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Literature reviewed for this study has included articles from academic journals and textbooks, government policy, guidance and briefings and other guidance produced by non-statutory organisations such as the National Care Advisory Service. Key themes within the literature reviewed have included the experiences of young people in care that contribute to their leaving care experiences, the effectiveness of services aimed at care leavers, social work practice with care leavers and the views of young people themselves on how prepared they feel when leaving the care system.

Background

Studies about young people leaving care point to the different life experiences that many care leavers have in contrast to their peers and argue that these have an impact on how prepared young people are to leave care. Whilst in the care system they face disadvantage plus a greater risk of social exclusion and poor outcomes such as low educational achievement and homelessness, unemployment and mental health problems (Stein et al 2000, Courtney et al 2000). Particular groups of care leavers can also face specific types of discrimination and disadvantage. Black and ethnic minority care leavers face identity problems due to a lack of contact with family and community (Barn et al 2005), young disabled people in care may encounter problems with poor planning in relation to their housing in the transition period from care (Priestly et al 2003) and young women in care are at greater risk of teenage pregnancy and the associated risks of poor outcomes (DfES 2006). Jones (2002) noted significant qualitative differences between young parents who have family support and those living away from home.

The life history of looked after children also plays a part in their preparation to leave care. Many looked after children can have complex needs that are related to their earlier childhood experiences. These experiences can impact on how they settle into their looked after placements and the level of educational achievement that they reach at school. Their educational achievements will affect how they manage in life after care. Looked after children often have a number of social, emotional or behavioural difficulties such as challenging behaviour, low self-esteem and poor concentration skills, which again can affect their transitions into adulthood (Soan and Lee 2010).

Transition

Everson-Hock et al (2009) attempted to analyse the effectiveness of transition to adulthood support services (TSS’s) to leaving care and their impact on outcomes including education, employment, substance misuse, criminal and offending behaviour, parenthood, housing and homelessness and health (Everson-Hock et al, 2009). The study, based largely on US quantitative studies found that young people leaving care were more likely to complete compulsory education if they received TSS’s; that there was moderate evidence that TSS’s improved employment prospects and; moderate evidence that TSS’s lessened the likelihood of negative impacts from substance misuse, offending behaviour, homelessness or early parenthood (Everson-Hock et al 2009). Whilst accepting that US based studies could not simply be transferred to UK experiences, the study conclude that “TSS’s do have a beneficial effect on the adult outcomes of looked after young people, in particular for education, employment, parenthood and housing” (Everson-Hock et al 2009, p52).

A study in Scotland identified planning transition to adulthood as important and noted that leaving care at an early age can be a concern. Moving from residential care to supported carers and then allowing young people to move in a planned manner that allows them a say in when they leave care is also important (Kendrick 2008). This study also identified failures by local authorities to make adequate preparations. Many care leavers did not receive a programme of preparation, particularly those in foster homes or being cared for at home. It was also identified that 60% of the young people surveyed had not received a formal leaving care review (Kendrick 2008). Evidence elsewhere also suggests that care leavers are often hurried out of care with the Director of the Office for Children’s Rights commenting “a common theme among those young people consulted was in their having remarkably short periods of notice to leave, together with their sheer lack of preparation to do so”(Morgan and Lindsay 2006).

Stein found that since the 1990’s there has been more of a focus on outcome studies (Stein, 2006). Nonetheless, the wide variation in both research and the collection of statistical outcome data by the government has been highlighted by international leaving care work (Stein, 2006). Likewise Simon and Own (2006 citied in ibid) stated that the information base for those in care and leaving care has immensely enhanced since 1998. However, they have also found three existing weaknesses. Firstly, the dates mainly have short follow up times. Secondly they focus only a small parameter of young people’s lives. And finally, they are mainly available for England.

Stein differentiates that the transition itself, is crucial to getting young people ready for the ‘risk’ of society, by giving them the time for independence, discovering, thinking, risk taking and character exploration (Stein, 2006). He says that coming across danger is possible through chance, so in order to identify valuable and harmful effects, by the revelation to these problematic situations, it allows for opportunities emerge for both problem-resolving skills and emotional coping skills are provided (Newman and Blackburn, 2002, cited in Stein ibid). Stein’s study analysis significantly shows that care leavers as a group are more likely to be socially excluded and that there are still huge gaps in research knowledge, particularly nothing in terms of using experimental and quasi-experimental methods (Stein, 2006). Therefore, there is a high demand for the usage of cohort experiments in giving a refined understanding of risk and protective elements over time. Furthermore, he openly shows that there is also a high demand to develop connections between empirical and theoretical work, this is because most of the studies do not involve research from theory in regards to context, theoretical investigation and theory making.

In view of the concerns and increasing awareness of the poor outcomes of young people leaving the care system, the Government produced a consultation paper (Care Matters: Transforming the Lives of Children and Young People in Care 2007). Care Matters (2006) detailed a number of government initiatives to assist the transition into adulthood for care leavers. Included in the proposals were a pilot scheme to allow young people to live with foster families until they were 21; establishment of a capital investment fund to improve supported housing options; top-ups of Child Trust funds for young people in care and national bursaries for young people in care that go onto higher education. One of the key principles of Care Matters echoed research elsewhere into transition – that young people should enter adult life when they are ready rather than when a local authority social worker decides that they should do so. Most young people are supported by their families until their early twenties yet those in care often lack that sense of security – they should expect no less from a corporate parent in terms of help in the transition to adulthood than their peers who live with parents (Care Matters 2006).

Rainer (2007:2) states ‘The DfES Green Paper Care Matters, and the Next Steps document, set out a range of extremely promising proposals to improve services to young people as they move through and out of the care system. However, there is evidence that when it comes to housing support care leavers are not yet consistently receiving the service they are entitled to under current legislation’. His reports analysed the scale of the issues and highlights the terrible conditions in which some care leavers are expected to set up their first home. Similarly, Broad (2005 cited in Stein, 2006) found that for young parents, young accompanied asylum and refugee seekers and young people remanded, their services were mainly described as staying the same since the introduction of the Children Leaving Care Act 2000.

The DH (Department of Health, 2003) found that some young people are drawn to the concept of independence and will have a strong drive to leave, however that urge is driven by various factors, these including a placement breakdown, the limited placements available, issues with challenging behaviour management, traditional expectations and tight transitions. DH (ibid) realises that inconsistent planning for adulthood is common for young care leavers, furthermore, the specific needs have not been consistently given to certain groups like ethnic minorities or single parent. However, having said that, some young people do have positive experiences whereas some experience hardships, this sometimes even included high risk of homelessness. Stein (2006) debated that a holistic approach needs to be considered when preparation is made for leaving care, that it each element needs equal amount of importance, practical skills are equal to emotional wellbeing as well being equal to interpersonal skills.

Housing

Support with accommodation is also identified as an important issue for care leavers and they should have access to appropriate housing options. For many leaving residential care or foster placements, issues such as coping with finances, shopping and self-care were challenging and practical support in developing life skills is something that will help better prepare care leavers for adulthood (Kendrick 2008). The National Care Advisory Service (NCAS) also stresses that suitable and stable accommodation for young people preparing to leave care will enable them to develop their skills and options in other areas such as education, employment and social networking (NCAS 2009). NCAS identified the importance of pathway planning and highlighted an example of good practice in Barnsley where pathway assessments have a specific section relating to accommodation which considers things such as a young person’s current arrangements; their practical knowledge; awareness of tenancy rights and responsibility to be a good neighbour; budgeting skills and the care leavers’ ability to access housing advice (NCAS 2009).

Care matters (2006) highlighted the negative consequences of frequent changes in foster care. In 2005/6, of 23,000 children under 16 looked after for more than 2.5 years; 65% had been living in the same placement for at least two years or were placed for adoption. While this is 1% higher than the previous year, unless the rate increases dramatically the government is unlikely to achieve their target of 80% by 2008 and currently 12% of children in care still experience 3 or more placements (Care matters, 2006). ‘Care Matters’ made a number of proposals about commissioning; increasing choice and training and support for foster carers and residential workers. While these are all positive steps they will not necessarily address the issues of shortfall in foster carers and the poor status of residential work as a positive option for staff. (Barnardos,2007,p4) ref:bernardos.org.uk

Lack of stability was also highlighted as a barrier to social bonding and support, emotional well-being, and educational success. The social worker would be responsible for the budget of each child. Care plans need to be revised. In interview with children in care, “one placement” was top on their list of what they desired (Morgan, 2007).

