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The concept of civil society remains elusive, complex and contested. There are different meanings and interpretations and, over time, different schools of thought have influenced theoretical debates and empirical research. Civil society is conceived to be an arena of un-coerced collective action around shared interests, purposes and values. As a public sphere where citizens and voluntary organizations freely engage, it is distinct from the state, family and the market. From the above conceptions of civil society, they can therefore be considered as the wide array of non-governmental and non-profit organizations that have a presence in public life, expressing the interests and values of their members or others, based on ethical, cultural, political, science, religious or philanthropic considerations (World Bank 2006, Kaldor 2003, Carothers 2000).

The concept has its origin from the Greek philosophy though some scholars consent that its origin dates back in the seventeenth and eighteenth centuries (Kaldor 2003, John et al., 1999) Civil society also has been centrally linked to the contemporary status of democracy and change in the world. It has been presented as the beacon of freedom, the fountain for the protection of civil rights and of resistance against state repression, the mobilizing platform of society for the protection and projection of substantive interests, the compelling force for state moderation and the epitome of popular struggles and civil power has been a central force in political and economic reforms. The activities and even proliferation of civil groups have been seen by several scholars as vital to the democratization process and its sustenance.

Donor discourse on international development policy now places much emphasis on civil society than in the past. Therefore it would be worthy to note that in practical sense, the boundaries between state, civil society and even market can hardly be defined or drawn (Kane, 2001, Camarrof, 1999, John et al., 1999, Salamon and Anheier 1996). Hyden (1995) further clarifies on the concept by emphasizing that there are variables that determine civil society, these include: basis of social action, nature of state action, nature of political legacy and nature of inter-cultural relations. But above all these, from myriad studies conducted, it is clear that the middle class has on large extent paved the way for civil society especially in fostering democracy.

1.1 Objective

The purpose of this research is to understand reality of civil society in Uganda in relation to the theoretical concept of civil society and to go deep to understand the bilateral functions of civil society in Uganda. This study may be of great use to the policy makers, civil society actors, legislators and researchers who might be more enlightened about civil society in Uganda. In doing so the study will be contributing to the board of knowledge about civil society in Uganda.

1.2 Disposition

This thesis will be organized as follows; the subsequent chapter (two) will present methodology used in this study. Chapter three will present conceptual framework. This will include definitions and the concept of civil society that I consider to be crucial for this study. Chapter four will be about civil society reality in Uganda. Chapter five will be about data presentation and analysis.

1.3 Problem Statement

The past two decades have witnessed a proliferation of civil society organisations and they have made big strides towards improving the interplay between political and economic systems and thus have ensured democratic, participatory and decision making in society (World Bank 2006). NORAD (2003), UN-RISD (2005) present state, private sector and civil society as three separate arenas of development that operate independently from each other. Civil society has been well acknowledged as an important third sector whose strengths have positively influenced state and market and it is an important agent for promoting transparency, responsibility, accountability and openness. Civil society model recognizes functions that are believed to be universally applied in all societies and according to Edwards 2004, World Bank 2003, SIDA 2005, the core functions of civil society include: to protect the citizens’ lives, property and freedoms; monitoring activities of state, central powers and state apparatus; advocacy through articulation of interests of the citizens; socialization through practicing values and attitudes of democracy; intermediation and facilitation between state and citizens; building communities through voluntary interactions that build a bond between members of the society and service delivery in social service sector.

Despite its increased importance and value, civil society in developing world has lingered behind and somewhat not understood. In Uganda, the basic descriptive information about civil society, its size, area of activity, sources of revenue and the policy framework in which it operates seem not to be available in an organized way. There seems to be domination of state and market while civil society structures are superficial and are shadows of the ideal model of civil society (Salamon, Sokolowski and Associates, 2003). Moreover, civil society tend to play a supportive role rather than confrontational or conscious raising roles. A report by NORAD (2002) indicates that the involvement of civil society in policy processes is cosmetic with limited impacts in Ugandan society.

Therefore the actual situation about civil society in Uganda seems not to be according to ideal model of civil society in western societies. The point of departure in this study is to investigate and compare civil society reality in Uganda to the ideal concept of civil society in developed, modern and democratic societies while also trying to understand why the bilateral function of civil society in Uganda seem not to work properly. The purpose of the study therefore, is to investigate, understand and eliminate this discrepancy and comprehend the bilateral functioning of the civil society in Uganda with subsequent benefits derived from it.

1.4 StudyObjectives

The general aim of the study is to investigate the reality of civil society in Uganda in relation to the general concept of civil society. There are a number of specific objectives, these include:

To identify major areas of operation by civil society in Uganda.
To identify the major actors of civil society in Uganda.
To identify functions of civil society
To find out factors that influence State-CSOs relationship in area of advocacy.
To determine whether the Western models of CSOs are applicable in Uganda.

Research questions

How applicable is the western model of civil society in Uganda’s context?
How is the relationship between state and CSOs in Uganda?
In what areas of operation are CSOs active in Uganda?
Who are the major actors of civil society in Uganda?
What are the factors that influence the relationship between state and civil society in policy advocacy in Uganda?
What are the functions of civil society in Uganda
1.5 Research Frontier

The thesis aims at filling an apparent gap that exists since most studies have primarily focused on other areas of civil society like the relationship with political parties, civil society in conflict resolution and in poverty alleviation but little has been written on the civil society reality in Uganda with reference to the model concept of civil society.

1.6 Significance of the study

The study will contribute to the board of knowledge. It will be used as a literature for the future studies related to civil society and state in Uganda.

The study findings can also be used to harmonize the relationship between state and civil society so that they can work for the benefit of citizens in the country.

1.7 Structure

This thesis will consist of 6 chapters. Chapter 1 will be about Introduction of the study. Chapter 2 will include conceptual framework while Chapter 3 will be about Literature review. Chapter 4 will consist of Methodology and chapter 5 will be on Data analysis and results. The last Chapter 6 will consist of Conclusions and Recommendations.

CHAPTER TWO
2.0 Methodology of the Study

This chapter is about the methods that have been used in this study and explains the approaches that will be used in order to understand civil society reality in Uganda in relation to the model of the concept in the western democratic societies.

2.1 Methods

This is a qualitative study primarily based on desk research of available documentations about civil society as well as few interviews from the civil society actors in Uganda. The method used for this study has some advantages and disadvantages.

Advantages include: it saves time that would otherwise have been spent on collecting data. It provided a broad data base more than what one can collect. Secondary data also provided the basis for comparisons of the information about civil society in Uganda with the model concept of civil society in the western societies. Lastly, the author did not worry about the informed consent and human subject restrictions and the method is relatively cheap.

Much as the benefits of secondary sources are considerable, their disadvantages are also identified. There was likelihood of having outdated data. The author had no control over how the data was collected. There may be biases in the data that was already collected by researchers.

In order to ensure reliability and validity of the study, many comparisons between the data were made. This involved checking other sources such as other references and information from highly regarded sites on the internet for instance from World Bank, donor agencies, universities among others. The information used was in line with what was collected from other sources. The information is also reliable in a way that it was collected from government documents and other sites mentioned above. The information was valid since the findings relate to the issues and aim of the study.

2.2 Type of study-Case study

A case of Uganda will be used. Goerge and Bennet 2005:18 define case study “as well-defined aspect of a historical episode that an investigator selects for analysis, rather than a historical event itself”. Case study is one of the several methods used in conducting studies in the area of social science, psychology, political science and it has the following advantages:

It will be used in this study because of its high possibility or ability to achieve high conceptual validity. In other words, the researcher is able to compare, measure and identify which indicators best correspond to the concept. It has also been chosen because it helps to understand a variety of intervening variables and makes it possible to single out conditions in a case that trigger out causal mechanisms. However, case study method has a weakness of selection bias. In other words, there is a possibility of overstating or understating the relationship between independent and dependent variables (ibid)

2.3 Data collection

The nature of the study requires drawing lessons from multiple sources. Therefore, in undertaking this, it is proposed that a wide range of data collection methods should be used, both primary and secondary sources of data. The methods will capture qualitative data. The method will provide flexibility in data collection through triangulation of different research methods. This approach will also assist in cross checking information.

2.4 Primary Sources of Data

Different stakeholders will be targeted since they are able to provide valuable insights on various issues of the interest of the study. Among the specific methods that will be used to collect primary data will include:

Semi-Structured Interviews

Semi-structured interviews will be used with key informants in Uganda such as Civil Society actors. Interviews in this regards will be very helpful as they will deal with more detailed perceptions and experiences. The researcher intends to have deep and rich interaction with key informants in order to understand various issues pertaining to the various opportunities and challenges that Civil Society Organizations face. In all cases, confidentiality of sources of information will be ensured to allow for discussion of more sensitive issues.

2.5 Secondary Sources of Data

Relevant literature pertaining to issues under investigation will be collected from the various sources including government documents about CSO and official reports from various sources, including published books, journals, and other relevant materials will be consulted. Internet resources shall also be used to access relevant information as well.

Combining various methods of collecting data will enrich the whole study as each method of collecting data will capture a specific angle of the issue in consideration. Furthermore, different methods tend to have weaknesses when used in isolation, so combining various approaches will enhance chances of getting more reliable information upon which inferences will be drawn.

2.6 Sampling procedure

A non probability sampling strategy will be used, that is, Purposive sampling. This type of sampling will be used because it is helpful in targeting and getting views from those people who are perceived to be well vested with issues of civil society and policy advocacy in particular.

2.7 Data Analysis

Qualitative data from semi-structured interviews will be analyzed using qualitative techniques such as thematic analysis. This will be used because it is highly inductive and will help in understanding more about civil society in Uganda. Another advantage is that the researcher does not impose themes but rather themes are generated from the data.

2.8 Secondary and content analysis

Secondary analyses in this case regard to the studies that are taken from historical data as well as informational materials that exist beforehand but analyzed by other researchers which can be used as sources for new research or study under investigation (Goerge and Bennet, 2005). This will be used in this study on civil society in Uganda in relation to the model of concept of civil society in developed world.

2.9 Content analysis

This is another approach if used properly enables research problems to be identified both qualitatively and quantitatively. Three basic requirements used in this method include. First, the author should be objective, in other words he/she should not follow their instincts or the way they see materials but should follow an objective approach of representing the materials. In this study this will be followed and done. Second, is the exclusion and inclusion of the content. This implies that the author in some cases has to include or exclude some contents much as it can be useful or useless for the study (Mikkelsen, 2005). This has also been applied in this study in order to ensure coherence.

2.10 Materials used

Materials used in this study were obtained from already published books, articles and journals. Additional materials were obtained through the internet via various data bases that include: ELIN, LIBRIS, Google scholar. Official government websites were also used as well as other reputable sources like official website of the United Nations, World Bank, academic institutions and think tank organisations were also used.

Other relevant information about civil society in Uganda was obtained from the news paper publications of The New Vision, The Daily Monitor and The Weekly Observer and bulletins from civil society organisations in Uganda.

2.10.1 Evaluation of the sources

When dealing with sources which normally present different views from different authors, it is important to remain unbiased while using them as the source of information for the study but students normally find it very difficult to deal with. In order to evaluate the sources this study will base on the set of methodological rules of simultaneity, genuineness, independence and tendency.

2.11 Previous Studies on Civil Society

Several studies have been conducted and many authors have written a lot about civil society. Kaldor Mary (2003) a school professor on Global civil society at London School of Economics in her article “Civil Society and Accountability” highlights the issue of trusting civil society groups in regard to giving the voice to the marginalized. She further sheds more light about moral accountability and procedural accountability referring civil society groups being accountable to the people they serve and accountability as internal management respectively. She finally elaborates on difference between Non-Governmental Organisations and civil society by indicating that the former is a subset of the latter.

John Keane, a re-known scholar and a Professor of Politics at the Center for Study of Democracy, university of Westminister. He has published many books and articles on civil society, democracy and politics. He has collected myriad samples about what writers have produced on the subject of civil society especially writers in Europe. In one of his books “Civil Society and the State, New European perspective”. He clarifies on distinction between state and non-state realm of civil society. He further coins out why the distinction which was important in the first half of nineteen century but later lost trace (Keane, 1988).

Hyden Goran a professor of political science at the University of Florida. He has published a lot on governance, politics and civil society. In one of his books “Assisting the growth of civil society. How might it be improved?” he analyses various literatures on civil society and supports the idea that civil society is an important tool that has been directed at promoting democracy in societies which are under dictatorial regimes. He further points out that in many cases external support is meant to complement the efforts of transition from despotic rule, but rather, the strengths of civil society depend on the domestic social forces of a certain country (Hyden, 1995).

A study conducted by World Bank, (2006) elaborates that increase in conflicts in 1990s contributed to a focus on civil society as key actors in peace building initiatives and hugely contributed to massive increase of civil society sector. The study also points out that the presence of civil society does not simply result to peace building, but rather, proper understanding and analysis of civil society functions, validity, scope and content are paramount to peace building initiatives.

CHAPTER THREE
Conceptual Framework of Civil Society
3.1 Defining Civil Society

Different scholars define civil society differently. Some scholars define it broadly while others define it in specific or narrow terms. For instance Carothers (2000), Kaldor (2003) define it in specific terms as “a domain parallel to but separate from the state realm where citizens associate according to their own interests and wishes” (Carothers, 2000:1) and Kaldor, (2003) defines it as an associational sphere between state and family aggregated by organisations which are detached from the state and they are formed by society members voluntarily to guard and preserve their values and interests. From the above definitions, there is a common thread in which all authors depict civil society as autonomous from state and market. Further, there seems to be a consensus among the definitions on the term civil society signifying that it is an arena or sphere made up of different or a collection of groups amalgamated together with the a common shared purpose, values or interests. Is this amalgamation of different groups harmonious? It seemly unlikely to have a harmonious relationship between these groups because they have different interests, values and their social fabric is totally different. Therefore to belong to one sphere or dome and have same reasoning, tolerance among each other and advance one goal as civil society sector might remain a myth not a reality.

