge of the child and their social situation.

Contemporary social work can help promote resilience in the vulnerable in society however Ferguson (2009) states the discretion social workers once had has diminished because of the rise of bureaucracy, managerialism and targets. This may impact on the time a social worker is able to devote to those they are trying to help. Furthermore Gilligan (2004) queried whether there is to be stress on valued practice principles, for example focus on strengths in clients or is the emphasis to be on what agency management deem important, for example their latest policy or set of procedures. It is also clear that social workers spend a majority of their time at their desk rather than with service users, as Ince (2010) points out in recent child abuse cases the social workers became victims to the point where they have much more familiarity with the computers they use than the children in need they have responsibility for; however this is an opinion and does not appear to be backed up by research..

In conclusion it is clear that relationships and attachment theory is significant to our understanding of resilience. Social workers who work with families to make sure they take full account of their religion, racial, cultural and linguistic background in their work with them are demonstrating the link between social policy and socially inclusive practice. Psychosocial practices should be carefully though out and tailored to the needs of each service users unique circumstances. Access to social and cultural capital enables children and young people to cope with stressors and adversity and increase resilience. Theories of resilience are useful tools to call upon when dealing with the complex and chaotic lives of children, young people and their families/caregivers. However there is no one skill or theory to fit all but many approaches and skills are required to inform and manage effective contemporary social work practice.

2688 words