Employment, Education and Training

The educational under achievement of children in care up to year 11 is well researched and documented, but despite the long standing recognition of this issue there appears to have been no substantial improvement in recent years. ‘Care Matters’ recognises the importance of stability in education, particularly in years 10 and 11, but does not go far enough in outlining a school’s responsibilities to ensure looked after children are not denied access to their education through temporary or permanent exclusion. Given looked after children are disproportionately more likely to have their education disrupted through exclusion we are concerned about the degree of discretion in individual schools as to the interpretation of ‘last resort’. (Barnardos,2007,p7). While 56 percent of all children attained 5 good GCSEs of A to C in 2005, only 11 percent of children in care attained these levels (DfES, 2006); this level was 12 percent in 2006 (DfES, 2007).

A study of care leavers in the UK found that only 23 per cent were in full-time or part-time education (Everson-Hock 2009). The age that young people leave care can be a factor that leaves them ill-prepared for independent living. Many do so between the ages of 16 and 17, at a time when they also manage the move from education into training, work or unemployment. Their peers go through this transition most often whilst living at home with family support and the advantages of a stable home environment (Jones 2002).

The importance of attempting to achieve positive educational outcomes is stressed by a number of commentators as crucial in effective preparation for leaving care. Newman and Blackburn (2002) and Sinclair et al (2005) emphasise that having positive experiences at school and reaching an adequate level of educational achievement is strongly associated with resilience in young people in care and in getting them ready for adult life.

From a wider perspective, it makes sense for local and central government to invest in the future of care leavers and in England there is evidence in recent years of a change in philosophy so that supporting children and young people that are at risk of poor outcome is desirable so that that can maximise their potential in future (Stein 2008). Providing education and training focussed on future employment is crucial to this.

Health

Health services have an important role in supporting young people leaving care. Low levels of care leavers report seeing health professionals and high number report engaging in unhealthy behaviours such as smoking (Everson-Hock 2009). As part of effective partnership working, Directors of Children’s Services should ensure that health services, particularly mental health services are on hand to work with social workers and accommodation providers to assist care leavers (NCAS 2009). Young people with mental health needs especially might need help in locating suitable places to live. A further important health issue is for social workers to help young people to understand the importance of healthy living and have access to suitable cooking facilities (NCAS 2009).

Unfortunately, young care leavers are at a disadvantage here. For many 16-17 year olds, parents take on responsibility for arranging medical consultations, promoting a balanced diet, identifying ill health and discussing the dangers of smoking and drinking – local authorities as a corporate parent often take a less proactive role in this area (McLeod and Bywaters 2000). Added to the poor housing and deprivation that many care leavers experience and a consistent picture often emerges of malnutrition, infections, mental illness, drug use and susceptibility to physical attack (McLeod and Bywaters).

Being a young parent can have a great impact on people as they leave care. The prevalence of teenage pregnancy among looked after girls in England is around three times higher than that their peers under 18 in England (DfES 2006) and a study carried out by the Teenage Pregnancy Unit (2001) found that a quarter of looked after young people had a child by the age of 16 and nearly half had a baby within 24 months of leaving care. These young people in general are exposed to a number of risk factors associated with teenage pregnancies, including educational failure, socio-economic deprivation and involvement in youth offending (Kirton 2009), all of which have a negative impact on their preparation for independent living after care.

Quantitative research into young mothers leaving care was completed by Maxwell et al (2011). The studied acknowledged that the likelihood of pregnancy increases significantly in care leavers and used interviews and diaries kept by young mothers to try and identify how they were prepared to leave care as a parent. The study identified that young women wanted to provide a better childhood than they had experienced to their own baby and found motherhood as something that helped build a positive image (Maxwell et al 2011). Again, the research highlighted that the earlier lives of care leavers and the subsequent low esteem that they have can be a significant hurdle in preparing for life outside of the care system

Care matters (2006) propose that local authorities provide free access to sports and clubs, as well as opportunities for personal development and volunteering. The Healthy Care Programme supports this pledge, stating, “This supports the National Healthy Care Standard entitlement for looked after children to have opportunities to develop personal and social skills, talents and abilities and to spend time in freely chosen play, cultural and leisure activities” (DfES, 2006b, p. 3). More than 50 percent of the children who responded to the Green Paper reported having problems gaining access to such activities. (DfES, 2007).156 children in care rated the government’s ideas for what councils should promise to them. “A right to do leisure and sports activities” and “a chance to do a volunteering activity” were fifth and sixth on their list, respectively (Morgan, 2007, p. 33).

Support

Biehal et al (1995) also studied the impact of different leaving care services on the young people involved. This study found that specialist leaving care services were most likely to have an impact on those who came into care from the most disadvantaged starting point. Biehal et al found that many young people were unprepared to leave care, but that this could be affected by their earlier family relationships and housing experiences. Like other studies, it was identified that the best leaving care services should include making a contribution to improving accommodation options and helping young care leavers with life skills such as budgeting, negotiating and self-care (Biehal et al 1995).

Stein (2008) examined how to promote the resilience of young people in care and better preparation for adulthood, suggesting that this could be better achieved through provision of stability in care, a holistic preparation for transition and the provision of comprehensive services throughout their time in care which promoted a positive sense of identity. Stein also developed a theory that carer leaves fall into three distinct groups which can be shaped by their level of preparation to leave care – young people “moving on”, “survivors” and “victims” (Stein 2008).

Qualitative research into the views of young people on their preparations to leave care was undertaken by Morgan and Lindsay (2006). This identified that the assistance they were given in preparing to leave care varied greatly. Some identified good practice such as young people preparing to leave care gradually by spending a couple of days a week living independently in their new accommodation, and the rest of the week back in care. Support to learn practical skills such as cooking, doing laundry and housework was also seen as important but support in helping them learn these skills varied.

Morgan and Lindsay also identified that practical help received from local authorities when leaving care was often lacking. Only 52% received support for education and accommodation, 53% were offered continued support from social services and only 33% offered practical help with training or benefits and grants (Morgan and Lindsay 2006).

There is evidence that many young people feel largely unprepared for leaving care. Morgan and Lindsay’s study identified extremely short notice periods given to young people for leaving care, or young people being forced to leave care at a time when they did not feel ready to do so. In some of the worst examples, young people were given only 24 hours to leave a placement, they had no plan for the future, they had no ‘home-keeping’ skills and little choices as to where they would move onto (Morgan and Lindsay 2006). Many saw a leaving care worker as important but some saw their leaving care worker as unhelpful and unsympathetic.

Young people were able to identify what they wanted from leaving care workers – often simple things such as to be there to support but not to interfere, and to offer support in finding adequate accommodation. Again, a key point is that provision of effective leaving care support appears to vary greatly – Morgan and Lindsay summarise “the overall impression conveyed was distinctly that of a lottery, with some young people enjoying excellent preparation and support, whilst others received little or no help at all” (Morgan and Lindsay 2006, p22).

Mentoring groups or peer mentors – i.e. former care leavers – to assist care leavers have also been identified as useful in preparing young people to live independently (Clayden and Stein 2005). Young people leaving care can need support from different sources at different times and a range of support networks can be useful in helping them overcome the disadvantages that they face.

KEY FINDINGS

The key findings from the literature review have been firstly

aˆ?The accelerated process and young age of care leavers as opposed to other peers is a result of push factor such as placement breakdown, limitations in the supply of placements, problems in managing challenging behaviour, traditional expectations and personal choice.

aˆ? Limited housing resources and the unsuitable allocation and condition of various accommodation provisions.

aˆ? LA as a corporate parent take a less proactive role compared to the parents of young people who are not in care in regards to their health which continue patterns of instability were particularly vulnerable to ‘poor’ housing outcomes and were more likely to experience post care instability and homelessness.

aˆ? Young people who have left care are over-represented amongst young homeless people, including those who are sleeping rough.

aˆ? Entering the care system can prove to be highly problematic by disrupting a young person’s education progress due to placements complexities and the personal negative experiences of young people pre and post entering care.

aˆ? The lack of practical experiences and skills present during the transitions to independence presented as one of the main difficulties in conjunction with the issues of budgeting and housing as a main factor effecting a successful and stable transition.

aˆ? The research reviewed emphasised that young people would prefer and benefit from gaining support and experience in undertaking practical tasks prior to leaving care.

It is important to note that that the provision of leaving care services across the UK varies and young people in different areas will have different experiences and levels of support.

Most commentators agree that the experiences of young people both before they come into care and whilst in care can have an impact years later when they are preparing to leave care and that effective leaving care services are important in preparing care leavers for independent living. Support with accommodation emerges as one of the most effective ways to prepare young people to leave care along with provision of help and information on basic life skills such as budgeting, organisation and self-care.

There is certainly room for further research in this area, particularly based on the experiences of UK care leavers – at this point there is relatively little qualitative research into how young people feel about their preparations to leave care. The period before people leave care allows is an important period where carers and statutory organisations can make a positive impact on their lives – fully understanding the impact of TSS’s can be a valuable tool in delivering better outcomes.