However, some scholars define civil society broadly to mean that it goes beyond being an arena between state and family. For instance Centre for Civil Society goes further to mean that civil society does not only mean a sphere outside state and market but even its boundaries in between them can never be drawn and therefore very ambiguous and Shauder et al., (2003) portray it as an all-inclusive term often used to mean social structures and interests further than household and outside the state institutions, including voluntary associations and non-profit organizations where people mingle for their collective interests. It would be argued that by making civil society all-inclusive like what Shauder et al argues above, renders it more ambiguous because like it was earlier argued, merging different groups of different backgrounds clearly makes civil society mysterious concept.

There is another category of scholars who define civil society in a broad way for instance Cohen and Arato (1992), Michael and Edwards (1996:1) look at civil society as not only a sphere of charitable links and informal networks in which groups and individuals come together to participate in activities of public importance but also is a realm of private voluntary association, from neighbourhood committees to interest groups and philanthropic enterprises of all sorts.

According to the definitions above, civil society is consented as a set of voluntary and not-for-profits associations sharing same interests. This is not far from what has been defined by afore mentioned authors but the difference here is that Shauder et al broaden the definition to imply that civil society goes beyond household and state while Cohen and Arato include an aspect of “charitable links” and “informal networks” to the definition, to some scholars it is a mixture of formal and informal and perhaps that why its boundaries are unclear. These links and networks as commonly known are horizontal linkages/networks and vertical linkages, that is, a connection of groups in a same category and connection of groups in different categories respectively. These different points of view clearly depict the term civil society to be an imperceptible concept which many social scientist have come up to conclude that it has no universal definition and therefore difficult explain due to its vagueness.

It becomes different from what Parnini (2006:4) defines it as the “totality of groups and individuals in a country who show a regular concern for the social and political affairs in that country without fulfilling the function of political parties”. Closely related, in his writing, Hyden, (1995:3) defines civil society as “the political realm, specifically the means and processes through which citizens shape the character of political life in their country”.

All the definitions above portray civil society as a sphere made up of myriad individual groups and associations, but other scholars like Hyden bring in an aspect to show that civil society is a ‘political realm’ which becomes quite different from what other scholars or authors who believe that civil society is rather public or social realm. This sparks further debates; hence the term has become a centre of both political and academic discourses all over the world. It becomes an elusive term because what Parnini explains above signify that civil society cares more about what government should do to suit the interests of citizens but does not play the role of political parties, yet to some scholars, political parties are part of civil society and if anything there are some civil society actors which play the same roles as political parties; a case in point is the role of mobilizing citizenry. This role is played by actors like church, community based organisations or even non-governmental organisations.

The working definition for this study is thatcivil society is an amalgamation of both human and associational activities that operate in a non-restrictive, open to everyone sphere without involvement of the state and market. It is a dome where people express their interests and ambitions but with pull factors based on common goal, values and customs.

3.2 The Evolution of Civil Society concept

The contemporary term ‘civil society’ has its origins in the early modern period in the seventeenth and eighteenth centuries, however, Kaldor (2003), points out that the term has its origin from Greek political philosophy. This is not far from what John and Comaroff (1999) noted that the term became prominent in the late eighteenth and early nineteenth centuries in the period of modern European state formation, when it was used and explained by Ferguson, Kant, Hegel, Marx and Tocqueville. It is further argued that apart from being used by Gramsci, however, it did not thereafter dominate western political theory until recently (ibid). Kaldor (2003) further indicates that it has been narrowed in 20th century into forms of social contacts that are separate from both the state and market.

There is a commonality in which different authors above perceive the genesis of civil society. This implies that the concept itself was in existence though dormant before seventeen and eighteen centuries but civil society activism became prominent at a point in Europe when most societies sought to have a modern state. Thus modern state formation phenomenon in Europe was envisaged to have a civil society which would play an important supportive role in fostering democracy as part of the means of transforming societies from authoritarian rule. What should be known at this point is that civil society was brought in as one of the ingredients for democracy just as Hyden (1995) clarifies that civil society was a vital step towards the direction or realization of modern and democratic society.

The most recent usage the concept of civil society has been distinguished into three versions: the ‘activist’ version which emerged in 1970s and 1980s especially in Latin America and Eastern Europe which referred to the idea of a area outside political parties where individuals and groups aimed to democratize the state, to restructure power, rather than to capture authority in a traditional sense (Kaldor 2003). It is imperative to note that different versions were perceived differently by different scholars. In the first version (activist), the situation in Latin America and Eastern Europe compelled the need for civil society because there were military dictatorial regimes and totalitarian communist rule respectively. It seems the term was dubbed ‘activist’ because it was quiet hard for the common people to change governments in these regions, so what people did was to devise means of removing the government through formation of active groups independent of state which would change the relationship between state and societies (ibid)

The ‘neo-liberal’ version which Salamon and Anheier (1996) argue, is connected with views of ‘third sector’ or ‘non-profit’ sector that was developed in the United States where there are groups or associations that were not controlled by the state or even the market, but were important with potential of facilitating the operation of both. It is argued that this version was taken up by Western donors in the early 1990s because CSOs were needed to mitigate against the shocks associated with Structural Adjustment Programmes, to provide social safety net and foster good governance. It should be remembered that when SAPs were introduced by Bretton Woods institutions, governments were forced to cut on spending on public services, in so doing, civil society was to come in and bridge that gap as well as help in fostering good governance.

In comparison with the first or ‘activist’ version, it is observed that in the neo-liberal version came with the element of minimizing the role of state by checking the abuses and practices of the state just like what Kaldor had earlier alone argued, this version is linked with the ideas of social capital and trust of Robert Putman and Francis Fukuyama respectively. This differs from the first version of ‘activist’ in Latin America which mainly hinges on conscientization of the poor and breaking the culture of silence the ideas of Gramsci and the inspiration of liberation theory. The overall difference between these two versions seems to be that neo-liberal version has an element of endorsing the western way of governance just as Salamon and Anheier had earlier indicated that it was developed in United States; while the activist version aims at emancipation and enhancement of human rights and justice but both have a commonality of being western-driven.

The above versions are in contrast with the third version of civil society ‘the post modern’ which asserts that the ‘activist’ and ‘neo-liberal’ versions are a Western discourse. Post-modern version criticizes activist and neo-liberal versions because there is exclusion of civil society actors like religious groupings and organisations which are based on kinship, they are sidelined and considered as traditional, that is why John and Comarrof (1999) clarify on this by arguing that there should not be ‘good westernized civil society and bad traditional un-civil society. Therefore, here, we should ask ourselves, is there bad and good civil society? The answer is no and yes, but in order to be rational, the definition should include all the categories mentioned in the activist version (social movements), neo-liberal version (third sector) and post-modern version (traditional and religious groups).

The western concept of civil society has largely strayed from its original meaning and role where NGOs are considered as the same as civil society. The terms ‘civil society’, ‘NGOs’ and the ‘non-profit sector’ have been regarded as the same by western donors since the early 1990s (Parnini, 2006:4). However, it can be argued that a full understanding of civil society has more than what NGOs does because civil society is a public sphere where non-state actors are mingled together. It has to include social movements that promote emancipation of poor and excluded, it has to include social organisations that protect and promote the interests of members, and it has to include nationalist and religious groups that foster empowerment of national and religious groups respectively. Therefore, it is rather a combination of all these actors that a coherent and robust collection can act together in order to bring transformation in society.

Nevertheless, Kane (2001) observes, civil society can be fostered through taking part in participatory activities ‘through grassroots organisations, through se

CASE WORK ASSIGNMENT:

CASE STUDY

INTRODUCTION:

“Social casework is a method of helping people individually through a one-to-one relationship. It is used by professionally-trained social workers in social work agencies or organizations to help people with their problems of social functioning. Problems of social functioning refer to situations concerned with social roles and their performance. (Mathew 1991)”.

INTRODUCTION OF AGENCY:

Vinimay trust is situated in Koperkharaine, navi-mumbai (Maharastra State). Established in 1981 and registered in 1989. It is a social work organization [NGO] working for under-privileged children and youth staying in, and emerging out of, child welfare institutions. It is an organisation which run and managed by volunteers. Today it has more than 250 volunteers. It is working for children and youth welfare. It has a 3 storey building in Koperkharaine name Tarun Sadan, where the boys stays It is primarily working for child welfare and youth welfare.in child welfare it arranged the many activity, like birthday celebration, organising games games and picnic and various event in different child welfare homes that comes under the child welfare department in Mumbai, beside this it does youth welfare activity as rehabilitation of the boys through a facility of lodging, saving and various programme, which helps them to fit themselves in the larger society. The boys here come from various child welfare institution with various background they need various support through the government, through the society and Vinimay trust is just an experiment of that. It is fair to say that the flaws in the child welfare institution, leads to the creation of these type of institution. There are not so many after care institution in Mumbai and in these type of scenario, Vinimay trust took a step forward toward a just society. There are capacity for 52 boys in the Vinimay Trust who stay there for three years from the date of admission and this process is going on since its establishment Though these boys have no identity and address proof or other documents which are very critical for living today and in the lack of these basic documents, they have to face several hurdle in the life So the boys who come here must have to open their bank account, Aadhar card, pan card, voter card within six month from the date of admission here. Though Vinimay trust do these work and for that the local government body play a pivotal role in the process.

CASE STUDY:

I have selected the case of Gajanand for the assignment. Though he was new to Tarun Sadan. Usually boys there played cricket, watching TV in group. Prima facia he was also in the group but never talk much to anyone. Within three month he ran away four times four times from the Tarun Sadan. Though his background, that were written in the file of Tarun Sadan and that information itself come from previous institution says that he has experience of running away from home and from some institution. He is employed but he didn’t go to job regularly and he left the job thrice.

GENERAL INFORMATION:

NAME- Gajanand ( name has been changed for the purpose of confidentiality )
SEX- Male
AGE- 18
EDUCATION QUALIFICATION- 6th
RELIGION- Hindu
Name of the child welfare institution– David Sussane Industrial School
Family information- no family information
Date of admission in Tarun Sadan- 5/04/2013
Mother’s name- no information
Father’s name- no information
Skill– 6 month fitter course from Maharastra State Board of Vocational Examination in June with First class.
Harmful habit- Tobacco

Job detail

Current employment- Tayyar Ho. K, Juinagar
Position- housekeeper
Monthly salary-8500
Earlier Employment Detail- Anand Hotel, Koperkharaine

Life history

He was living with his family but he didn’t know about them. He ran from his home with his friend but he missed his friend somewhere in the train. His native place is Islapur, Nanaded. He think his family is living in his native place. He went to Pune once to meet his uncle but he took him at Sarva Seva Sangh 0rg. He also ran away from this organization.

WORKING WITH INDIVIDUAL- STAGE INVOLVED:

There are seven stage are involved while doing casework with individual. These stage are as follows:-

Engagement
Assessment
Planning
Implementation
Evaluation
Termination and
Follow-up

TOOLS AND TECHNIQUES:

Listening
Observation
Interview
Home visits
Relationship

TECHNIQUES:

Acceptance
Assurance
Facilitating Expression of feelings
Encouragement and Reassurance
Being with the client
Emotional support

In my field work there are very large scope of doing the casework study because its work for institutionalised people.

First stage is Engagement in which there is a systematic study of client, his/her situation related to his or her problem. In this process, I collect information like what is the problem with the client and what can be the associated problem can be arise with the problem. Though the first step is the most difficult step for any individual. How to interact, how to build rapport with them, how to make him free to speak up. When I first met with my client, it was confusing moment for me. As I tried to talk to him, when I says hey bhai, idhar aao, he looked at me and ran away from there and all the boys who were playing cricket there, laugh at me. After that whenever I tried to talk with him, he didn’t respond me appropriately as if he was fearing from me. He never looked at me properly but when I went to nearby park with some other boys of Tarun Sadan, I took him also and that trip was the ice-breaking between us. During the process of engagement I used several tools and technique on various occasion. The basic tenant for any social worker is acceptance and listen to them, what they are saying. In this stage I used listening, interview and observation by using almost all the technique. Earlier the client was not talking to me but through these techniques, it create an environment there where he feel comfortable and then my interview take place. Though it was not a onetime interview, it was an ongoing process. There I observe some behaviour in the client and that is

Being introvert
Shy
Not speaking to most of the boys
Not doing the job properly
Some little Memory of his family
Strong determination to go to his family
Individually tried to trace his family
Bad memory of child welfare institution
Not good perception on women
But he was very humble when he became familiar with me
He didn’t complain too much about anybody
No girlfriend and not focused on that
Says he will marry as their parents wish

In second stage, it includes assessment, which aimed at finding answers to three major questions: what is the problem? How it has arisen? What can be done to solve it? The need of social assessment is that of making a conceptual picture of the problem, which will help in deciding the action plan. It is the need to understand the structure of the personality and factors influencing and obstructing personality development. In this stage I figured out various incidents impacted his believe system and a strong attachment to his memory of his family. He ran away from his home, from Pune and from Tarun Sadan. The factor leading to leave his home was just a flow with his friend but after that he realised that what he is missing and that familiar care and support, that attachment to his family. Though the time he left his home he was 8 years of the age and he has little memory of his home. Only he know is his village and some memory of the station where he catches the train from his home. But one thing is clear is that due to his inner urge to go to his family leads to various other situation where he is not loving his job, running away from Tarun Sadan and being shy is a product of that. Though he stays with three room mate who has family in his village and other has sister, so this repeated expression of the attachment to the family of his roommates also forced him to think about his family.

Through during almost every process I used all the techniques that written above and regarding tools except home visit I used all. So the major problem I found in his situation is that

Familiar memory
Psychological support
Lack of confidence
Not believing on others
Fear of unknown
Hesitating to talk with other

Third stage is planning in which worker should make the plan for proceeding the case that how they proceed and how they start. So, my planning was

Counselling support
Tracing his family
Create an environment where he feels comfortable and doesn’t hesitate to talking with others
More engage in jobs and recreation activity
Try to search a better livelihood option for him

Though in my case assessment, planning and implementation overlap many a times. In some cases what I understood about my clients some aspect of his behaviour earlier was changed after some incidence. I am just giving an example of him is that when I first though that it’s his laziness that why he is not wanting to go to job but with rigorous engagement and analysis of the situation it came that it was his obsession for his family that captured his mind so much that he doesn’t think beyond it. So earlier what I planned changed as I came up through new aspects.