What is the difference between helping service users and being a professional Social Worker?

Social work in UK has been a regulated profession since 2005 and the title ‘Social worker’ is protected by its regulatory body (GSCC) that entitles only those professionally qualified to use this term to describe themselves. Social work professionals are held accountable to the law, their employers, service users and to the GSCC code of ethics. They are guided by principles which make up an ethical framework these can sometimes prevent a social worker to do what service users may see as helping. More than helping, social work is seen as enabling people to resolve their problems. Therefore, working with them to develop skills required to overcome the problem, rather than providing a quick fix. The skills of empowerment, advocacy and user involvement are needed in professional practice so the social worker would be able to exercise their duty in line with the professional code of practice and conduct. This would help to limit bad practices while also promoting moral and job satisfaction.

Firstly, this essay will give a brief definition of what is social work; it will then go on to examine the key principles in social work practice. The role of a social worker, their responsibilities and the ethical framework will be described in some detail. It will then conclude with an examination on the significance in working in partnership. Lastly, I will look into the issues of diversity along with AOP and ADP. Finally, this essay will look on the significance of service user and carer experiences and perspectives along with a brief conclusion.

Social work is defined by the International Federation of Social Workers (IFSW) as a ‘profession that promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work’ (IFSW, 2000).

This definition of Social work shows that the duties of social work practitioners are linked with principles of empowerment, human right and social justice. Social work’s main duty is ‘to enable all people to develop their full potential, enrich their lives, and prevent dysfunction’ (IFSW, 2000). They will act as advocates on behalf of the people they serve and their duty is focused on problem solving also bringing about change. ‘Social work is an interrelated system of values, theory and practice’ (IFSW, 2000).

Social work is also a form of social control, ‘this because it involves promoting and protecting the welfare of not only the individual but also the wider community this dual responsibility often causes conflicts and tensions’, (Thompson, 2009, p.3). Social workers come to contact with individuals from many different backgrounds. Their aim is to help people overcome difficulties and live a successful life, while there are times where practitioners are there to support people in accepting a situation that cannot be changed (e.g. terminal illness, etc.). What differs social work from other professionals is the complexity and the variety of the roles in which they are involved.

The need to involve service users wherever possible and working closely with other professionals is required by a number of legislations, this makes the practice in a way easier, as it rules out misunderstandings or the possibility of missing out on important information. Individuals and other professionals involved in the process of working in partnership have to be involved during each stage of intervention. Partnership working is seen as a highly skilled activity, ‘it requires the ability to communicate and engage, assess and plan, to be sensitive and observant, and so on’, (Thompson, 2009, p.118).

Social work practitioners are expected to take regular training in order to expand their knowledge as the result of continuous developments in policies, theories etc. “Social work is an evolving profession, constantly responding to new policy aspirations, expanding knowledge and rising public aspirations.” (GSCC, 2008, p.10).

Trevithick (2009) categirizes knowledge under three headings that overlap and are linked together:

Theoretical – borrowed theories, analyse theories (purpose of SW), practice theories/approaches
Factual – law/legislation, social policy, etc.
Practice/practical/personal – acquisitioned, used, created knowledge.
Trevithick (2009, p.25-43).

The advantage of this framework would be that it gives directions where there is a need to further expand your knowledge. Social work profession requires a breadth and in depth knowledge base, however, ‘the knowledge base of the caring profession is not appreciated by the general public ….. partly due to the assumptions about the caring professionals being ‘common sense’ and requiring little or no specialist knowledge or skills’, (Thompson, 2009, p.11)

Social work professionals are guided by a set of values and a Code of Practice. Practice ethics are based on these values which aim to inform social workers intervention with service users. The code of practice set up by the general social care council (GSCC) offers an ethical framework to its practitioners’, this aims to maintain a standard of conduct for both employers and employees.

The social work code of conduct is designed to serve social workers when practicing their profession, it contains ethical principles which will underpin the approach taken in practice. ‘The professional code of conduct serves many different functions such as; guidance, regulation, discipline, protection, information, proclamation, negotiation,’ (Values and ethics in practice, p.127). It is very helpful to social workers as it offers guidelines as to what is expected from them as professionals.

Social workers have to be familiar with their value base and abide to them in day to day work. They have to put into practice the understanding of the values when practicing their profession. Ethical awareness is an essential part of the social work practices, a social worker’s ability to act ethically is vital when aiming to provide a high standard of services. ‘The code of conduct, ideally, offers the prospect, tantalizing if theoretical, of resolving value and ethical issues in social work’ (Adams et al. 2009, p.37). The day to day practice and the uncertainty which social workers can sometimes face would carry ethical dilemmas which will challenge their practice, ‘ethical dilemmas occur when the social worker has a choice between two different courses of action that can be both morally right but only one choice can be made, or when either course of action if chosen, would lead to the compromise of values or principles, (Purtilo, 1993),’ (Values and ethics in practice, p.117 ). Ethics and values can also intersect ‘when values or moral principles are in conflict, which poses a challenge about what to do, then an ethical problem has occurred, (Purtilo, 1993),'(Values and ethics in practice, p.117 ).

The traditional values developed by Biestek (1961), outlined the principles which formed the fundamentals of the social work practice. These principles were made up of seven points and act as an underlying framework to intervention with service users.

Individualisation;
Non-judgmental attitude;
Acceptance;
Purposeful expression of feelings;
Controlled emotional involvement;
User self-determination;
Confidentiality.
(Crawford and Walke, 2008, p.6)

These principles are essential to social work practice as they comply with what social work stands for, human right and social justice. Individuality for example gives the right to the service users to be free from bias and prejudice, therefore the social worker should avoid labels and stereotyping. Non-judgmental attitude would assure the situations are examined without bias, requiring social workers to avoid personal feelings and prejudices. Acceptance implies the expression of genuine concern, acknowledging the service users point of view, mutual respect, etc. Social workers have to give the opportunity to service users to purposefully express their feelings. In this way they will feel empowered and respected. Controlled emotional involvement requires the social worker to express their feelings but however in a controlled way, they should not come across as cold or disinterested this should be guided by knowledge and purpose, at the same time avoiding to over identify with the service user. Self determination is a principle that places importance in recognising the service user’s rights and needs to autonomy, right of decision making and the right of choice. Confidentiality is a right that service users are entitled to; this implies that consent must be taken from the service users before the information can be disclosed, unless there is a situation where other people may be at risk.

In social work there is a wide variety of theories and methods that help social workers intervene, the theory or method chosen will influence the language used and will shape the relationship between the social worker and service user. Language is the wealth of communication, it can open or close doors but also it can influence actions. ‘Language plays a big part of power relations that have to be unpacked and understood for empowerment to occur, (Dominelli, 2002)’ (Adams et al. 2009, p.175). Being a good communicator is essential to social work practice as communications skills are essential to building a relationship and also interviewing. ‘Lishman (1994) identifies four types of communicating: symbolic, verbal, nonverbal and written’, any type of communication is essential to all professional practices therefore social workers have to ‘simultaneously ask good questions, listen actively, convey information, exercise scepticism and reflect on interaction’, Adams et al (2009, p.176-178).

” Social work professionals are expected to work in partnership with people to find the solutions and achieve the outcomes they want, and to collaborate with other agencies and disciplines to ensure support is delivered in a coordinated way.” (GSCC, 2008, p.6)

One of the principles in building an effective relationship will be honesty (e.g. explaining the reason for intervention). Exercising mutual respect should be another fundamental principle in relationship building, keeping appointments or being on time is a very simple example but however very important. Respect should be exercised even in a case of different personal values as social workers are not there to judge but to help. Consistency is another principle that the service users appreciate, as it shows concern about their situation and understanding. Ethical behavior is essential, because as a social worker there is the duty to respect the code of conduct that social work abides to. Explaining issues that might arise during the intervention and making things clear before work is commenced can rule out later misunderstandings. All these principles will contribute to underpin the trust aspect of the relationship and make the intervention more effective.

Social workers always try to involve service users as much as possible in every aspect of their intervention, however, this is not always possible. There are times where social workers are requested to reach decisions and make judgments so that they can protect vulnerable people or in order to implement control. Social workers have legal powers which they would exercise to protect vulnerable people who may be at risk, this however may sometimes conflict with what other people involved wish for.

Anti-oppressive practice is a frame work that aims to incorporate the social work value base, it is a response to the continual lobbying by the oppressed individuals. Professionals providing anti-oppressive services redefine professionalism within an open power sharing framework and precise human rights-based value systems. ‘Practicing equality involves practitioners in valuing ‘difference’ in life-styles and identity instead of demanding uniformity’ (Adams et al. 2009, p.55).