Fourth stage is Implementation or intervention in which there are the helping activities for the client known as intervention. This step has to blend with the plan of action following social assessment. There are many ways through client can be helped like assistance in terms of emotional and concrete support, material things like money, articles, medicines etc. non-material resources like information and knowledge, by bringing change in human and physical environment and through counselling to facilitate change in the feeling, thinking, knowing, speaking and doing behaviour of the client. In this stage I implements all the plan that I took, as tracing the family, counselling supports, better livelihood options etc. though in the Tarun Sadan there is facility of Counselling by a NGOs Disha Kendra. But he didn’t go to that session regularly and also he speak not too much there. In nutshell according to him “ye sab chutiappahai”. I took several session with group and individual on self-assessment and motivation. Whenever I interacted with him I tried to give some input of thinking in him and make him aware of many reality.

I tried to trace his family, I discussed with my field work superintendent on this issue, how to trace his home though he has experience of tracing many boy’s family there. Still I didn’t able to trace his family, though several fact which are needed to correlate and understand the real fact is really a hard and time consuming job. Once again I blame the time but I know blame is not outside its inside me. Regarding the livelihood option I went through several processes of finding the jobs and contacting many agencies that provide job. Still I am in the process of implementation.

Fifth stage is Evaluation in which we look at the result that we can achieve our goal or not? Till this stage I couldn’t reach. The implementation part was so long and the time that I spend on the case work was not too much for me to finish this case work. Though I used to evaluate myself on the fact that either I achieved the task that I took. Though in my case I evaluate my own approach and where I am going every day whenever I interacted with my clients. Though final evaluation didn’t taken place.

DILEMMAS:

As a social work student who has to discuss things about my client to supervisor had dilemma regarding the how can I ensure the confidentiality.

RESISTENCE:

There were lots of resistance which was actually improved through communication, rapport-building & home-visits.

Transference and counter transference was not observed.

According to the World Health Organisation, most developed world countries have accepted the age of 65 years as a definition of “elderly” or older person. (WHO: 2012) However, in the UK, the Friendly Societies Act 1972 S7(1)(e) defines old age as, “any age after fifty”, where pension schemes mostly, are used, it is usually, age 60 or 65 years for eligibility. (Scottish Government: 1972) The term ageism, is defined as process of discrimination and stereotyping against people because of their age. Around a quarter of older adults in the UK, report having experienced age discrimination. (Age Scotland: 2012) It affects many institutions in society and has a number of dimensions, such as job discrimination, loss of status, stereotyping and dehumanization. Ageism is also about assuming that all older people are the same despite different life histories, needs and expectation. (Phillipson: 2011)

The policy, All Our Future also (Scottish Government: 2007) indicates that over the age of fifty, is a stage where life circumstances start to change in ways that can be significant for the future. An example of this can be; children leave home, change in working patterns, people have less work and more time for themselves. In addition, from fifty onwards, this can be a time when physical health may deteriorate, causing possible health problems, such as, osteoporosis, osteoarthritis or coronary heart disease. What is more, the state of general health overall, decreases substantially, people face changes in appearance, their physical state deteriorates and they are not as fit as they used to be. Surely, this must be difficult to accept! However, ageing can also cause some psychological effects, such as, changes in memory function, a decline in intellectual abilities, or even memory loss. As a result of a degenerative condition of brain’s nerve cells or brain disorders, many people may develop dementia, Alzheimer or Parkinson disease. Wilson et al. (2008) who draws attention to physical, biological and psychological effects of the ageing, pointing out that ageing is not itself a disease, but some specific diseases may be associated with this process.

Older people are a group that used to be in a marginal concern in the social work profession, but has recently moved to one of central importance. (Phillipson: 2011) This is caused by the remarkable speed of demographical change. The number of older people is increasing, both in absolute numbers, and as a proportion of the total population. The ageing of the population indicates two main factors: the downward trend in the birth rate, and improvements in life expectancy. (Phillipson: 2011) In Scotland, in 2010, there were an estimated 1.047 million older people age over 60, with older people being one fifth of the Scottish population. (Age Scotland: 2012) In the last hundred years, Scotland’s life expectancy has doubled from 40 in 1900, to just over 74 for males, and just over 79 for females in 2004. By 2031 the number of people aged 50+ is projected to rise by 28%, and the number aged 75+ is projected to increase by 75% (Scottish Government: 2007) This issue requires to be deeply analysed in terms of how society will be able to respond effectively to the complex needs of older people.

This part of the report takes into account the socio-political context of the welfare policy. Social work underwent fundamental changes from the 1960s, following broader ideological, political and economic developments. To understand the current role of social work within society and wider policy framework, particularly with older people, it is important to analyse the past that has reflected on contemporary practice. By the 1960s, more attention was beginning to be paid to the social consequences of capitalism, that started to be seen as the economic order of an unequal and unfair society. The strong critique of that system is known as radical social work, that grew on the ideology of Marxism. (Howe: 2008) The publication of the Kilbrandon Report (1964) consequently led to the introduction of Social Work (Scotland) Act 1968. This embedded social work firmly within the state sector, with the voluntary sector as complementary. (Ferguson & Woodward: 2011) Social work wanted to be seen as a unified profession, that offered generic services, to overcome earlier fragmentation and overspecialisation of services. Social workers were obligated by law, to assess needs and promote social welfare by providing services. However, the government of Margaret Thatcher began to weaken the state welfares responsibilities to help people in need, leading to the major ideological shift in 1980s called neoliberalism. As a result, the Barclay Report (1982) intended to clarify the role and task of social workers employed within statutory or voluntary sector. The later Griffiths Report (1988) was similar to Barclay Report, in terms of promoting greater choice, participation and independence of the service user and carers. However, neoliberalism undermines the role of welfare professionals, allowing the rich to become richer, and marginalise the poorest and most vulnerable individuals. (Ferguson & Woodward: 2011) Woodward and Ferguson (2011) argue that the neoliberal trend has been continued under the new labour government, leading to managerialism and bureaucratisation. Therefore, contemporary practice is drawn by extreme pressure of marketisation and managerialism, leading to a profession dominated by stress, frustration and strongly focused on meeting deadlines. The labour government has also been driven by the developments associated with consumerists ideas, such as, personalisation that places the service user at the centre of service design and delivery, or direct payments that emphasise independence and individual choice, through giving service users their own money, to buy their own services. (Woodward & Ferguson: 2011) For a long time, neoliberal economic and social policies in the UK speculated a very different concept of what social work should be about. The Changing Lives report of the 21st Century Social Work Review (Scottish Government: 2006) has brought a significant shift within social work polices, through an expression of dissatisfaction of social work, that was mainly caused by a lack of opportunity for relationship based working with service user. The policy has reshaped the profession, providing social workers with additional space to develop good social work practice. There have been initiatives to improve recruitment, and increase professionalism and standards within the workforce, as well as improve integration in the planning and provision of social work services. (Scottish Parliament: 2008) Integration has been developed through Modernising Community Care: An Action Plan (1998) and Community Care Joint Future (2000) that introduce Single Shared Assessment (SSA). In Scotland, Joint Future is the driving policy on joint working between local authorities and the NHS. The other key policy themes are personalisation, self-directed support, early intervention and prevention as well as mixed economy of care. (Scottish Parliament: 2008) Another significant report that brought about change in policy, and later, in Scottish legislation, is the Sutherland Report (1999). This provided free personal and nursing care on the basis of assessed needs. (Petch: 2008) The above review of social work policies framework, is a good illustration of the constantly changing role and function of social work. Social work operates within the wider context of a constantly developing policy, ideology and legislation. The reality and ideology has changed people and society to face a new challenges. Social work makes a key contribution to tackle these issues by working with other agencies to deliver coordinated support to increase the wellbeing of older people.

In terms of needs and issues when working with older people, the first thing to consider is the partnership of health and social care, especially within areas such as: assessment, care management, intermediate care and hospital discharge. The main problems are, tight budgets, resources and reconciliation of financial responsibility between bodies. Which always raises dispute who should pay for services? Wilson et al. (2008) stresses the importance of rationing services in social work, due to a low budget, which leads to delays in provision of services, and lack of time to develop more creative forms of practice. This causes unnecessary delays and constraints. One might expect that new Integration of Adult Health and Social Care Bill (Scottish Government: 2012) will resolve these problems by the joint budget and equal responsibilities of Health Boards and Local Authorities.

The next issue is the assessment and intervention process, that are seen as balance between needs and resources, evidence and relationship based practice. It can be an issue to find appropriate resources that will meet the needs of the individual. A major element during assessment is the relationship with service user, and that the appropriate methods of communication are adopted to identify the needs of older people. The practitioner must take the time to get know the older person and resist pressure from other professionals to do a quick assessment. (Mackay: 2008) In social work there is constant need to utilise evidence based practice on the grounds that it is empirical knowledge which guides the decision making process, such as three stages of theory cycle (Collinwood & Davies: 2011) There is no doubt evidence based practice is important, but this view may undermine relationship based practice, which is equally important. Rightly, Wilson et al. (2008) refers to relationship-based as a main feature of social work practice, that shapes the nature and purpose of the intervention. It is a unique interaction between the service user and the practitioner, that helps to obtain more information and define the best way of intervention.

The problem of autonomy and protection is another factor in the relationship when working with older people. This raises the question of capacity, consent and the deprivation of liberty of older people. This group of service users is often a subject of legislation that deprives their human rights, this is because they are likely to be affected by cognitive disorder such as dementia. The term dementia, includes Alzheimer’s disease, vascular and unspecified dementia, as well as dementia in other diseases such as Parkinson’s. It has been estimated that in the UK the number of patients diagnosed is 821,884, representing 1.3% of the UK population. (Alzheimer’s Research Trust: 2010) The assessment of incapacity or mental disorder is not straightforward and proves ethically and morally difficult for both service user and social worker. Social workers have to manage the balance between acting in accordance with the wishes of the individuals, and what is in their best interests. It has been suggested by policy and legislation that the views and wishes of people expressed through self-assessment would remain at the heart of intervention. (Wilson et al.: 2008)

Another issue is abuse of older people, which may have many forms, and can be very severe in extend. Older people are vulnerable to abuse, or indeed, not having their rights fully respected and protected. The problem came to public awareness not as long as few years ago. Despite the fact that legislation came into force through Adult Support and Protection (Scotland) Act 2007, it is estimated that elder abuse affects 22,700 people in the Scotland each year. (Age Scotland: 2012) Older people are a subject of physical, psychological abuse, neglect, sexual or financial harm, that normally takes place at home, in hospital, residential care or day centre. (Ray at al.: 2009)

Age discrimination is next issue one wish to consider, older people are disadvantaged because of their relatively low socio-political and cultural status in a contemporary society. They are repeatedly presented as a drain on resources as they no longer actively contribute to the growth of society. They do not work and do not pay taxes anymore. Older people are systematically disadvantaged by the status they now occupy within society. Wilson et al. (2008: p. 620) rightly suggests that old age is “socially constructed”. A good example of this is retirement, which officially, makes people old and unavailable to work, despite the actual physical and emotional state of the individual.

Other forms of social construction that significantly affect the experience of old age are class, gender, race and ethnicity. (Wilson at al.: 2008) An illustration of this can be the statement that older people have much more in common with younger people from their class, than they do with older people from other classes. (Philipson: 2011) Disadvantages and inequalities, experiences during life can magnified during the process of ageing, through differences in access to health facilities, health status and lifestyle that may influence life expectancy. There is no doubt that experience of ageing is subjective, and depends on many factors, but it seems to be a matter to firstly, consider class, gender and race at the first place. When discussing poverty and inequalities, the points to bear in mind are issues of discrimination of older women, who are less likely to have as great a pension as a male partner, due to the fact many women are paid a lower wage then men. Moreover, women tend to live longer than men, therefore, are potentially more vulnerable to live alone and in poverty. (Age UK: 2012)

There are many forms of disadvantage associated with older people in poverty such as; low income, low wealth and pension, debts or financial difficulties, feelings of being “worse off”, financial exclusion, material deprivation and a cold home. The first three are experiences by around 20% of older people, half of older people experienced at least one of the nine forms of poverty described above, and 25% had two or more. A minority 3% suffered from three or more forms of poverty. (Age UKa: 2012) In terms of ethnicity and race there are significant inequalities in the process of ageing. An illustration of this can be the black community of older people, who are more likely to face a greater level of poverty, live in poorer housing and have received lower wages. In addition, they are more susceptible to physical and mental illness often due to heavy manual work, racism and cultural pressures. (Phillipson: 2011) All these discussed factors must be taken into account when working with the older person.

It can be argued that one of the main needs of older people is the importance of active listening to this group of service users, who are often because of age ignored or disregarded. This is supported by Kydd et al. (2009) who highlights how important it is for older people to feel that they are being listened too. Another important need of this group of service users, is the need to stay at home as long as possible, which is supported by the policy, All Our Future (Scottish Government: 2007) that offers; free personal care, telecare development programme, care and repairs services or travel scheme free bus passes. The policy aims to improve opportunities for older people, foster better understanding towards this group of service users, create better links between generations to work together and exchange experiences. Improve health and quality of life by promoting well being and an active life within the community; enhance care support and protection of older people. Improve housing and transport as well as promote lifelong learning.

The last part of the report identifies policy framework and organisational responses. The discussion about social care for adults began in the UK through Green paper Independence, Well-being and Choice (Department of Health: 2005) and the subsequent White Paper, Our Health, Our Care, Our Say (Department of Health: 2006) these documents set out the agenda for future. This is based on the principle that service users should be able to have greater control over their own lives, with strategies that services delivery will be more personalised than uniform. The contemporary social work is driven by emancipatory issues such as social justice, empowerment, partnership and minimal intervention. (Dalrymple and Burke: 2006) Empowerment theory is the process of helping people gain greater control over their lives. Empowerment is not simply a matter of enabling or facilitating but it involves helping people to become better equipped to deal with challenges and oppression they may face. (Thompson: 2009) On the grounds of empowerment grew the idea of service user participation that came to law in 1990 through NHS and Community Care Act. (Ray et al.: 2012) There is still increasing acceptance that people who receive services should be seen as own experts in defining their own needs. This is in accordance with the exchange model of assessment presented by Smile and Tuson et al. (1993), where the social worker views the individuals as experts of their own problems. The role of the practitioner is to help the service user to organise resources in order to reach goals that are defined by the service user. The Scottish Government’s policies and initiatives addressing to older people, highlights the importance of developing services that focus on maintaining independence, encouraging choice and promoting autonomy, such as; Changing Lives (2006), All Our Future (2007), Independent Living in Scotland (2010), Reshaping Care for Older People (2012a). These policies highlight the importance of service user participation in the process of decision making and intervention. These tendencies of improving choice and autonomy of older people, have resulted in the creation of personalisation and self-directed support programmes.

Personalisation enables the individual to participate and to be actively involved in the delivery of services. Personalisation also means that people become more involved in how services are designed by shaping and selecting services to receive support that is most suited to them (Scottish Government: 2009) The programme directly responds to wants and wishes of the service user regarding service provision. Personalisation consists of a person centre approach, early intervention and prevention, and is based on mentioned above empowering philosophy of choice and control. It shifts power from the professionals, to the people who use services. (Department of Health: 2010) However, it could be argued that approaches which extend to service user control, in realty, can be seen as transferring risk and responsibilities form the local authority to the individual service user (Ferguson: 2007)

Another option, recently promoted by the government, is Self Directed Support (SDS), a Bill that was introduced into the Scottish Parliament last year, and recently has passed stage three. The bill seeks to introduce legislative provision for SDS and the personalisation of services and to extend the provisions relating to direct payments. (Scottish Parliament: 2012a) The SDS approach had been brought into Parliament previously, and was reflected in many reports and policy initiatives such as: Changing Lives, Reshaping Care for Older People. SDS allows people to make informed choices about the way support is provided, they can have greater control over how their needs are met, and by whom. Social workers, working on behalf of local authority, will have a duty to offer SDS if the individual meets the eligibility criteria. The four options to consider are; direct payment to the individual in order that that person will arrange their own support, the person chooses the available support and the local authority will make arrangements for the services on behalf of that person, the social worker will select support and make arrangement for provision, the last option is a mix of the above. (IRISS: 2012) The idea of SDS is a great opportunity for service users to expand their control over which services provided. However, this raises a question of how many people will be ready to utilise option one of SDS. Would an ordinary person, who uses the services, have the skills and knowledge to take responsibility for their own care, for example to employ their own carers, a personal assistant or to buy their own services. One could envisage that it could be possible if the role of social worker changes from care management, to brokerage and advocacy. A potential care broker will provide assistance to obtain and manage a support package, drawing on individualised funding. It can be questioned if social workers who are mostly accountable to local authorities are reliable to perform this task whilst working across three sectors. (Wilson at al.: 2008)

In conclusion, there is a shift from a paternalistic stance of social workers to viewing service user as experts of their own lives. From institutional care, through service led and needs led, to outcomes focus provision. A fundamental part of working with older people is to recognise and respond to the way in which they may be marginalized. This can be achieved by a deeper understanding of the process of ageing, and the issues that older people may face. Working with older people, based on new premises, will be focused on to maximise resources, and the role of the social worker will be transferred from care management to advocacy and brokerage. One may expect that active involvement and participation of older people in service provision will have a crucial role not only by exercising more control and choice but also in challenging social exclusion.

The aim of this assignment is to discuss the strengths and limitations of the social model of disability and how nurses can promote anti-discriminatory practice in relation to people with disabilities. Defining disability is said to be very difficult due to the fact that disability is a ‘complicated, multidimensional concept’ (Altman 2001). Furthermore Slater et al (1974) has gone as far as stating that constructing a definition that would fit all circumstances is in ‘reality nearly impossible’. However attempts have been made by various different people, legislation and models in different ways.

According to Altman (2001) these attempts are the reason why there has been a lot of ‘confusion and misuse of disability terms and definitions’. The Disability Discrimination Act defines a disabled person ‘as a person who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities’. (DDA 2005) However the medical model of disability sees disability as the individual’s problem and that it should not concern anyone other than the disabled person, for example, if a student who is in a wheelchair is unable to get into the building due to the steps, the medical model would assume that it is due to the wheelchair rather than the steps. Whereas on the other hand the social model would say that the steps are acting as a barrier to the student, therefore the barrier should be removed.

The social model of disability was brought about by activists in the Union of the Physically Impaired Against Segregation (UPIAS) during the 1970s. This model is seen as the main theory which tests disability politics in Britain (Shakespeare et al 2002). The UPIAS argued that there is a major difference between impairment and disability. They defined impairment as ‘lacking part or all of a limb, or having a defective limb, organ or mechanism of the body.’ They have also defined disability as ‘the disadvantage or restriction of activity caused by a contemporary social organization which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities’ (Giddens 2006).

The social model of disability can be defined as an idea that it is society that disables an individual with the way everything is constructed to meet the needs of the majority who are not disabled (Shakespeare et al 2002). Whereas, the social model can be compared with the medical model of disability which tends to focus purely on finding a cure and that to be able to fully participate in society they need to treat their ‘impairment’ (Crow 1996).

The model has several key points. First it describes disabled people as an oppressed social group (Shakespeare et al. 2002) meaning that on top of their impairment, disability is something more deep that excludes and isolates them from participating in society (Oliver 1996). The difference between the impairments that people have to deal with and the oppression which they experience is fundamental to the British social model. Finally, the model defines disability as a form of social oppression, not a form of impairment (Shakespeare et al. 2002). Therefore the aim of the model is to empower disabled people so that they don’t feel as though their condition is the problem, but that society is the problem due to the number of barriers it places on disabled people (Giddens 2006). For example, everywhere you go there will be steps, steps to get into a building, steps to climb floors and it is this barrier which causes problems for disabled people therefore the social model provides a solution saying that ramps and lifts should be fitted in all buildings, the problem of not being able to stand for too long should be tackled by placing more seats in public places. It is barriers like these that the social model aims to find solutions to.

The British disability movement has found great importance in the social model in various different ways. Hasler (1993) describes it as the ‘big idea’ of the British disability movement. For example, identifying a political strategy to remove barriers in society that played a large role in disabled people’s lives, which was also the main strength of the social model (Shakespeare et al. 2002). Examples of barriers that disabled people faced in all areas of life were the inability to access public transport systems due to the fact that a person was in a wheelchair or had visual or hearing impairment, their inability to find work because employers felt that the disabled person was incapable of doing the job, housing problems and so forth (Thomas 2004). The removal of such barriers would mean that if those people with impairments felt disabled by society then by taking away these barriers would help to empower and promote the ‘inclusion of people with impairments’ (Shakespeare et al. (2002).

The model tries to bring about change in society to suit the individuals need rather than taking up a medical view where you try and look for a cure, or rehabilitation (Shakespeare et al.2002). For example, people who have schizophrenia have to take medication in order to live normal lives. However it is argued that the social models complete view of changing society has become too simplistic or rather an over- socialised explanation. Furthermore, Vic Finkelstein (2004) argues that the social model looks at enabling people to be ‘human’ in a society rather than having access to their ‘rights’.

However the medical model of disability has a different perspective. They believe that people with disabilities need to be assessed, that they are incapable of making their own decisions, that they are the problem and that people with disabilities have to be adapted to fit into the world, but if this is not possible then they are placed in specialised institutions or ‘isolated at home’ where only basic needs are met (Rieser, 2009).

A second strength seen from the model was the actual impact on the disabled people themselves. The social model made disabled people feel free as they lifted the view of a medical approach, where the problem was the individual and placed it on society saying that social oppression was the root of the problem. This as a result made people feel liberated and empowered as they were made to believe they were not at fault: ‘society was’, that society was in need of the change: not the individual (Shakespeare et al. 2002). The social model helped to bring disabled people to ‘come out’ like raising feminist consciousness in the seventies, or lesbians and gays ‘coming out’ (Shakespeare et al. 2002).

The social model has played a very important part in many disabled people’s lives, however, despite these strengths to the model there are a number of limitations. Firstly, the social model has been criticised for being unable to deal with the realities of impairment (Oliver, 2004), meaning that the model is not about peoples personal experience of impairment (Oliver, 1996) but about peoples collective experiences of disablement in society (Oliver, 1990).

Another point criticised is that other social divisions such as race, gender, ageing, sexuality and so on are not incorporated in to the social model (Oliver, 2004). However Oliver (2004) that just because the social model hasn’t incorporated these divisions does not mean that they are unable to. Oliver (2004) states that those who criticise the model are the ones who should try and ‘forge the social model into action’ when dealing with issues such as race and gender and age and sexuality.

Cultural values have also been pointed out to be ignored by the social model. There is an argument about the issue of otherness, meaning that it is the cultural views that people hold which place disabled people as ‘others’, not the physical and environmental barriers (Oliver, 2004).

Furthermore, another limitation of the social model is that it clearly neglects and ignores the experiences of impairments and disability which are the main cause of problems in most disabled people’s lives (Giddens, 2006). Shakespeare and Watson (2002) argue that ‘we are not just disabled people, we are also people with impairments, and to pretend otherwise is to ignore a major part of our biographies’. Against this accusation, Oliver (2004) finds it difficult to accept that disabled peoples experiences are not considered because it is after all the main reason why the model emerged to begin with-due to a number of disabled activists in the 1970’s. Furthermore defenders of the model argue that the social model merely focuses on social barriers that disabled people face rather than denying them of everyday experiences due to their impairment (Giddens, 2006).

The social model has been criticised as being ‘inadequate as a social theory of disablement’ (Oliver 2004). Corker and French (1998) talk about social model theorists and then conclude that the social model is not a theory, however Oliver (2004) argues that how can people criticise the social model for something it has never claimed to be? Oliver (2004) states that most people who have developed the social model have claimed that they have said the social model of disability is not a theory of disability.

Leading on from the strengths and limitations, there is a substantial amount that nurses can do to promote anti-discriminatory practice in relation to people with disabilities by maintaining a positive attitude towards people with disabilities as they are constantly involved with the treatment and care of people with physical or intellectual disabilities (Klooster et al. 2009). Nursing schools as like other professions, tend to be based around the medical model of care where they aim to diagnose and treat diseases (Klooster et al. 2009). However as Byron et al (2000) has stated that not all disabled people are unwell and may not have a disease.

Nurses have an important role, like other health professionals, in influencing a disabled person’s response to treatment (Oermann &Lindgren, 1995). Therefore Carter et al (2001) has stated that inappropriate attitudes and behaviours from staff are the biggest barriers which disabled people face, which has led to further research indicating that nursing students should move away from the medical model of care when working with people with disabilities and should focus on a more social model perspective (Scullion, 1999).

Further research has indicated that nursing student’s attitudes towards disabled people may be improved by educational programmes which can help nurses to be in direct contact and to work with disabled people (Oermann &Lindgren, 1995). However, the research literature suggests that this is currently not happening in nursing practice (Klooster et al 2009). For example, Brillhart et al (1990) found that nursing students had more negative attitudes then the person with the disabilities themselves.

Nurses can help to provide clear information as Hammel (2003) states that professionals need to ‘listen to what people are telling them’ and that ‘actions and non-verbal messages can speak very loudly’. Nurses can form strategies to communicate with disabled people in order to make their life easier (Hammel, 2003). However it is common that fewer health care professionals are reluctant to provide services for disabled people as they age (Hammel, 2003).

By providing clear information nurses also involve other people who are important in the disabled person’s life and ensuring that they are informed about options and benefits for the disabled person as well as themselves. Nurses can also act as advocates for disabled people so that they have equal use of services or even provide information of advocacy groups for the disabled person for example Centres for Independent Living (Hammel, 2003).

Furthermore, where young people are concerned nurse can give advice to families about possibilities for independence and can also refer them to community resources that may help young people pursue further education, find a job and live independently (Blomquist et al. 1998)

Lastly the Disability Discrimination Act is a guide for nurses to help them provide better care for people with disabilities and also how they can develop their practice (Aylott, 2004).

There are many aspects with which nurses can help promote anti-discriminatory practice in relation to people with disabilities however, nurses need to keep a positive attitude towards people with disabilities in order for the anti-discriminatory practice to work.

In conclusion for there to be equal rights for people with disabilities, Oliver (2004), states that people spend too much time discussing the strengths and limitations of each model therefore he suggests that both models should be integrated, ideas of both models should be put together and used in concordance so as to actually help people with disabilities. Oliver (2004) claims that ‘if we imagine that throughout history carpenters and builders of the world had spent their time talking about whether the hammer was an adequate tool for the purpose of building houses, we would still be living in caves…’. Therefore there is a hammer in the disability movement and if it was used properly then the social model of disability can become the ‘hammer of justice and freedom for disabled people’ (Oliver 2004).

References

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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.

Now a days social workers are expected to write their reports in a coherent way, justifying it using theory and research. Sociology offers some important social theories, which provide explanations and critiques of human behavior, social actions and interactions as well as the institutions and the structures of society. The fact that social work is concerned with social change and problem solving is precisely why sociology is important to social work.

In this essay I have selected two sociological theories – to examine and understand Ms. B’s situation. I will be applying these theories to my understanding of my position as a social worker. The essay will also consider how these theories or perspectives helped my thinking about Ms. B’s situation and how these theories or perspectives were unhelpful in my understanding of Ms. B’s situation. In this essay I will also considers what other theory might have been applied, and as an integral part of the essay, considering anti-oppressive and anti-discriminatory practice.

Functionalism views society made up from numerous interconnected parts which together form a system. The basic part of this breakdown is the society, and its variety of parts can be understood in terms of their collective relationship. In the initial stages of this theory Functionalism drew comparisons between society and the human body. Mainly this comparison existed since they viewed the society operating in theory in a similar way of the human body.