Power imbalance is an important issue that should be addressed when working in an anti-oppressive way. The power that the social worker holds can be used both ways, constructively – aiming to empower the service user, but also social workers can abuse this power therefore reinforcing the power imbalance and oppression. However there is always the risk of being oppressive even though not intentionally, e.g. Through ‘naivety or ignorance, reinforcing stereotypes, inappropriate language, using power inappropriately and by acting as an ‘expert’, Thompson (2009, p.158-159). Social workers are involved in many complex interactions, ‘we have to recognize the potential for social work to do harm as well as good’ (Thompson, 2009, p.80). When looking at how inequalities and oppression manifest themselves, the PCS (Thompson, 1996) would be helpful.

Service user and carer involvement and participation can be challenging and also rewarding. However it is very valuable to social work practice, service users and carers can get involved in their own package of services or in a strategic planning and service development. ‘Users’ views of the quality of services and their participation in providing regular feedback on all aspects of social work are therefore an essential part of good practice’,(Warren, 2009, p.15). Service users’ and carers’ perspectives on services provided, have been sought by many researches for and also evaluators. However, in the recent years there has been a distribution of power which has resulted in the participation of the service users but also giving them the power to drive the research project.

In conclusion, social work is a challenging profession which continually challenges the boundaries of its practitioners, whether on a personal, cultural or professional level. Ethics, morals and values are all essential parts of the profession practice. Social workers have to practice in e reflective way, while recognizing diversities which they come across in a daily basis. ‘A social work practice that takes no account of existing inequalities runs the risk of: failing to recognize important factors in someone’s live, causing tension, reinforcing the negative effects of discrimination’ (Thompson, 2009, p.26).

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Bibliography & References
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Adams, R., Domilelli, L., Payne, M., (2009), Social Work: Themes, Issues and Critical Debates, 3rd edition, Palgrave Macmillan.
BASW (1996) The Code of Ethics for Social Work, (www.basw.co.uk – accessed: 09/04/2010)
Crawford, K., Walke, J., (2008), Social Work with Older People, 2nd Edition, Learning Matters.
Eby, M., Gallagher, A., Values and Ethics in Practice, Chapter 7, (Course material).
http://www.ifsw.org/f38000138.html (accessed: 12/04/2010)
Thompson, N., (2009), Understanding Social Work, 3rd Edition, Palgrave Macmillan.
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Warren, J., (2009), Service User and Carer Participation in Social Work, Learning Matters.

As human beings, we socially categorise people as members of social groups rather than as individuals. The reason why we do so is because it ‘provides useful information that cannot immediately be perceived and it allows us to ignore unnecessary information’ (Bruner 1957 cited in Smith and Mackie: 145).

The danger of this social categorisation is that it’ makes a group seem more similar to each other than they would be if they were not categorised’. (McGarty et al cited in Smith E and Mackie D: 165)

The process of seeing one’s self as a member of a group or self categorisation can have positive effects for individuals within a group. Tajfel (1972) argues that ‘people seek to derive positive self-esteem from their group memberships’. (Smith E and Mackie D: 189)

As social care practitioners, we work with various social groups such as people with disabilities, the travelling community, young offenders, children in care, the elderly and many others social groups. These groups have been socially categorised and can often be considered as ‘outgroups’ by society. They are often considered by society to be vulnerable groups and are often’ pushed to the margins of society and excluded from the mainstream’. (Thompson: 2003)

The definition of social care is the ‘provision of care, protection, support, welfare and advocacy for vulnerable or dependant clients, individually or in groups’ (Joint Committee on Social Care Professionals cited in Share P and Lalor L: 5)

Each individual who is in need of social care can socially identify themselves as part of a group. Tajfel’s Social Identity theory suggests that members of a group gain a self-concept and self-esteem as a result of their group membership. ‘Seeing oneself as a group member means that the group’s typical characteristics become norms and standards for one’s own behaviour’. (Turner et al cited in Smith and Mackie: 195). This, therefore results in members of the group acting in group typical ways.

This theory can help us to understand the behaviours of various groups we are working with as social care practitioners. For example, a group of young adults who are engaging in criminal activity may be doing so as this behaviour is a norm within their group.

It also enables us to see why these groups are considered as outgroups in society and can help us to understand why these groups are seen as ‘oppressed’ by mainstream society.

Tajfel ‘s theory also tells us that often the individuals who make up the group are seen as ‘uniform’ and their diversity is underestimated.

This is certainly common with people who have intellectual disabilities. The ‘ingroup’, which in this case is the group who does not have intellectual disabilities, often views the ‘outgroup’, or the people with disabilities as all ‘being the same’. The individuals who have disabilities are categorised because of their disability rather than their individualistic characteristics and are therefore stereotyped due to their disability.

Stereotypes can be described as ‘over generalised sets of beliefs about members of a particular social group.’ (Schultz and Oskamp: 63) They are the views we form about groups as a result of social categorisation and ‘reduce the complexity of the world into a few simple guidelines that suggest how members of certain groups should be treated’ (Schultz: 63)

They act as ‘generalisations about a group of people in which identical characteristics are assigned to virtually all members of the group, regardless of actual variation among members’. (Aronson et al: 2004:466)

These stereotypes can lead to both positive and negative evaluations being made about the members of the group. They can also lead to the target group acting in stereotypical ways, for example, one of the reasons why a group of young offenders may be engaging in criminal activity could be a result of stereotype threat. This refers to ‘being at risk of acting in a manner consistent with a negative stereotype about ones group’. (Schultz: 69) The group of offenders are seen as an out-group and ‘may feel their offending behaviour is justified because they have been oppressed, but their treatment must be disproportionately severe’ (Harrower J, 2001:4)

Prejudices, ‘hostile or negative attitudes towards a distinguishable group of people, based solely on the membership in that group.'(Aronson et al: 2004:467) can have extremely adverse effects on the individuals within these categorised social groups.

‘Any group that shares a socially meaningful common characteristic can be a target for prejudice’ (Smith and Mackie: 143)

Prejudices against people in marginalised and vulnerable groups are prevalent in the society in which we live. ‘By virtue of their role and the social groups they engage with, social care practitioners witness the impact of inequality on the everyday lived experience of people affected'(Share and Lalor: 110)

Ethnic groups such as the travelling community are constantly subjected to prejudices. Much research has been carried out in recent years in relation to this. One survey found that 42 percent of the population held negative attitudes towards the travelling community (Behaviour and Attitudes in Ireland 2000) and another revealed that 72 percent of the settled community did not want the travelling community to live amongst them. (Lansdowne Market research 2001).

People with disabilities are another group in society which are subject to prejudices. Often society has the ‘assumption that disability is a form of illness’ (Oliver: 1990 cited in Thompson: 128)

People with disabilities have also been viewed as ‘not fully human, or even subhuman’ (Brandon: 4). Despite the fact that society’s attitude towards people with disabilities has improved over time as a result of moving away from the medical model to the social model of disability which involves the integration of people with disabilities into our communities, people with disabilities are still not regarded as ‘complete human beings of an equal status to the remainder of society’. (Share and Lalor: 334)

Research suggests that prejudice is learned from the groups in which we belong. ‘Racial and ethnic identity is a major focal point for prejudiced attitudes’. (Aronson: 457)

Discrimination can be defined as ‘unequal or unfair behaviour toward an individual based on his or her membership in a particular group’ (Schultz: 63) and is commonly seen in the area of Social Care at many levels.

Thompson (2003) outlines many processes closely linked with discrimination. He refers to Invisibilzation, a type of discrimination whereby ‘ dominant groups are constantly presented to us, for example through the media, and are strongly associated with power, status, prestige and influence, while other groups are rarely, if ever seen in this light'(Thompson’: 2003.13) This is true of many social groups in social care. People with disabilities are rarely seen in the media.

Infantilisation, which Thompson refers to as ‘ascribing a child-like state to an adult’ (Share and Lalor: 2009:278) is also common in social care. Society tends to regard people who are elderly or who have a disability as ‘child-like and dependant, unable to interact in their own right’. (Thompson: 88)

Thompson also argues that discrimination occurs in other forms such as marginalisation, welfarism, medicalization, dehumanization and trivialization.

The Experience of discrimination in Ireland (2004), a piece of research carried out by the Equality Authority, found that people with disabilities reported one of the highest rates high rates of incidents of discrimination both while accessing services and at work.

Various theories in the area of social psychology focus on the ways to minimise prejudice and discrimination within society.

Allport’s theory known as the Contact Hypothesis, suggests that ‘intergroup contact’ can lead to reducing prejudice but only under a number of suitable conditions. These conditions are that (a) the groups in the situation have equal status, (b) are not competitive and (c) have support from the relevant authorities for the contact and (d) have common goals.

As social care practitioners, we can promote Allport’s theory through the work we do with the various vulnerable groups we are involved with. This can be done by promoting social inclusion within the community.

Although attitudes towards groups such as people with disabilities have changed over recent years, there is much work needed in order to ensure that this group has equal status within our society. The same can be said for the other vulnerable groups we work with as social care practitioners.

The subject of prejudice and discrimination is highly relevant to the area of social care and with the help of research carried out in this particular area of social psychology, we can have a clearer understanding of the reasons why, as human-beings, we develop and utilise these actions and behaviours. By having this understanding, we can develop skills and mechanisms to help reduce prejudice and discrimination, and combat the damaging effects that they can have on vulnerable groups in society.

I was requested to complete a Pre-Birth Assessment with regards to Case BB. The referral was made by the Community Midwife to the Children and Families Area Team where I was on my placement. The Community Midwife’s concerns were BB’s age, she already had a child who was under one year, her partner was in prison and the Midwife was further concerned about BB’s lack of engagement with the health services particularly ante-natal services. The Midwife was also concerned with BB’s emotional state of mind. To consolidate what little information was on the referral I contacted BB’s current Health Visitor whereby I was subject to a litany of BB’s misdemeanours regarding her care of CA. Although the Health Visitor regarded BB’s care of CA as poor I noted that there had been no social work input requested from the Health Visitor and that the Health Visitor had quite a forceful personality. However, I took on board the information the Health Visitor provided with an objective mind.

BB is 19 years old and lives in a local authority house in a rural village with few local amenities. The village is not well served with public transport which makes it difficult for BB to access the main town. BB’s sole income is benefit based. BB now has two children, CA who is 15 months old and LA who is 3 months old. BB’s partner, BA (who is 22 years of age) is at present in prison, serving a sentence for Assault to Serious Injury. BA is not expected to return to the family home until October 2010. BA is the natural father to both CA and LA. My role was to complete a Pre-Birth Assessment with regards to convening a Pre-Birth Conference if necessary. This is in line with the local authority’s High Risk Pregnancy Protocol. My role was also to support and work in partnership with BB and her family in the longer term.

The context of my practice was that of a statutory role with statutory responsibilities. Therefore, I had to consider how to support the family by assessing BB’s strengths and pressures as well as promote the welfare of BB’s child and unborn child and in the wider sense to keep the family together. According to Hothersall (2008) these are principles inherent within the Children (Scotland) Act 1995 which themselves derive from broader principles surrounding the rights of the children and the importance of positive development as the basis for a meaningful life. Further to this Healy (2005) points out that within the practice context it is the legal aspect which has precedence over other aspects of practice. This incorporates the fulfilment of legal duties and responsibilities.

The Children (Scotland) Act 1995, as mentioned previously, is the underpinning legislation within Children and Families. This legislation with regards to parental responsibilities was I felt, pertinent to this case. For example, the responsibilities of a parent to a child under 16 are set out in Section 1 of this Act. They are to safeguard and promote the health, development and welfare of the child and to provide appropriate direction to the child according to age. These parental responsibilities were important to consider when completing the Pre-Birth Assessment in response to both BB and her partner BA’s capacity to parent. The Getting It Right For Every Child (GIRFEC) (Scottish Executive, 2005) policy was also crucial in my assessment. GIRFEC provides a practice model which promotes holistic assessment and planning for children, centred upon indicators of well-being and as a policy is about intervention as early as possible and provision of the right help at the right time. Within GIRFEC is the ‘My World’ assessment model which I used to help me complete the Pre-Birth Assessment particularly in relation to BB’s parenting skills with CA. I also utilised Getting Our Priorities Right (GOPR) – A Guide for Workers in Best Practice (Local Authority Child Protection Web Pages). Underpinning this assessment was Protecting Children and Young People – Framework for Standards (Scottish Executive, 2004).

Within the context of completing the assessment I was aware of the statutory legal responsibility involved and the requirement to work within the framework of current legislation and policy. During supervision discussion was centred around the issue of care and control from the perspective of my practice based on statutory responsibility. According to Thompson (2005) to ignore control is to run the risk of being ineffective, while to ignore care can lead to potentially abusive and oppressive practice. Further to this Banks (2006) points out that the reasons for many ethical dilemmas and problems stem from the social work role as…

“a public service profession dealing with vulnerable service users who need to be able to trust the worker and be protected from exploitation; and also from its position as part of state welfare provision based on contradictory aims and values (care and control…protection of individual rights and promotion of public welfare) that cause tensions, dilemmas and conflicts.”

(Banks, 2006, p.25)

As Banks also points out, in practice it is the rules of the agency that define who is to be regarded as a service user and provide the context in which the social worker operates. This, for me reflects that need to recognize the significance of discrimination and oppression in service users’ lives and for my practice to be ethically sound and develop a participatory approach to my practice.

Considering these points helped me formulate how I was going to engage with BB. I had an understanding of my statutory responsibilities from a legal and policy perspective and I had an understanding of my personal and professional values in terms of the tensions caused by care and control. Therefore, I needed to build a working relationship with BB which would allow me to build ‘a theoretical understanding of the interrelationship between the individual and society.” (Watson & West, 2006, p.13) This would help me complete a meaningful and insightful assessment of BB’s current difficulties with appropriate interventions.

To complete the assessment, I took into consideration Germain and Gitterman’s The Life Model of Social Work Practice (1996). Payne (2005) describes this model as a formulation of the ecological systems theory which is based on the relationship between people and their environment. The aim of social work is to increase the fit between people and their environment by alleviating life stressors and increasing people’s personal and social resources to enable them to use more and better coping strategies. Payne further points out that practice must be carried out through a partnership between worker and service user that reduces power differences between them. The environment and the demands of the life course should be a constant factor in making decisions.

By utilising Germain & Gitterman’s life model of practice (1996) I was able to create an accepting and supportive environment by describing my role clearly to BB and encouraging BB to give her thoughts about the referral. This elicited background information about her relationship with BA and support networks she had within her own extended family and with BA’s extended family. We discussed the birth of her second child particularly in respect of how BB felt she could cope with CA as well as with the new baby. BB identified this as a worry for her as she was concerned that she would not be able to manage. To make sense of this information Payne (2005) describes resources that people have in order to cope. These are self-efficacy, self-esteem and self-concept. BB had none of these emotional resources available to her at this time. Coupled with this she had no self-direction in the sense she did not feel she had any control over her life.

To allow me to elicit further information regarding BB’s parenting skills I observed her care of CA. The ‘My World’ model which draws on upon the work of Bronfenbrenner (1979) and encourages practioners to take an ecological approach to the assessment process helped me in this respect. By looking at the three domains of growth and development, what is needed from the people who look after me and my wider world I was able to elicit the positives in the situation and the areas of pressure in relation to the safety, well-being and development of the child. Further to this, attachment theory, which according to Schofield (2002) is “primarily a theory for understanding” (Schofield, 2002, p.29) was also useful in that although directly seeking to improve the quality of interaction between children and caregivers, the child’s sense of security, self-esteem and self-efficacy may also be increased by intervening in the systems around the family, for example providing social support to the mother or funding a place for the child in an activity group.

A visit with BA was also organised, who although in prison presented as a significant risk factor due to alcohol consumption and increasing levels of violence, albeit the incidents were not in or near the family home and did not involve BB nor his child. BA was at first uncommunicative which was understandable due to the setting and nature of the visit. Trevithick (2007) suggests that asking a range of different questions is central to interviewing however, before asking a question ‘we must be interested in the answer’. (Trevithick, 2007, p. 159) By careful use of open and closed questions I was able to draw out BA’s views on the assessment and gain some sense of a working relationship with him. However, what really opened the conversation was when I commented on how CA looked very like him.

BA then started to talk about CA and how he was looking forward to the birth of his next baby. During the course of the visit I was able to understand how BA supports BB by allowing her the freedom to take care of CA while he did the cooking and looked after the house. BA went on to explain that his relationship with BB was ‘sound’ but that he was aware he had let her down badly particularly as she was pregnant with his second child. BA was aware that he had missed a lot of CA growing up and he did not want this to happen with his second child. BA was also open about the circumstances leading to his arrest and he admitted that it was due to a feud between two different villages that had been going on since school. BA confirmed that the whole thing was ‘stupid’ and that he now realised he needed to ‘grow up’.