Therefore, for one to understand the function of an organ in the human atonomy, for example the heart, it is essential to understand its relationship with the other organs in the human body and especially, its contribution towards the maintaining of the organism. Thus, functionalism argues that, an analysis and examination of the functioning of society is therefore important as it illustrates its relationship with the other parts of society, and most importantly, its contribution to the maintenance of society.

According to Emile Durkheim (1895), the founder of Functionalism, crime and deviance are normal and necessary. Given that they are found in all societies, functionalists argue that it is a form of social change, as through deviance the society would learn about the accepted behaviour. However, too much crime can bring on a state of ‘anomie‘, which is a state of normlessness in society. This arises when cultural goals and structural means of achieving those goals is unbalanced. The anomie state would result in conflicting the agreement of the functioning of society. Durkheim described the state of anomie as ‘a feeling of aimlessness or despair…traditional moral controls and standards are largely broken down…this leaves many individuals in society feeling lack of meaning in their daily lives’.Giddens(2006, p 14)

Durkheim (1895) suggested that the theory of Merton gives an idea of the individuals who have high expectations and are unable to fulfill them through structural means then ‘strain occurs’. Robert Merton’s (1938) ‘Strain theory’ modified the Durkheim’s ‘Anomie’ to refer to the strain put on individuals when accepted norms conflict with reality.

While the symbolic interactionalist theory are more concerned with agencies of social control; how they label certain behavior as deviant and the effects of these labels. Interactionists dispute the functionalist assumption that there is an agreement throughout society as to what behavior is criminal or deviant. They aimed to find out why certain behavior was labeled as criminal or deviant in some contexts but not in others.

Howard Becker was one of the initiators of the labelling theory, he stated that “Social groups create deviance by making the rules whose infractions constitute deviance, and by applying these rules to particular people and labelling them as outsiders”. REF

The labelling theory looks at how the social response to crime is made and how certain behaviour comes to be considered deviant or criminal. Labelling theory also suggests that the very imposition of social judgments on certain individuals, helps turn those individuals even more into paths of criminality that have been already identified. The labelling becomes a self-fulfillment prophecy as the stigma, or label, only pushes the offender further in the direction of criminality. In simple terms, give a dog a bad name he will become a bad dog, Llewellyn et al (2001, p 90).

The theoretical formulations of Colley (1992) and Mead (1934) have served as a source when trying to understand the self-fulfilling prophecy. They both argue that social interaction is the basis upon which an individual formulates his or her self-concept. Cooley and Mead models give examples of the individual’s conception which arises through interaction with other members of the society that constitute his/her significant social circle. Specifically, the social looking glass theory posits that one’s self-conception is determined by the way in which it is reflected or mirrored through the eyes of the other people involved, Allen (2001, p 58).

As a SW, I believe it is my responsibility to try to really understand the SU’s situation, from their perspective. Thinking about Ms. B’s situation, in terms of the two theories is very useful to me as a SW as sociological theories are helpful in providing insights into the perspectives of the SU. Therefore these two theories are helpful in helping to identify how Ms B’s situation may have come to being constructed and, so can be understood.

For example, functionalism could help me understand Ms. B’s situation from the perspective of Ms. B’s culture, race, gender and mental health status: Ms. B could potentially, be multiply discriminated against along any of these.

Analyzing and examining the SU’s problems in a functionalist view can, therefore, give structure to my understanding of the problem as a social worker. Especially in terms of how SU’s might be discriminated or oppressed against, Dominelli (2002).

For instance, in Ms B. case, a functionalist analysis to her situation would consider the behavior of Ms B. as deviant, because it is preventing her from participating in society. She is seen as unable to fulfill her role as a mother and her social interactions are affected. Supposing that she has permit to work, it would be not possible for her to find or maintain a job due to her deviant behavior.

Functionalists would consider this as a “faulty socialization”. Furthermore functionalism would view this situation as costing to society, as a result not contributing to the maintenance of the society functioning. This fault in socialization has to be fixed in order for Ms B. to fully participate in society and contribute in its maintenance; as a result the label put on her would be a form of social control. However as a consequence to the label, Ms B. would feel that her culture, race and gender are not taken into account and that she is being discriminated against, she may feel oppressed and at the same time socially stigmatized.

The Robert Merton’s (1938) ‘Strain theory’ would be very helpful in better understanding Ms B. behavior. Durkheim (1895) suggested that the theory of Merton gives an idea of the individuals who have high expectations and are unable to fulfill them through structural means then ‘strain occurs’. Robert Merton’s (1938) ‘Strain theory’ modified the Durkheim’s ‘Anomie’ to refer to the strain put on individuals when accepted norms conflict with reality.REF Linking this to the case of Ms B, her asspiration to enter paid employment does not coincide with her immigration status. Therefore this disparity between desires and fulfillment will be felt in deviant motivation. Evenmore this could be the point where Mrs B feels the strain and as a result deviates from the societies norms.

Due to the variety of problems that Ms B. is currently facing, Agnew (1992) in Levinson (2002) would give another functionalist view to better understand her reaction to the label. He argues how the strain theory can lead to other deviant adoptions. Agnew criticizes the earlier strain theory, he argued that strain theory should ‘generalize the concept to include all negative relations with others, rather than just the negative relations that are the result of striving from uneatable, but culturally mandated goals’. Levinson (2002, p 79).

” It is not so much the unique quality no any single event but the accumulation of several stressful events within a relatively short time span that is consequential”) Agnew (1992,) as cited in Levinson (2002, p 62-63).

Ms B. immigration status may feel very oppressing to her. By not taking the medication prescribed as well as reacting in a deviant way, is the only way in which Ms B. can show her anger, which is accumulated by many issues during a short time. Agnew placed great importance to the feeling of ‘anger’ as he argued that ‘anger is the key emotion because it increases the individual’s level of felt injury, creates a desire for retaliation/revenge, energizes the individual for action, and lowers inhibitions, in part because individuals believe that others will feel their aggression is justified’ as cited in Levinson (2002, p 60).

While functionalism helped me to reflect on the possible ways a person can be discriminated against; even more it placed a great emphasis on my understanding of the importance of being culturally competent, especially in the profession of social work. In the other hand the labelling theory not only lead me to a deeper understanding of Ms B situations but also, helped me to understand the potential start of Ms B’s deviance behavior. For instance, once the label of ‘mental ill’ was given to Ms B, she may well have chosen to simply organize her life around that label and adopt the new identity that was endorsed on her. In this way the self fulfilling prophecy comes into play. The act of labelling Ms B as someone with scrixophenia would had an adverse effect on her future behaviour.

Deviance can be defined as a failure to conform to culturally expected norms of behaviour, which reflect the dominant values and rules of groups or society in a given period, Llewellyn et al (2002, p 90).

As the labelling theory argues that the person is categorized and classified as deviant ; the stereotyped person has their identity reinforced, which in turn promotes the deviant behaviour that it is intended to prevent, Llewellyn et al (2002, p 90).

When reading and applying the functionalist theory, it is obvious that this theory assumes that the middle class values are accepted throughout society. Therefore whoever deviates from this values it is regarded as having a faulty socialization. Even more as we see on the Anomie theory and the adapted strain theory, one can understand that there is an assumption that everyone aspires the same level of success.

The labelling theory has been very helpful in developing policies, such as ‘diversion’ from the courts and the criminal justice systems. However the labelling theory has its own limitations, it can be argued that it is too deterministic as it assumes that the deviant will accept the label, some people fight against the label and prove it wrong. As well as it does not consider the process that lead to the deviant behavior.

There are other sociological theories that could also have helped to explain other aspects of Ms. B’s life, such as her living in poverty, which can lead Ms. B to be discriminated against and oppressed by mainstream society. Marxism conflict theory and anti-racist theory/black perspectives, would have been helpful in achieving a bigger picture of Ms B situation. For example Marxist would argue that Ms B is being oppressed against due to her social class, poverty and her ethnicity. There are past and current studies to show that “a high number of people from black ethnicities, are being diagnosed with schizophrenia, with some studies reporting between two to eight times higher rates of diagnosis, compared to the White population” mind.org.uk (accessed 16/12/09).

Even more the past detention of Ms B under the mental health act would coincide with the fact that “people from black ethnicities are more likely to be held under the Mental Health Act, and to receive medication rather than be offered therapies such as psychotherapy” mentalhealth.org.uk (accessed 16/12/09).

Applying the black feminist theories could have explored more about Ms B current situation, Black feminist would argue that Ms B may be facing oppression from her partner as well as they would argue about the mental label being ascribed to her as a result of her gender but most importantly her ethnicity. Also “it is important to note that only the difference between Black Caribbean women and White women can be considered as statistically significant” mind.org.uk (accessed: 28/12/09)

In summary, it is obvious that actively considering and using sociological theories can allow meaningful analyses of the SUs’ problems. As a result the SW practice becomes applied more, and of more use to the SUs’. Theories would provide informed solutions to SU’s problems in a more anti-oppressive and anti-discriminatory manner (Dominelli, 2002).

In conclusion one of the barriers to social work participation would be when service users are viewed in a stereotypical way, by the social worker. Every individual has a unique perspective of the world, and as such should be treated as an individual regardless of illness, colour or belief system. It is important that those in need of help and guidance be given access to it, and that the best possible outcome for the service user, is secured. This should be done with the help and support of all those involved, including health care professionals, social workers and the service users themselves, in order to enable individuals to become more independent and re-integrated back into society.

References

Jones, P., (2003). ‘Introducing Social Theory’. Polity, London.

Gidens, A., (2006). ‘Sociology’ , 5th Edition, Polity Levinson, D., (2002). ‘Encyclopedia of crime and punishment’, Volume 1, SAGE Cunningham, J., Cunningham, S., (2008) Sociology and Social Work. Learning Matters.

Dominelli, L. (2002). Anti-oppressive social work theory and practice. Palgrave MacMillan.

Fernando, S. (2002). Mental Health Race and Culture. Palgrave.

Rogers, A. and Pilgrim, D. (2003). Mental Health and Inequality. Palgrave.

Macionis, J. J., Plummer, K., (2008). Sociology: A Global Introduction. Pearson.

Haralambos, M., Holborn, M., (2008). Sociology: themes and perspectives. Collins.

Llewellyn, A., Agu, L., Mercer, D., (2008). Sociology for Social Workers. Polity.

Allen, L. R., (2001). The concept of self: a study of black identity and self-esteem.
Wayne State University Press,

http://www.mind.org.uk/help/people_groups_and_communities/statistics_3_race_culture_and_mental_health (Accesed:28/12/09)

http://www.mentalhealth.org.uk/information/mental-health-a-z/black-minority-ethnic-communities/#Afro_Carib (Accessed: 16/12/09)

Evaluate critically the role of child death inquiries as a vehicle for policy development, and consider the implication for social work with children and families.

The purpose of this assignment is to show a critical understanding of the role of child death inquiries as a vehicle for policy development. This assignment will explore the purpose of child death inquiries. It will show a critical understanding of the complex relationship between family and the state, the tensions between the duty to safeguard children, the parents and child’s rights and when the state should intervene. The types of child death inquiries will be investigated examining their purpose, limitations and values. The assignment will examine the impact of changing child welfare policy on organisational structures with reference to multi disciplinary teams. This assignment will show reference to critical evaluation and the bias that may precede it. Finally concluding given the weight of evidence how useful child death inquiries are as a vehicle for policy development.

Recently the benefits of child death inquiries and serious case reviews have come under particular scrutiny, this assignment will use evidenced based information and practice to find other approaches or how to improve the form of the inquiry so its benefits outweigh its limitations.

The United Nations estimate that every week two children in the United Kingdom die from abuse or neglect (UNICEF, 2003). The United Nations Convention, article 3 on the rights of the child places a duty on countries to protect children from abuse or neglect, the best interests of the child must be the primary concern when making decisions which may affect them, article 6 focuses on the importance of safeguarding their right to life (United Nations Convention on the Rights of the Child, 1992).

There are two types of child death inquiries; serious case reviews and public inquiries. A serious case review takes place when a child dies and abuse or neglect is suspected. They also take place in other circumstances where serious situations have occurred for example where a child has suffered from serious sexual abuse. The purpose of child death inquiries according to Working Together, 2010 is for agencies and individuals to learn where problems have arisen and to learn from these to improve their practice. The lessons learnt should be given to all individuals who work in this area to ensure they safeguard children in the correct way. When agencies already know where certain problems lie they should improve upon them before the serious case review is finished. A public inquiry for example The Colwell Report (1974), The Climbe inquiry (2003) is a inquiry ordered by the government to review events, in this case child deaths. To conclude where practice could be improved upon, recommendations can be given and lessons can be learnt.

Under regulation 5 of the local safeguarding children’s board requires that the local safeguarding children board undertakes reviews of serious cases. Serious case reviews must establish lessons to be learnt, identify which lessons are within agencies and which between and how long they have to act upon the changes to be undertaken. The reviews must also improve upon inter and intra agency working to promote and safeguard the wellbeing of children (chapter 8, Working Together, 2010). Laming (2009) states that serious case reviews are an important tool for learning lessons. Currently there is debate regarding the approach used in serious case reviews some believe that there are different approaches to take to learn lessons from social work practice. Effective safeguarding practice is an approach considered, to learn from what is already proven to work.

The obvious aim of child death inquiries is to try and avoid future tragedies. There is a repetitive circle within child protection. Families collide with professionals and most of the outcomes involve protection. The tensions involved between families and professionals involve competition of rights. The Human Rights Act, 1998 article 8 stipulates the family’s right to a private family life and to be able to conduct their lives according to their culture and understanding. The opposite to this argument is to ensure all children are protected. When should professionals become involved? Parton (1991) describes the dilemma of how can the state establish the rights of the child and still promote the family to be an independent body in which to raise their children how they see fit and not intervene in all families and consequently reduce its autonomy.