Taking into account the information gained and observations made during my visits with BB, CA and BA I was able to start to make sense of their environment, their strengths and pressures and the roles each of them had within the home and their community. Intervention at the initial stages of the process was I believe successful with regard to forming a working partnership with BB and to an extent with BA. Further visits with BB drew further information regarding informal support networks which in the main was her mother. BB’s mother was a source of practical support and advice and they were in contact daily. BB described her mother as ‘her ear’. Permission was sought from BB to meet with her mother. BB’s mother was keen for her daughter to gain support from social services as she realised how difficult her daughter was finding things at this time.

To complete the assessment and take into account risk factors and strengths I had to analyse and reflect on the information I had gained. According to Helm (2009) this information needs to be analysed before an understanding is developed which allows a judgement to be formed which can lead to an appropriate decision or action. Calder (2002) further offers a framework for conducting risk assessment by assessing all areas of identified risk and ensuring that each is considered separately e.g. child, parent, and surrounding environment each worrying behaviour should be assessed individually as each is likely to involve different risk factors. To counteract the risk factors present family strengths and resources should also be assessed, for example good bonding, supportive networks.

After a thorough analysis and supervisory discussions I recommended that a Post-Birth Multi-Agency Conference not be convened. However, I recommended that a further assessment take place when BA returns to the family home and a Post-Birth Multi-Agency meeting to discuss future interventions be arranged as I was aware that the birth of the new baby could be a future pressure on BB. In line with anti-oppressive practice and partnership working, I discussed both the assessment and recommendations with BB and by letter with BA. Both were given the opportunity to put their views across and both were happy to continue to work voluntarily with the department for the present.

The reasons behind my recommendations were that BB although socially isolated had a strong supportive network with her extended family and BA’s extended family. Further to this BB has a close and supportive relationship with her mother whom she sees every day. According to Hill et al (2007) a vast array of research shows that parents in poverty, or facing other stresses, usually cope better when they have one or more close relationships outside the household and these are activated to give practical, emotional or informational support. Most often this is informal but, for isolated parents access to family centres or professionals including health professionals can make a great difference to both the parents and the social and emotional health of children. (Barlow & Underdown, 2005)

With regards to CA, BB had a good bond with her daughter and was quick to attend to her needs. BB also had a routine in place for CA regarding mealtimes and naps this also included a bedtime routine. CA was reaching her developmental milestones (Source: Sheridan’s Charts). CA had age appropriate toys and had the freedom of the living area. BB had erected a baby gate to stop CA from gaining access to the kitchen and the stairs. However, since CA started walking, BB has to continually keep an eye on CA due to the open fire and hearth in the living area which is proving stressful for BB.

Immediate interventions included obtaining Section 22 funding to purchase a safety fireguard and information was obtained regarding BB making applications for Sure Start and Healthy Eating Grants. These applications were successfully made by BB and allowed her to purchase essential items for the new baby. BB had highlighted this as a worry for her as she was struggling financially. Working in collaboration with the Community Midwife arrangements were made for BB to make the trip to the clinic on alternate weeks when her benefits were received. The Community Midwife visited her at home the other weeks.

I believe I managed to build a positive working relationship with BB. According to Wilson et al (2008) relation-based practice is the emphasis it places on the professional relationship with the service user. The social worker and service user relationship is recognised to be an important source of information for the worker to understand how best to help. In order to make informed decisions and critically evaluate practice, reflection and analysis of information should embrace all sources of knowledge which have to be drawn upon. Further to this, a potentially more informative, relationship-based and reflective response would be to articulate the service users’ feelings by which the service user can acknowledge their own responses to the situation. As Fook (2002) points out:

“Reflective practioners are those who can situate themselves in the context of the situation and can factor this understanding into the ways in which they practice…

(Fook, 2002, p.40)

Banks (2006) also indicates that part of the process of becoming a reflective practioner also involves being aware of one’s own position of power and how dominant discourses construct the knowledge and values we use to describe and work with situations and practice. This has been discussed in supervision with regards to BB’s Pre-Birth assessment and to visiting BA in prison.

It is difficult to evaluate whether aspects of my work were effective or not. However, in supervision we discussed how keen BB was to gain support and seemed to appreciate the partnership approach. This was discussed in relation to Hill et al’s (2007) research and Barlow and Underdown (2005). Small aspects of my intervention, such as the provision of the safety fireguard were described by BB as a ‘godsend’ and she was proud to show me the baby items she had purchased on receipt of the grants.

Discussion in supervision also centred round the next stage of intervention which was after the baby was born. I discussed with BB the opportunity for CA to attend a local authority nursery one day per week. This would help CA’s social and emotional development and at the same time allow BB to spend time with LA. This referral was successful as was gaining the services of a volunteer driver to transport CA. However, CA has only just started at the nursery and therefore difficult to gauge if this referral has been effective.

Reflecting on my work overall, I should probably have explored more with BB her social isolation and worked on strategies to get her more involved in the community. Further to this resources in this village are non-existent and the parenting groups which were suitable were not available locally. BB was interested but location of the Family Centre and lack of public transport negated this. I enquired with regards to Outreach Work but this was not available. Discussion with other colleagues in the team reflected the same theme regarding facilities for the outlying villages. Further discussion in supervision raised for me the difficulty of maintaining empowering and anti-oppressive practice within this context as assessment should be needs led not resource led.

2,979 words

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

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

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

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

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

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

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

Inter-professional Practice

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

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

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

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

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

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

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

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

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

Emerging Themes and Evidenced Based Practice

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

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

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

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

Conclusions

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

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

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

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

Word Count: 2530, apart from bibliography

Critically analyse your practice of the Motivational Interviewing approach with specific reference to your classroom learning and work placement

On reflection I have learnt a great deal about the MI approach, putting the classroom learning into practice, then reviewing my performance on the DVD has been a fundamental part of my learning process. Although being familiar with many of the techniques, which are similar to skills I already possess, the actual approach was new to me.

In brief MI allows a normally client lead Person Centred Approach to have direction by allowing clients to recognise their ambivalence acknowledging that change is possible and cultivating their innate forces to make necessary changes that are acceptable to them. I have recognised that for myself I’m going to need to practice, review and hone my techniques & awareness with implementing this model.

It is emphasised with MI that the spirit of the approach is conceivably more important than techniques used . I feel the only real way to describe this phenomena is to acknowledge that the spirit would be how the therapist presents themselves & the way that he/she utilises the techniques. With MI it is the client’s responsibility to resolve their ambivalence finding intrinsic motivation to change problematic behaviours, not the therapists to impose or suggest change. The counselling approach is generally a soft, quiet eliciting style, which places importance on the working relationship being a partnership.

The extreme contrast to MI would be confrontational approaches, which may attempt to break a client’s denial through authoritative derogatory shaming approaches stripping away individuals defences and rebuilding their identities with societies or groups philosophies .

The therapeutic approach of a pure Person Centred counselling model essentially relies upon the three core conditions of Congruence, Empathy and Unconditional Positive regard these conditions contribute to the presence of the Counsellor influencing the relationship formed with the client.

With addiction treatment settings where time constraints are prevalent Motivational Interviewing can allow more structure & direction being applied to the normally client lead Person Centred Approach. By developing discrepancy between client beliefs and problematic behaviours direction can be achieved. According to “when discrepancy becomes large enough and change seems important, a search for possible methods for change is initiated” (p. 11).

I have already integrated some use of MI into my practice however, I’m aware at times my agencies policies and procedures are in conflict with the MI spirit. Recently, I have had to check my own incentives in using MI, making sure I’m not implementing it as a form of manipulation to move clients into adherence with agencies policies, which would blemish the spirit of the MI approach.

The compatibility of the MI approach in my place of work is questionable in some areas. Our treatment modality is a 12 step abstinent based approach, which immediately arises two conflicts with the MI spirit. Firstly, not all clients may wish total abstinence and those who do may wish to achieve it in some way that is not 12 step orientated. It is agency policy that all clients attend 12 step fellowship meetings every evening during their treatment duration.

In our treatment setting the MI approach has proven to be useful in several areas when clients initially arrive in treatment anxiety levels are high if not addressed can lead to dropout. Application of MI here can help the client focus on the influencing factors that motivated them to contemplate treatment in the first place. In addition, MI is acknowledged a beneficial approach to use with angry clients especially the principals of rolling with resistance and the expression of empathy .

Although the clients have attended our treatment facility for a variety of reasons, it is difficult to place them all in one bracket concerning the “stages of change” model. Taking into account their alcohol / drug use the vast majority would be in either contemplation or active change. Some clients may display signs of resistance to change around other areas of their life which may include being in a relationship with a partner who is still active in addictive behaviour. Many clients also have difficulty with assertiveness, which is going to be necessary to develop for them to help maintain addiction free lifestyles. It is a process of change for clients conversely many of these distinct essentials are met with varying degrees of resistance by individual clients.

The first example I’m going to use is a male client of 42 years of age who has been dependent upon substances for twenty years. He displays high levels of interest in the abstinent approach registering high using a Likert assessment tool to gauge his Willingness, Ability & Readiness regarding an abstinent way of life. With reference to his substance use, I would assess him to be in the action stage of Prochaska and DiCliemente “The stages of change” (see appendix A).

He has a partner who still is a substance user; he displays high levels of resistance to changing this area of his life and feels that he will be able to change her view on substance taking once he returns home after the completion of his treatment. I have been affirming the client consistently with the changes he has made to his behaviour whilst in treatment and with permission from him, pointing how his changes are in line with the 12 step abstinent based approach. What I’m trying to achieve is too reinforce his belief in himself about this particular approach. By doing this I feel that there are inconsistencies further developing between his two cognitions “I want to remain substance free, yet I want to go home to my partner who is a substance user.” As he is now beginning to question his own thinking, I can see that the cognitive dissonance is beginning to have an effect I’m hoping he will seek to alter the risky dissonant cognition by remaining in Bournemouth to attend aftercare.

A client we recently had at our facility who presented for cannabis use, and admitted his main motivation for being in treatment was to avoid going to prison displayed resistant behaviours towards the treatment modality. His resistance would manifest in ways of walking out of group therapy, getting up and walking around whilst clients were presenting personal assignments & generally showing no respect for what other clients were trying to achieve. The application of MI in this instance was quite difficult as a direct approach in line with agency policy and procedures needed to take place first. We had tried on several occasions not to take too much notice of the unacceptable behaviours he presented which could be considered rolling with resistance, however eventually had to enforce an ultimatum. In circumstances like this I found it very difficult almost impossible to remain in a totally pure orientated spirit of MI.

To say that I have mastered the “concepts & principles” of MI would be a significant over estimation. I have furthered my knowledge of the contributing elements of MI which included the “stages of change model”, the techniques used to work with ambivalence & resistance. Most importantly, I have learnt above all else MI is about allowing the client to be the expert and for me to be mindful of the type of language that I use. The spirit of MI I have no real problem with other than perhaps on occasions avoiding the “expert trap” generally I do present myself within the spirit of this model.

The application of this particular model I’m using at work in a tentative way, in other words I’m applying it in certain situations where perhaps I feel confident to use it. An example of this would be, when clients seem to be making rash decisions to leave treatment or are displaying ambivalence about an abstinent approach.

After reviewing the DVD it is clear to me that I lack confidence in the application of the MI approach. I do however feel though that practice and reviewing my practice can only help with me developing my implementation of this approach. I feel that I need to be more mindful of the language I use whilst working with clients. As it became apparent to me whilst reviewing the DVD that I can without realising fall into traps. An example of this would be at the end of the session I asked my client if I could give him something to take away. On reflection, I could have asked him how he felt he could assess his decision on getting a shed.

My future development is going to involve applying & reviewing my practice, what I have started to look for at my work setting in my own practice and that of my work colleagues is to identify what clearly is not MI.

Some observations I have acknowledged not only with this approach are the ethical conflicts that can arise between benevolence & autonomy . On reflection, the example I used earlier on in this assignment with a male client whose partner remains in active addiction. His autonomy was to return home after treatment completion my interest or benevolence is with the safety of the client. As a professional, I know it would be risky for him to return home to someone who remains actively taking illicit drugs. The question is do I then use MI as a way to manipulate the client? My answer is yes of course I do. Questionably is this really in the pure spirit of the approach?

Appendix A
The Stages of Change
Intervention process using the Stages of Change model
Source; Adapted from the work of Prochaska and DiCliemente

This study takes up the examination of social work practice in the area of mental health in the UK. It is based upon the experiences of the author in the course of her work as a Mental Health Professional in a multidisciplinary team in a community care setting.

Mental health issues, more specifically mental illnesses, have troubled humans from the dawn of human civilisation. The history and literature of all historical societies reveal numerous instances of mental disorders among people and the inevitably associated ostracism and discrimination faced by such people. Mental illnesses in the UK, till even some decades back were associated with abnormal, deviant and dangerous behaviour and thousands of people with different types of mental issues were housed in high security asylums against their will for years on end. Such blatant violations of fundamental human rights were carried out at the behest of the medical fraternity with the active support of the government, the judiciary, the legal system, enforcement agencies and society.

Social workers entered the area of mental health in the UK in the early decades of the 20th century and progressively increased their interaction and work with mentally ailing people. The involvement of social work practice in the area grew slowly until the 1960s but increased rapidly thereafter. Greater involvement of social work practice led to the development of psycho-social models for providing assistance to people with mental ailments and helped in changing societal perceptions towards such persons. The post Second World War period also witnessed a very substantial shift in governmental and medical approaches towards people with mental health disorders. The last full fledged asylum for housing the mentally ailing was closed down in ….

Medical disorders are now viewed to be strongly related to various social and economic conditions as also to phenomena like racism, oppression and discrimination. The overwhelming majority of people with mental health ailments are now treated in the community, in the midst of family and friends, and institutionalisation is resorted to only in extreme cases and that too for limited periods of time. Social work practice has become very relevant to the area of mental health. Qualified social workers like the author of the study, known as mental health professionals, work with medical professionals like doctors and psychiatrists and play active, even leading, roles in the assessment, planning, intervention and evaluation of people with mental health disorders.

This study takes up the case of Maya, a 68 year old Asian woman, who lives in East London. Maya is a first generation immigrant and has spent much of her life in an alien society. She suffers from depression and has been referred to the local social work authorities. Maya’s case is fully described in the appendix to this study and is thus not elaborated here.

The essay examines various aspects of Maya’s life and experiences in order to crystallise the various factors are contributing to her current mental difficulties. Special emphasis is given to the challenges faced by people suffering from depression and to the high incidence of depression among South Asian women. The study takes up the application of social work theory to practice, the role of oppression and discrimination in the development of mental ailments, the role of social workers in helping mentally ailing persons and the importance of adoption of anti-oppressive approaches in dealing with them. It also details the social services that are available to such service users and how such services can help Jaya.

Causes and Consequences of Depression

Maya has been intermittently suffering from depression for the last 27 years and has undergone medication and counselling on five occasions. She was specifically referred by her GP to the local social services department following an episode of some severity.

Crippling depression is one of the biggest reasons for misery in modern day Britain. It is a submerged problem of immense dimensions that is kept out of sight by family shame. The Psychiatric Morbidity Survey reveals that one in six of UK residents are liable to be diagnosed with depression. It would surprise many people to know that 40% of all physical and mental disabilities are caused by mental illness, even as 17% of such ailments are caused by depression alone. The incidence of depression among people is more than 3 times that of cardiac disease.

Psychologists agree that mental illness constitutes the most important predictor of human distress in the UK and is far more powerful than poverty or various other types of disability. With few forms of deprivation being worse than chronic depression, it is evident that social workers should give the highest priority to care for persons with depression and other mental health ailments.

Much of research on the causes of depression has necessarily being medical in nature. A number of medical studies reveal that depression can arise out of a range of factors like medical and physical disabilities, the death of loved people, social isolation, exclusion and loneliness, and abusive relationships, separation and divorce. Depression can also be initiated by economic and other types of stress, estrangement from family members, the compulsion to care for ailing family members and relocation.

Social work research on the other hand reveals that social phenomena like racism, discrimination and oppression can play significantly causal roles in the emergence of depression. Individuals from different religious, ethnic and cultural backgrounds have often been subjected to discrimination in the UK. The decades after the closure of the Second World War witnessed a large influx of people from erstwhile British colonies in Africa, Asia and the Caribbean into the UK. Such immigrants, many of whom came to the UK to escape from lives of poverty, hardship and violence in their home countries, were often subjected to various degrees of oppressive and discriminatory treatment, both in the workplace and in the community.

Such discriminatory treatment manifested itself in areas of employment, education and access to public facilities. Immigrants were treated differently and subjected to discrimination because of their lack of familiarity with the English language, their different physical appearances, religious traditions, cultural and social habits and their clothes. Such discrimination sometimes assumed distinctly undesirable dimensions like in the case of Christopher Clunis. A mentally disturbed person of African origin, Clunis murdered Jonathan Zito, a young white man, at a tube station in 1992.Whilst subsequent enquiries revealed that Clunis was mentally disturbed and he was subsequently institutionalised, the British media built up a picture of Clunis, (as a large, clumsy, unkempt and violent man), with strong overtones of racism. The numerous incidents of discrimination and ill treatment of persons of Asian origin in the USA after the September 11 attacks reveal racism and social discrimination to be a latent phenomenon that continues to work under the surface in societies and surfaces in response to different types of provocation and perceptions.