Depending on the theoretical viewpoint the professionals and current Government takes would impose when the state should intervene. A laissez-faires government would have little intervention, the professionals would only intervene when abuse or neglect had taken place. However State paternalism is a perspective which favours more involvement of state intervention to protect children from abuse. This theory regards the child’s welfare as more important than family autonomy. This perspective was reflected in the Children Act, 1989 as it introduced the expression likely for the child to be in significant harm. If there is a likelihood of significant harm there are possibilities of child protection orders being produced, and in other extensions of state power.

Tensions between the duties that social workers have to safeguard children, the family’s right to a private family life, the rights of the child, working in partnership with the parents and understanding when the state should intervene cause problems within social work practice. Knowing when to intervene has always been a problem for social workers within this area. Malcolm Hill (1990) found that published child abuse inquiry reports identified working with parents as a common problem. He found that papers noted access difficulties, in a number of cases parents didn’t cooperate when the social worker needed to see the child at risk. Hill (1990) concluded that papers found social workers were too ready to believe parents. Hill (1990) concluded that the Colwell report (1974) found that social workers should focus on parents demonstrating their parenting skills and not to assume all was well because the parents said so.

Social workers also need to look at the care the child is receiving holistically not focus on single areas of the family where they are showing positive steps, for example social workers may be satisfied as the family are participating in counselling but they need to still look at their parenting at home whilst this continues. Thus depending on the theoretical viewpoint the social worker takes decides when they should intervene. This assignment will adopt a state paternalism perspective, this perspective although draws conclusions that the child is likely to suffer significant harm which may affect the family relationships and autonomy it’s better to intervene now then wait until abuse or neglect has taken place and then safeguarding the child. This perspective takes a view that children have a high priority in society, they have rights to high standards of care and using this approach ensure that they are protected at all costs by the force of the law (Fox Harding, 1997).

Child death inquiries are seen as an important tool used to improve local practice, also implementing wider community health approaches to improve upon infant mortality rates. Bunting and Reid (2005) found that there numerous benefits to serious case reviews taking place these included more effective multi agency working, improved communication between agencies, they found that death certificates had become more informative they also found that from participating in serious case reviews practitioners had more knowledge surrounding child death and the causes of them ensuring a further focus on preventative measures of child death rather than focusing on child abuse.

Corby, Doig and Roberts (1998) have found that there is a great concern on the impact of child inquiries on professionals especially social workers, they found that over the inquiries taking place there has been a continual criticism of social workers. The Maria Colwell case made social work practice public and put it under great scrutiny. Professionals within this case became points of focus of criticism, their work was scrutinised in incorrect contexts focusing on training of social workers affecting their morale significantly (Corby et al, 1998).

The impact of child death inquiries on social workers and other professionals in this area can be psychological and emotional. Corby et al (1998) argues both sides of the case although child death inquiries highlights poor practice and the need for the public to know why children already known to social services and other departments can still go on to be abused and killed. However the emotional and psychological effects on social workers can be so detrimental because of the scrutiny they are under, their work will be affected, and affecting further work they do.

Corby et al (1998) investigated child abuse cases and inquiries and how useful they are and what changes have been made by using child death and abuse inquiries as an approach. Of the seventy inquiries they used between 1945 and 1997 they all produced main recommendations in areas of improving inter agency co-ordination, training of professionals, improving child protection systems and using more experienced staff. Using this information to highlight that changes made between 1945 and 1997 because of the recommendations given haven’t been obvious because they are still proposing the same issues.

Child death inquires do have their place in the public eye specifically when practice goes wrong, nevertheless they have a number of limitations. Child death inquiries affect personal confidence of the social workers and other professionals when they become embroiled within the investigation. Due to the nature of the child death inquiries the public only see the negatives of social workers, social workers fear the association of such inquiries. Practice will not change when inquiries focus solely on the structure of children and families department. If social workers feel like the target when involved in inquiries their work will be affected therefore affecting the work they do further on for example other children may be more at risk because social workers have no confidence in the work they are practicing.

To use child death inquiries as a vehicle for policy development may not be the most effective approach to take. Child death inquiries are very expensive. If a more effective approach was to be taken and social workers and other professionals were able to learn more from this different process it would be more beneficial to take this approach than to carry on wasting money and concluding the same issues from all inquiries. Parton (2004) has found that the same issues have been identified on numerous times without any obvious changes in social work practice (Devaney, Lazenbatt and Bunting, 2010). Devaney et al (2010) found that child death inquiries can still be effective but more emphasis needs to be more on recommendations and implementing the recommendations and acting upon them. Devaney et al (2010) also argue that policy makers need more understanding of the difficult situations in which children are at more risk from abuse or neglect. Devaney et al (2010) argue that this can help the policy makers express what social workers can do and make a distinction between that and what should be done.

Child death inquiries make assumptions that something has gone wrong and that the inquiry can find out what and give recommendations to learn from the mistakes. It assumes that practice will change because of the recommendations given and many inquiries don’t focus on acting upon the recommendations, if they did then future inquiries wouldn’t produce the same recommendations. Inquiries assume that the method they use is sophisticated. However, research into inquiries and literature has shown that other approaches could be more effective and less intrusive in practice and less strain can be put on professionals. Inquiries assume that multi agency working will be more effective, though if tensions between professionals are tense already these will be difficult to resolve. Inquiries cannot assume that these tensions can be worked at by the professionals they need a superior management style to overlook the different professionals to be able to work effectively together.

As well as the implications for social workers individually and for policy makers regarding the process of child death inquiries, organisational structures will be also be impacted upon when changing child welfare policy. Due to changes within organisations, for example changes in roles of professionals involved in child death inquiries the foundations of interprofessional multi agency work are not secure, concluded because inquiries focus excessively on the role of social workers rather than the antecedents of child death or abuse. With regards to the case of Maria Colwell (1974) the Secretary of State Barbara Castle concluded that social workers alone cannot solve the underlying problems. All professionals in this field of child welfare need to understand their role but if child welfare policy continues to change constantly the role cannot be undertaken as professionals have poor ideas of what their role is and how they should practice. All professionals need to work effectively together and have an understanding of delivering comprehensive services to diverse communities so no children are lost in the system or ignored. The importance of effective interprofessional multi agency work is such that until there is a balance of role and practice then the safeguarding of future children may be affected.

Contemporary social work values may be affected, social workers have their own values personally and from learning from experience. Social workers must focus on human rights and social justice as their motivation for social work. Some critiques may argue that depending on the theoretical framework for example state paternalism some social workers may not be able to justify their motivation to impose this framework in their practice by not letting the family have a right to private family life (Human Rights, article 8) and be too quick to intervene. To ensure anti discriminatory practice social workers must understand different cultures have different behaviours when it comes to parenting. The social worker may thing its not appropriate, the family however believes differently. This can lead to the social worker not act at all. The social worker must ensure anti discriminatory practice, they need to see things from the perspective of the culture the family employs. Though still maintaining the values and knowledge they have regarding child abuse and when they should intervene. They must keep each case individual and make judgements based on evidence, not on their assumptions.

To evaluate how useful child death inquiries are as a vehicle for policy development evidence needs to be considered whilst investigating journal papers to gain an understanding of where bias may occur. Using a wide range of sources gives a broader idea of what has been proven to work in social work practice (Roberts and Yeager, 2006). Research evidence is more valued than other sources, those papers that are repeatable use a large amount of participants are more likely to have less prejudice in concluding how useful child death inquiries are as a vehicle for policy development. Higgs and Jones (2000) propose that evidence is knowledge derived from various sources, which has been tested and found credible.

Having read all the information the weight of evidence suggests that changes need to be made to the approach of child death inquiries. The limitations and implications to practice are too substantial to ignore. Professionals and public haven’t seen any major changes because of the recommendations give by the inquiries. Corby et al (1998) found that of seventy public inquiries between 1945 and 1997 the main focus of recommendations was on improvements on inter agency co-ordination and improving the training of staff. The gap between the time of the death of the child and receiving the results of the inquiry is detrimental to social workers. Corby et al (1998) also argue that the cost inquiries have and the negative impact on social workers affects their future practice and may create more risk to other children they are safeguarding because they don’t have the confidence to practice anymore. The most effective approach to take would be one that focuses with less scrutiny on the social workers so their confidence is not affected and acts upon the recommendations it has made. Policy can develop by using a different vehicle instead of child death inquiries. At the minute the impact of changing child welfare policy on social workers and organisational structure is considerable. An improved approach to child death inquiries can be more effective in changing policy than the constant changes that are currently happening because of the results from child death inquiries.

1. Introduction

This essay concerns the application of social work theory and practice with adults within the context of a specific legislative framework. The assignment specifically takes up different aspects of social work theory and practice that concern the carers of old and disabled individuals. It makes specific use of the case study on Betty, her daughter Elizabeth, and other members of Elizabeth’s family. The case study is provided in the appendix to this essay. It is considered as read and is thus not described in the body of this essay.

The assignment deals with the role of carers in the UK social work infrastructure and their needs and rights. It also takes up the importance of interprofessional participation and partnership between social and health care professionals and carers in delivery of social and health care, including the management of risk.

2. Identification of Issue

This assignment focuses on the responsibilities, difficulties, and needs of Elizabeth, the 49 year old daughter of Betty, who is 74 and has been living with Elizabeth and her family for the last 2 years. Elizabeth, who is white, is married to Charles (48), who is black and of African-Caribbean origin. They have two children, Mathew (22) and Elisa (19), who live with them.

Betty suffered from a stroke two months ago and is recovering in hospital. She has developed poor left side mobility on account of the episode and will require a wheel chair to move about. She has been medically assessed as ready to return home, where Elizabeth is expected to care for her. The situation and the caring relationship, whilst transparent and logical, has become complicated because of Charles’s redundancy from employment and his strained relationship with Mathew, who is yet to start earning. The domestic environment could become disturbed because of the possibility of Charles resuming his old drinking habits, the tendency of Mathew to engage in substance abuse and his stealing from his grandmother to fund his drug purchases and the possibility of Elisa’s moving out to live with her boyfriend. An application of Erikson’s theory of human development reveals that Betty is now firmly entrenched in her late adulthood, whereas Elizabeth is in her middle adulthood. Betty, if she is properly cared for, will find it easy to accept her life stage and prepare for her final years with complacency. For Elizabeth, these are years of activity and being in charge. Taking care of Betty will add meaning to her life, reduce stagnation, and establish a caring and stable home environment.

Elizabeth is obviously in a complex and difficult situation and whilst she must care for her ailing mother, she also has responsibilities towards her husband and children. Social work policies in the UK detail the ways through which social and medical care should be provided to adults in need (Oliver & Decoster, 2006, p 243). Specific policies exist for providing medical and social support to elderly people with mental and physical disabilities. Such services are provided through the aegis of social work practitioners, mental health professionals, medical professionals and medical workers. These diverse professionals are expected to work in partnership for the delivery of comprehensive social and medical care to the old and disabled (Oliver & Decoster, 2006, p 243). With the majority of such service users being expected to be cared for in the community, in their homes and in the midst of their near relatives, carers form an extremely important component of the social work delivery process (Stalker, 2003, p 67). Elizabeth, in her role as the primary care for Betty forms the pivot for delivery of social and health care services.

This assignment delves into the social work infrastructure and policies in the UK that are available for carers and makes particular use of relevant frameworks including the Single Assessment Process and National Service Framework for Older People. The essay also discusses relevant sociological and psychological theories for human development and behaviour and examines the ways in which inter-professional practice and partnership of professionals with carers can help in improvement of social work delivery.

3. Social and Medical Care for Adults and Old People

The official approach for providing social and medical care for older people was revamped and improved significantly after the publication of the White Paper on Modernising Social Services in 1998 and the adoption of a national agenda for improvement of care and services (Baker, 2004, p 12). The National Service for Older People (NSF-OP), which was adopted in 2001set standards for the promotion of better services and greater integration of health and social care services for people (Baker, 2004, p 12).

The NSF-OP is developed around 8 standards, namely (a) age discrimination, (b) person centred care, (c) intermediate care, (d) general hospital care, (e) stroke, (f) falls, (g) mental health and (h) health promotion. The NSF for older people very importantly introduced the concept of person centred care, which aimed to ensure that older people were treated as individuals in their own right and received care packages that satisfied their individual needs, irrespective of boundaries between health and social services (Baker, 2004, p 12). These standards aimed to ensure the integration of health care and social work services for older people and ca;;ed upon health and social care workers to participate and collaborate with each other to provide holistic and rounded services to people in need (Baker, 2004, p 12).

The person centred approach for provisioning of social and health care is an important outcome of the gradual development and acceptance of the social model of disability (Moulin, 2002, p 43). The still dominant medical model of disability assumes that disabilities result from the physical or mental limitations of individual persons and are largely unrelated to their social or geographical surroundings. It places the origin of a problem with a person and states that solutions can be found by focusing on the individual, rather than on his or her surroundings (Moulin, 2002, p 43).

Whilst the medical model has for centuries dominated human approaches towards disabled people, recent decades have seen the emergence and the progressive acceptance of the social model, which views disability to be the consequence of social and environmental barriers that restrict people with disabilities from participating in society (Moulin, 2002, p 47). The person centred approach is routed in the social model and aims to empower people with disabilities by allowing them to participate and agree to the medical and social care plans that are made for them (Moulin, 2002, p 47). Such empowerment provides service users with significant independence to participate in their rehabilitation and treatment process and allows care plans to focus on rehabilitation and prevention, rather than on symptomatic treatment (Moulin, 2002, p 47).

The single assessment procedure was introduced in the SAF- OP, specifically to further the standard concerning person centred care (Baker, 2004, p 14). The SAP facilitates a single assessment for the medical and social needs of individuals and calls upon respective agencies to work together for provisioning of appropriate and holistic care to individuals in need (Baker, 2004, p 14).

The SAF-OP is particularly relevant for Betty, because it provides a framework for providing of holistic social and medical services to individuals who have experienced strokes.

4. The Role of Carers

Whilst Betty’s medical condition and social needs are certainly addressed through policies like the SAP, the SAF-OP, the progressively greater use of the social model, the person centred approach, the existing social health care infrastructure, the efforts of the individual carer, in this case her daughter Elizabeth, will play a critical role in the delivery of such care. The progressive elimination of hospitalisation and institutionalisation for people with physical and mental ailments and the replacement of such approaches and methods with community centred care commenced in the 1960s and progressively increased over the years through appropriate policy modifications.

It is now widely accepted that people with disabilities live far more enriched, satisfied and productive lives amongst their families, friends and communities than in specialised institutions. Betty, after her recuperation from her stroke, is expected to come back into the community, live with her close relatives and family members, and be cared for by people who care for her. Such community care, whilst extremely desirable as an alternative to institutionalisation, however calls for the services of specific carers for individuals, who cannot manage their own activities, and thus need to be looked after by other people (Office for National Statics, 2006, p 1-2). Such carers, in the overwhelming majority of cases, constitute of family members, spouses, siblings, parents or even children (Office for National Statics, 2006, p 1-2) Betty, after her stroke, has reduced left side mobility and will need a wheel chair for her personal movement. Whilst she may, in all probability, be able to look after her own needs to some extent, it is probable that she will certainly need the care of another person. Elizabeth, her daughter and the person with whom she is living at present, is expected to fulfil the role of her carer.

Carers occupy a unique role in the British social care infrastructure. Practically 11% of the population, i.e. approximately 6 million people, provide unpaid care in the UK to individuals in need. Whilst practically half of these carers fall in the age group between 45 and 64, many of them are very young as well as quite old. The majority of people who receive care live either in residential premises (Office for National Statics, 2006, p 1-2). Caring for an elderly person, as Elizabeth will be required to do, calls for significant amounts of sensitivity and commitment. Most people involved in care for older people look after parents or relatives who were previously used to looking after them (Weinstein, et al, 2003, p 114). Elderly people often wish to remain self reliant and make their own decisions as long as possible.

Such changes in family relationships can often be complex and lead to situations of conflict if they are not handled with adequate care and thought (Weinstein, et al, 2003, p 115).

Whilst caring for older people has to be handled with great sensitivity to avoid upsetting the people who are being cared for, it also calls for a great deal of hard work, effort, and self sacrifice on the part of carers (Williams & Robinson, 2000, p 18). Carers often have to adjust their responsibilities towards their employers, if they are employed, and to their other family members who may need their emotional and physical support, in order to look after the individuals whose care has been entrusted to them (Williams & Robinson, 2000, p 18). With carers playing critical roles in supporting and providing essential services to disabled and ailing elderly people, it is essential for them to work in close coordination and participation with responsible medical, health and social care professionals in order to facilitate the provisioning of holistic medical, social, physical and emotional support to their elderly wards (Stalker, 2003, p 81). Such partnership helps in better assessment of risks that are faced by persons in care and formulation of appropriate care and intervention plans. Social and medical care plans thus need to be carefully formulated by the concerned social workers after appropriate assessment with the use of person centred approaches and the involvement and agreement of the service user and the carer (Stalker, 2003, p 81).

Elizabeth, as has been stated before is experiencing difficult domestic conditions at home because of the unemployment of her husband. Whilst her husband Charles did not previously have any objection to Betty’s staying with them, his attitude might now change because of her illness as well as straitened domestic circumstances. He has a history of alcohol misuse and domestic abuse and his employment redundancy, as well as annoyance with Matthew’s unemployment, drug abuse and household thievery may upset him enough to relapse into his old ways. Elizabeth could in the normal course of events expect assistance from her two children in discharging her caring and household duties. This however looks improbable because of Elisa’s plans to shift in with her boyfriend and Matthew’s disturbed emotional state and surreptitious misuse of drugs.

5. Assessment of Needs of Carers

Carers, like Elizabeth, perform vital and pivotal roles in the delivery of social care to individuals under their care, who are otherwise unable to manage, at home, without some form of support because of issues like disability, mental health needs, and illness or learning difficulties. Such carers have their own problems and needs that can easily be overlooked by the people around them. Elizabeth’s problems, as explained in the previous section, whilst not apparent are complex and real.

The previous New Labour government recognised these needs, and introduced significant legislation for the protection of the rights of carers, through the enactment of the Carers and Disabled Children Act, 2000, and the Carers (Equal Opportunities) Act, 2004. The Carers and Disabled Children Act provides carers with the rights for separate assessments of their needs, if they provide or intend to provide regular and substantial care to others (Department of Human Services, 2003, p 18).

The person under care is usually assessed for his or her needs under the provisions of the 1990 NHS and Community Care Act (Department of Human Services, 2003, p 18). This is the best way of helping, both the carer and the person in care. The services provided to people who are in care often helps to support carers through the provisioning of some of the care that is being given by carers. The Carers (Equal Opportunities) Act aims to assure that carers can avail of opportunities that others often take for granted (Department of Human Services, 2003, p 18).

Assessments of needs of carers take into account the need of carers to continue with their work, return to work and excess education as well as training or leisure activities (Department of Human Services, 2003, p 19). The provisions of UK law state that carers are entitled to assessment, when they provide, or intend to provide, regular and substantial care to individuals in need, and the person being cared for, can access services from the Community Mental Health Team or the Department of Community Services (Department of Human Services, 2003, p 19).

Such rights for assessment provide carers with (a) opportunities to reflect and discuss their own needs as carers, (b) share their caring experiences, (c) obtain recognition for their roles as carers, (d) obtain information and advice, (e) identify and discuss existing and potential difficulties, and (f) create contingency plans for circumstances that may not make it possible for them to continue in their caring roles (Stalker, 2003, p 83). Assessments are made to investigate the ways in which social and health care professionals and the existing infrastructure can help people in their caring roles by maintaining their health and wellbeing (Stalker, 2003, p 85).

Such assessments concern issues like different aspects of individual caring roles, availability of breaks from caring, health issues of carers, maintenance of relationships with the person being cared for and others in the family, caring for home, accommodation, finances, work, education and training, support, emergencies, alternative arrangements and the future. As is evident, existing policies aim to make the assessment of carers as holistic as possible (Stalker, 2003, p 87). Such assessments take up a whole range of issues like the time being taken for caring, understanding the condition of the person being cared for, and difficulties in providing suitable care (Stalker, 2003, p 88). Health, relationships, finances, and work, are very important components of the assessment process, and social and health care professionals aim to assess whether carers can be helped in their relationships with people important to them and in their health, their finances and their leisure activity (Department of Human Services, 2003, p 19).

Assessments for carers lead to personal discussions with them on the help required by them and the preparation of care plans that try to accommodate the wishes and constraints of carers to the maximum extent (Department of Human Services, 2003, p 21). The Department of Community Services can, after such assessment, provide help to both the carers and to the people who are being cared for. The persons who are being cared for can be helped with direct payments in order to allow them to purchase their own care, practical or personal care at home, respite care, adaptations and home equipment, and day care services (Department of Human Services, 2003, p 21). Carers can be helped with support in the form of (a) direct payments to help them to buy the support they need, (b) substitute care in order to enable them to take breaks from caring, (c) assistance with specific tasks and equipment to help them in their caring efforts, (d) advice and support in their role as carers and (e) short breaks (Department of Human Services, 2003, p 21). Elizabeth can ask for an assessment, discuss her various problems with the social worker and try to work out, not only the best available care plan for Betty, but the ways in which she can obtain help to perform her caring functions effectively, maintain her home, help her children, and continue a good relationship with her husband.

Conclusions

This essay takes up the analysis of the case study of Elizabeth, her mother Betty, and her immediate family, and uses Elizabeth’s particular circumstances, as a would be carer for her mother, for an examination of existing legislation, theory and practice in areas of social and health care for adults with disabilities and their carers.

Social work policies, practice, and theory for carers, as well as the persons they care for have evolved significantly over the last decade. Whilst assessment policies and intervention tools for adults with ailments or disabilities have been streamlined significantly in order to account for their individual needs and to empower them with independence in choosing their care and treatment plans, the importance of carers in the delivery of social work in a community care environment has come to the forefront.

Carers are acknowledged to be critically important in the delivery of care. Social and health workers are expected to work collaboratively and in partnership, with each other and with carers, for the planning and delivery of holistic care and health services that take care of the individual needs of service users. Carers are also entitled to assessment of their needs and various forms of assistance to make their caring duties more effective and less onerous.

Whilst Elizabeth’s responsibilities towards her mother and her family members are undoubtedly onerous, the social and health care policies of the country provide significant facilities that can help in making her responsibilities easier and her life more enriching and fulfilling.

Title: ‘Framework for practice, exploring social work theory.’

The case throws up several interconnected issues. The essay will examine these through the lens of two different theories, on one hand the ecological theory of human development by Bronfenbrenner (1979), and on the other hand, the social model of disability as it has been proposed by social work theorists over the last three decades (Oliver 1996). The case demands a decision to be made and theories at best have a contributory role to play in the decision making process (Banks 2006: 27).

A brief list of the issues involved in the case should heighten the awareness for the complexity of the case. First, there is the question about the levels of parental competence and capacity for effective parenting given that both parents suffer from learning disabilities. Second, social workers need to evaluate the chances that Stan and Cassie will be able to provide a stable parental environment that has significant advantages over that provided by Cassie’s parents Marian and Bill. There are further issues surrounding the rights of parents and the rights of the child which may be perceived as mutually exclusive. Additionally, social workers will have to assess the impact of changes in location and in providing a generally supportive and protective environment which a relocation of the child to her natural parents may precipitate.

Bronfenbrenner was concerned to construct a theory of human development that recognised the dynamic interconnectedness of environmental and biological factors. He envisaged this theory to ‘lie at the point of convergence among the disciplines of the biological, psychological. and social sciences’ (Bronfenbrenner 1979:13). In a later article he elaborated his notion of the role of external environments and called for a new focus of psychological research in human development. His theory, so he argued, was uniquely suited to map out the various factors that influence child development as they were encapsulated in the institution of the family (Bronfenbrenner 1986).

Bronfenbrenner suggests that there are three dimensions which represent the units of psychological inquiry. There is, firstly, what he calls the immediate environment of human engagements (mesosystems) in which the child as well as the parents ‘actively participate’ (Bronfenbrenner 1979: 25). It comprises the entire range of activities, roles and interpersonal relations that are ‘experienced by the developing person’ (Bronfenbrenner 1979: 22) and the interconnections amongst several of these patterned behavioural structures. Bronfenbrenner proposed that mesosystems are only the intermediate structures that connect the individual to the next highest level of environmental contexts. He calls this the exosystem which characteristically does ‘not involve the developing person as an active participant, but in which events occur that affect… what happens’( Bronfenbrenner 1979: 25) in the mesosystem.

Yet, how does this contribute to a more grounded and fairer decision in the given case? Bronfenbrenner’s main thesis, implicit in the model of ecological development, is that external events do have a direct impact on child development even if they seem to be initially non-quantifiable to an outside observer and within static models. Meso- exo- and chrono-systems influence the family context, of which the chronological and exogenous dimensions are most relevant in the given context of this case. In a detailed article in which he defends his ecological model of human development and supports it with research evidence, he singles out several aspects of family existence which determine directly and noticeably child development (Bronfenbrenner 1986). Amongst others he dwells on employment (maternal and paternal), schooling, community involvement and parental networks of assistance as well as peer group involvement and pressure for the child. We may usefully add case worker-parent relationships as well as the wider policy context in which social workers operate in assessing child care cases (Calder 2003).

Bronfenbrenner analyses research evidence within his theoretical framework and against the background of social work objectives such as educational and occupational achievement of children (in later life) as well as stability of living environments (Bronfenbrenner 1986: 726). Within the UK context that is framed by the DDA and the Code of Practice one would have to add the respect for individual human beings, justice and individual rights to lead a fulfilled life, self-determination, as well as the eradication of discrimination on grounds of ethnic differences or disability which has been part of the policy agenda of New Labour (Garrett 2003; Banks 2006).

Bronfenbrenner’s model now allows a social worker to theorise the following aspects in the adjudication of opposing claims to raise Rebecca. First, they may assess the chances that Cassie or Stan find/remain in employment which evidently has a positive impact on child development (Parsons 1982). Second they may take into account the resources of support that are available to Stan and Cassie within their own family as well as the wider community (Hall 1997, Bronfenbrenner 1986). Thirdly, they would like to assess the relevance of being raised by their biological parents or by the grandparents. And social workers may look at the wider family context in which crucial activities such as schooling and after school care provision may be provided when Rebecca lives either with Stan and Cassie or her grandparents. Additionally, they may consider that parents often provide role models for children and that this may positively influence the child’s self-esteem and confidence in social settings (Parsons 1982).

Furthermore, Bronfenbrenner’s theory allows social workers to conceptualise singular events as having a long term impact on child development. The ecological theory of human development urges assessors to consider the influence that disruptions to the normal life of a child, such as the relocation to Rebecca’s natural parents may have on her chances to future educational achievement (cf. also Olsen 2003). Bronfenbrenner subsumes these factors under the chrono-system which conceptualises sudden alterations in the child’s environment in its long term effects (Bronfenbrenner 1986). Bronfenbrenner argues that child development needs to be understood in a ‘life course perspective’ in which sequences of developmental transitions can have cumulative effects (Bronfenbrenner 1979).

Like all guiding theories of psychological development that are supposed to assist in decision making, however, Bronfenbrenner’s model fails to provide a ranking of values which could help determine the eventual outcome of decisions in the long run. He points in his work to convincing evidence that parental employment is a significant factor in normal child development, as well as the importance of social networks on which parents can rely for support in raising the child (Bronfenbrenner 1986). What his model cannot do is to contrast meaningfully these indisputably desirable factors of child development with the equally valuable wider goals of public policy such as reinstating parental rights to people with disabilities.

The social model of disability represented a major landmark in changing the theoretical assumptions that informed public attitudes to disabilities (Oliver 1992; Hedlund 2000). Articulated by social scientists such as Finckelstein in the 1970s, the social model was proposed in contradistinction to the medical model of disability which located the origin of disability in a lack of conformity to normal functioning (Oliver 1992). Theorists who challenged this model prevalent in disability theory and practice argued that there are two dimensions to disability. On one side there is a physical impairment, while on the other hand society is structured and organised in such a way as to disallow disabled people to carry out certain functions which they are certainly capable of (Oliver 1992; Olsen 2003; Morris 1993).

The social model thus places the onus of change on society which hitherto has prevented people from functioning to their full abilities. The critical edge of the social model is apparent (Hughes 1997). Disabled people certainly have the capacity to being a parent if society removes the obstacles to effective parenting that is has erected over centuries and provides the support to disabled parents that they are entitled to. Parental competence is something that should be assumed on the side of disabled parents rather than working on the presumption that a physical impairment renders disabled people incapable to exercising certain functions in society.

This model thus shifts the burden of proof to society and therefore stipulates that fundamental rights of individuals, such as having the chance of being a parent, can only be infringed if it can be shown that significant harm comes to the child through neglect, injury or considerably diminishing of the opportunities for the child. Once again, this must be judged not against the capacities of disabled parents to raise a child under circumstances of prevalent discrimination against them by society but under conditions of equality with able bodied persons (Morris 1993).

In this framework the tables are turned. Arguments in favour of Rebecca being raised by her grandparents must show a significant violation of her rights to have a fulfilled life when living with her biological parents or the chance that effective parenting is not possible in a household that comprises a father and mother both suffering from learning disabilities. Although the child’s welfare is paramount this principle cannot be assumed to contradict and ultimately to override the right to raise your own children simply because society may not provide an environment free from discrimination against disabled people which may impinge on the abilities of the Stan and Cassie to provide a stable and caring family setting.

There exists a comprehensive assessment framework for child welfare cases like this and one of the first principles is that the natural family is the best place in which children develop and grow up (Calder 2003). Doubts about the parenting competence and capacity of Stan and Cassie thus heavily draw on the medical model of disability which, within the policy context of the UK, has been rejected as a valid framework for assessments of disability care.

Both theories have advantages and disadvantages for the assessment process in the given case. Bronfenbrenner’s model allows case managers to take into account events that may considerably disrupt Rebecca’s life and, in the long run, impinge on her abilities to perform well in educational and vocational settings. In contrast, the social model of disability raises awareness for the basic principles of equity and fairness in making decisions in a social care context. It urges social workers to understand the particular situation of Stan and Cassie as determined to a large extent by society. Lack of resources and support in raising Rebecca would therefore have to be tackled by the social welfare system in contribution to placing both parents in a profoundly unjust situation in the first place.

While Bronfenbrenner’s theory may incline social workers more towards deciding in favour of Rebecca’s grandparents, the social model of disability reiterates strongly the need of the social welfare system to remove all obstacles to disabled parenting so that Stan and Cassie can raise their own child.

References

Banks, S. (2006). Ethics and Values in Social Work. Third Edition. Basingstoke: Palgrave

Bronfenbrenner, U. (1986). Ecology of the Family as a Context for Human Development: Research Perspectives. Developmental Psychology, 22, 6, 723-742

_______________ (1979). The Ecology of Human Development. Experiments by Nature and Design. Cambridge, Mass.: Harvard University Press

Garrett, P. M. (2003). Swimming with Dolphins: The Assessment Framework, New Labour and New Tools for Social Work with Children and Families. British Journal of Social Work, 33, 441-463

Hall, S. K. e.a. (1997). Caseworkers’ Perceptions of Protective Services Clients’ Parental Functioning: Toward an Ecological Integration. Children and Youth Services Review, 19, 3, 179-194

Hedlund, M. (2000). Disability as a Phenomenon: a discourse of social and biological understanding. Disability and Society, 15, 5, 765-780

Hughes, B. and Paterson, K. (1997). The Social Model of Disability and the Disappearing Body: towards a sociology of impairment. Disability and Society, 12, 3, 325-340

Morris, J. (1993). Independent Lives? Community Care and Disabled People. Basingstoke: McMillan

Oliver, M. (1996). Understanding Disability. From Theory to Practice. Basingstoke: MacMillan

Olsen, R. and Harriet Clarke (2003). Parenting and Disability. Disabled parents’ experiences of raising children. Bristol: The Policy Press

Parsons, J. E., Terry F. Adler and Caroline M. Kczala (1982). Socialisation of Achievement Attitudes and Beliefs: Parental Influences. Child Development, 53, 310-321

This essay will consist of four main parts. In part one; the essay will give a brief introduction and history to social work theories and methods. Moving forward the essay will look at the importance and value of theories and methods in relation to social work and how it informs practice. Throughout, reference will be made to the most popular theorist. Part two will consider how social work theories and methods can be successfully applied in the drug and alcohol field. Given an overview of this, it will be necessary to demonstrate how two social work methods are chosen, and applied, in the intervention of an example case study. Where applicable, contributions from service users will be used to bring more insight and balance to the essay. Part three will be an analysis of a social work method used in the example case study. From the method, the essay will explore and evaluate, in depth, the way it underpins anti-discriminatory practice.

Part four of this essay will conclude with a reflection on how the student has gained a valuable knowledge base throughout the module and assignment. This reflection will also show how the student will use this knowledge base in practice. No reflection would be complete without a concise look at how reflective practice can play a vital part of future social work practice.

An initial risk assessment was carried out by the referral worker, in the vein of a questioning model to identify possible risks and dangers to staff and other service users, however as discussed by Smale, Tuson and Statham (2000) taking a strengths based approach would allow referral workers and key workers to work as collaborators, facilitating service users to identify needs and outcomes. During intervention with Mr AB sessions, in the form of an exchange model, were carried out endeavoring that further assessment became a process of dialogue rather than just a fact finding mission with the exchanging of ideas and information. This approach is compatible with the framework of task centered practice, appropriate with this intervention (Ford & Postle, 2000)

Key work sessions started with Mr AB and from the outset the process was explained and the objectives made clear, it was also explained to Mr AB that due to company policies, and his terms and conditions of stay in the night shelter, these sessions were time limited so a positive ending to the professional relationship was hoped for. It was also considered that this approach would reduce the power imbalance in the relationship; however the power will never be fully balanced when working within legislative and multi agency procedures (Parker & Bradley, 2008) However as stated by Dalymple & Burke (2000) it is necessary to endeavour to empower rather then disempowere with the need to balance power relationships. In this instance this can be evidenced by the written agreements in the form of the assessment and support plan

. Weekly key worker sessions agreed to by Mr AB provided further support as required and opportunity to review whether desired outcomes were being achieved, as in the National Occupational Standards Key Role and outlined by Supporting People and the agency policy and procedures (ODPM, 2004). (Walker & Beckett, 2007). It is also necessary to not only collect information as part of the key worker sessions but to balance findings in order to produce an overall analysis of risks and need (Walker & Beckett, 2007).

Throughout the assessment procedure it is necessary to be aware of the influences of ethics, power, and professionalism along with anti- oppressive practice. Middleton (1997) states that in order to empower, it is

necessary to respect the individual, enhance their strengths and coping abilities. It is therefore vital that key worker sessions be conducted with a non judgmental attitude. While acknowledging the key worker has different values and status to Mr AB showing acceptance to people in all situations can be difficult however as stated in by Carl Rogers (1951, 1961) the human psychologist the person should show they are genuine, and portray empathy and warmth.

It become apparent as key worker sessions continued that Mr AB was reluctant to engage with this service as he was in pre contemplation (Denial) (Prowchaska & Di Clamentis 1996). However, the threat of eviction if he did not adhere to his conditions of stay was a considerable worry to Mr AB as was the thought of becoming homeless and having to sleep rough. It is very important to remember that as key working intervenes in the lives of vulnerable people these people have the right not to be victims of untested and possible harmful interventions. This confirms the need of understanding how theory relates to practice and learning from research and evidence based practice (Rutter, 2006)

This confirms Maslow (1970) who shows in his hierarchy of need, that before higher needs can be met basic needs are required to be in place.

Therefore to allow Mr AB to move forward in his life he requires support to start a procces to put these needs in place (Giddens, 2006).

Mr AB during his key work sessions discussed his feelings and it was felt by him that no opportunities were open to him and that he was struggling against a society that was oppressive and keeping him down. It was pointed out to Mr AB that his position in society was that of a lifestyle choice, that society is changing to support people to progress and that choices were open to him (Giddens, 2006)

). It is however necessary to acknowledge as stated by Bronfenbrenner (1979) that different levels of society will influence the individuals life course. Also stated by Jack and Jack (2000) individuals are products of their environment and can never be fully understood separately from one another.

As stated by Crawford & Walker (2005) transitions have the potential to be stressful even those that are planned and welcomed. As the intervention process progressed and the support plan auctioned positive outcomes including building on self confidence which led to Mr AB seeking and securing part time employment

Doel (1994) states that service user motivation may weaken and it was therefore important to continue supporting and encouraging Mr AB’S interest and commitment to work. By adopting a model that worked with service users strengths helped to ensure that an anti oppressive focus was maintained.

. Using task centered practice as discussed by Ford & Postle (2009) goals were set which would support the researching and attending of courses which provide basic computer skills, with the attainment of each goal aimed to promote self-confidence and further motivation (Rooney & Larsen, 1997).

Subsequently in this instance the planned ending and outcomes have not been realized, with events determining an alternate course of action (Walker & Beckett, 2007).

The first part of this essay will lookA at the relationship between social work methods and substance abuse

Denial can also be explained as a defence mechanism whichA is establishedA by aA person when there is aA dangerA that heA or she will become aware of or actA onA unconsciousA primitive impulses that areA unacceptableA (Freud, 1967).

). Knatz (1999) states that denial is a defense mechanism by which individuals are able to cope with unpleasant realities.

Be aware that the term ‘alcoholism’ implies disease/condition.A IfA youA use the term alcoholism in assignments, be sure toA establishA that youA meanA to say ‘alcoholism’ and not ‘alcohol dependency’

). IfA youA useA generalA references around statistics on alcohol, try to refer to British statistics, you could use National Treatment Agency website reports, Office of National Statistics (ONS), NICE guidelines on treatment of alcoholA dependencyA for British/UK data, all available on line

Let’sA giveA theA wordA relationshipA a different definition from the dictionaries, forA unlocking theA meaningA of theA wordA often leadsA to greater understanding.A -A tooA colloquial, would be better to state, “The word ‘relationship’ has varied definitions from different sources of literature.”

Conflict is aA partA of most every interpersonal relationship.A ThereforeA it could be stated that managing conflict,A is importantA if the relationship is to beA long-lastingA and rewarding.A Jason and Beth have numerous conflicts and barriers which prevent them from having a more effective relationship.A Interpersonal relationships and communication (is a two-way street), too colloquial, say ‘have mutuality’

Beth and Jason seemA to rarely communicateA between each other, aA furtherA factor which appears to contribute to the disintegration of their relationship.

It can give rise to greater anxiety, depression,A insomnia, and general distress, reducedA self-esteemA andA confidence, and sometimes disrupted family relationsA ((Fryer,1992;Jahoda,1982).

Bibliography

Barber, G (2002) Social work with addiction.A Palgrave Macmillan, Hampshire

Berger, G. (1993), Alcoholism and theA family.A New York: Franklin Watts

Conville, Richard (1998) The meaning of “relationship” in interpersonal communication.A Praeger Publications.A Califonia.

Heider, Fritz (1958) The Psychology of Interpersonal Relations.A LawrenceA ErlbaumA associates

Jahoda, M (1982) Employment and Unemployment (The Psychology of Social Issues).A Cambridge University Press

Knatz, H (1999) Getting on Oxford Books.Oxford

Levinger, G. (1983).A Development and change.A Freeman and Company.San Francisco.

Manstead, Antony S. R. and Miles Hewstone (1996).A The Blackwell Encyclopedia of Social Psychology.A Blackwell Publishing, Oxford.

Maslow, Abraham.(1954) Motivation and personality.A Harper and Row, New York.

Steele, CM (1985) TheA psychologyA of drunken excess.A London Press, London.

West, Robert (2001) TheA theoryA of addiction.A Blackwell publishing, Oxford.

The principle areas of social , administration and social workstudies include health issues and administration, employment services,community care, housing needs, crime prevention, disability checks,unemployment concerns, mental health, old age as well as social issues of raceor gender and poverty (Drake, 2001).

Social work practice focuses on dealing with the problems of service users. The maintenance and improvement of their social, physical, and mental states is often dependent upon the effectiveness of social work intervention. (Miller, 2005)

A Providing appropriatesocial services is an important target of social care policy and social policyin general (Adams, 2003).

Welfare is general well being of individualsand when provided by the State, refers to a form of social security or social protectionthat aims to protect people from conditions such as sickness, ill health,diseases and poverty (Malin et al 2002)

Social work practice has, over the years, become integral to Britain’s working life and current estimates put the number of active social workers in the country at significantly more than one million. (Parrott, 2002)

Social work practice focuses on dealing with the problems of service users. The maintenance and improvement of their social, physical, and mental states is often dependent upon the effectiveness of social work intervention. (Miller, 2005) Users of social work services are largely economically and/or socially disadvantaged, and the vulnerabilities, which arise from these circumstances, frequently contribute to the nature of their relationships with service providers. (Miller, 2005) Social work makes use of a broad range of knowledge and incorporates information obtained from several disciplines; it empowers social workers in practice to use their acquired knowledge and skills first to engage service users and then to bring about positive changes in undesirable emotional states and behavioural attitudes, or in positions of social disempowerment. (Miller, 2005)

A Social work makes use of a range of skills, methods, and actions that are aligned to its holistic concentration on individuals and their environments. (Harris, 2002)

Counselling, whilst being a catch-all term, used for describing of various professions, is, an important component of social work practice. (Rowland, 1993)

Specific counselling approaches have been developed to assist people with problems related to substance abuse, gluttony and for giving up smoking. (Pease & Fook, 1999) In some areas of counselling, which deal with addiction, for example, with users of hard drugs, counsellors engaged in social work practice, function side by side, with sets of legal restrictions and moral issues. (Pease & Fook, 1999)A