Immigrants and their families even today have much poorer levels of education, income, health and public participation than members of the mainstream white majority in the UK. Maya is a first generation immigrant who was uprooted from her familiar North Indian environment when she was still in her teens and thrust into alien surroundings; she was unfamiliar with the local language and found it extremely difficult to communicate with others. Her social life was perforce restricted to the local Indian community in east London, which itself was very small when she came to England. Her husband and children, who had to adjust to the local community and its demands and expectations in order to survive and enhance their life chances, would have in all likelihood faced numerous incidences of discrimination and oppression over the course of their lives.

Maya’s domestic problems were also intensified because of her compulsion to stay with her husband’s parents, a tradition that is still widely followed by the Asian community in the UK.

Depression among Women from South Asian Communities in the UK

A number of social work surveys and studies indicate that the incidence of depression is significantly high in South Asian women. Whilst such women originate from a large and ethnically diverse area that comprises of India, Pakistan, Sri Lanka and Ceylon, many South Asian women suffer from similar causes for mental depression. Fenton and Carlsen, (2002) state that the main causes for depression amongst such populations are experiences of racism, family difficulties, financial problems, poor physical health and lack of employment. Women from these communities experience excessive mental pressure on account of community influence and reputation. Some of them have to cope with unsuitable marriages and unhappy relationships with their in-laws. Such circumstances create enormous difficulties and life challenges and moreover do not provide any avenues for escape. Some women have described how their families and the larger Indian community made them feel inadequate and repeatedly impressed upon them that they were failing in meeting their familial obligations. Such women also feel pressurised because of social isolation, lack of friends and acquaintances, inadequate education and stressful living conditions.

The case study reveals that Maya has often been subjected to stress because of her difficult and strained relationship with her mother in law. It is also evident that the option of setting up home independently was never explored by her husband. It needs to be noted that whilst joint family living is common in South Asian communities, it is also often economically necessary because of straitened financial conditions and the additional costs that are likely to be incurred if children opt to live separately from their parents.

Depression evidences itself in symptoms like change in eating and sleeping habits, lack of interest in normal daily activity, withdrawal from children, family and friends, overlooking of necessary activities at the home and outside and finally self destructive tendencies. Depressed people are prone to self harm and develop suicidal tendencies. Maya suffers from irregular sleeping habits, often sleeps late at night, gets up late in the mornings and is sometimes unable to cook for her family. She has reduced her interaction with outsiders and is becoming distant from her immediate family. She often suffers from headaches and cries for no reason. Such manifestations and symptoms constitute strong reasons for addressing depression in an elderly person like Maya.

Not treating depression can place her and other older people at increased risk for additional physical and mental health problems. The disinclination to get out of the house and exercise can increase her hypertension, lead to diabetes and faster deterioration of the heart, lungs, bones and muscles. It can also lead to deeper, debilitating depression.

Implications for Social Work Theory and Practice

Social work theory and practice is fundamentally concerned with the improvement of the social and economic circumstances of disadvantaged individuals and groups and the challenging of oppression and discrimination in all its forms. Systems theory in particular, whilst abstract in nature and not applied systematically, has helped social workers to move from linear and causative medical models to significantly greater multi-causal contexts for the understanding of human behaviour. General systems theory provides a conceptual scheme for realising the interactions among different variables, rather than by reducing behavioural explanations to one reason.

This is clearly evident in the area of mental health, where depression in people and their resultant behaviour is associated with a number of interacting social, biological and psychological factors. Systems theory requires social workers to examine the multiple systems in which people interact. Assessment of mentally ailing persons will for example require social workers to obtain information from different sources and place them in appropriate family and community contexts. Knowledge of social constructionism theory on the other hand enables social workers to realise how language has been used by medical experts and other dominant groups to build up images of the mentally disturbed as people who cannot look after themselves and their families and who need to be treated by medical “experts”.

Modern society’s perceptions about mental illnesses are significantly shaped by medical models, which state that medical ailments represent serious conditions that can make it hard for persons to sustain relationships and engage in employment. They can lead to self-destructive and even suicidal action (Walker, 2006, p 71-87).

Social constructionism theory states that such perceptions are built by purposely developed vocabularies of medical models, which are bursting with complex nomenclatures for mental ailments and fixed on deficits. Walker, (2006, P 72), argues that vocabularies of medical models, including that of mental illness, are social constructs, comprising of terms that detail deficits and view humans as objects for examination, diagnosis and treatment, much like machines. Such perceptions result in treatments that is focused on removal of symptoms and do not take account of actual client needs (Walker, 2006, p 71-87). Social constructionism can assist social workers in realising the disparaging chimeras that have been built by existing medical models about the mentally ill.

Social workers must also be informed by the theories of oppression and discrimination that condition and shape the behaviours of people, both the oppressors and the oppressed, towards poor, isolated and disadvantaged segments of society. Neil Thompson’s PCS theory of oppression (2001), states that oppressive and discriminatory attitudes in people are socialised over the course of their life by three strong influences, namely personal perceptions and cultural and structural influences. Personal perceptions about the mentally ill can arise through reading about such people, viewing them on cinema, thinking about them and other such associated activities. Cultural influences comprise of numerous cognitive inputs from school, friends, family and the larger community about the mentally ill and unstable. Structural influences arise from the various embedded factors in the larger environment like their lack of fitness for employment and their need to be bodily restricted. These PCS factors shape the minds of individuals and build up strong discriminatory attitudes that rest below the surface and are manifested in various ways. The media outrage over the Clunis incident and the construction of the person into a larger than life image of a socially dangerous person represents the way in which such discriminatory attitudes can often shape the behaviours and actions of people.

Chew-Graham et al (2002), state that whilst the incidence of depression among South Asian women is significantly higher than the national average, such women faced numerous barriers in accessing social services because of internal and external barriers. Whilst internal barriers occurred because of family structures and community pressures, external barriers happen because of their unfamiliarity with English, difficulty in communicating with local social services departments and the disinclination of social workers to come to their aid. Services thus tended to be accessed only at points of desperation if at all and increase the tendency of such women to engage in self destructive activities. Dominelli (2002), states that discriminatory attitudes are deeply embedded in the existing social work infrastructure and can be eliminated only if there is a genuine and widespread feeling among social workers to do so. The labelling theory states that the self identity of individuals is often determined by the terms that are used to describe them.

During placement, I worked for a charitable, voluntary organisation that supports Asylum Seekers who were destitute. For the purpose of this essay, I will utilise a pseudonym for the client, which will be Sam, to ensure that her confidentiality is maintained. Sam has authorised consent and confirmed that I may use her experience as material for this essay. I have chosen to examine this intervention as it is based upon this service user’s presenting issues upon point of contact. Firstly, I will explain the background of Sam’s situation, to give you an idea of her story, and outline the agency involvement giving a brief description of the context and setting for their work, which will include relevant legislation and policies. Secondly, I shall discuss a substantial piece of work where I have met Sam on a number of occasions whilst working at the agency and demonstrate my theoretical understanding of critical reflection that took place during this intervention. Finally, I will discuss how my own values informed the work I undertook with Sam and will demonstrate critical reflection and the skills applied during this intervention and what I had learnt through this process. Furthermore, I will discuss how this had impacted on my own identity in practice and the effectiveness and the outcomes from this intervention.

Sam is a 31-year-old woman who entered the United Kingdom (UK) on a work-visa in May 2009 from South Africa. She is of a South-African ethnicity and has faith in Christianity. She is an intelligent, resourceful woman who has more of an advantage in terms of communicating articulately in English over some of the other clients I have met; who do not acquire the basic English language. This made communication effective and according to the National Association of Social Workers (NASW, 2000) it has been stated that “Cultural competence is a set of congruent behaviours, attitudes and polices that come together in a system or agency or among professionals and enable the system, agency or processionals to work effectively in cross-cultural situations” (NASW, 2000). Sam entered the UK with leave to remain until May 2010 on her work-visa, with no recourse to public funds, which means that people who are under this bracket are not entitled to receive help from the Government.

Furthermore, at point of contact Sam was pregnant and was in receipt of Statutory Maternity Pay (SMP). SMP is a contributory benefit based upon National Insurance contributions that Sam had prior paid whilst engaged in full-time remunerative employment. As such, it is not classified as a public fund as Sam was therefore at liberty to claim and receive this benefit irrespective of not being a UK citizen. According to the Department of Work and Pensions (DWP,2009) SMP is paid for a maximum period of 39 weeks, and unfortunately remaining Social Security benefits and associated support such as Housing and Council tax benefit were not available to her as they are classed as public funds. I was concerned from a safeguarding perspective as to Sam’s welfare, especially keeping mindful that she was pregnant and that the weekly rate of SMP, ?123.06, would be insufficient for her to meet priority needs such as rent, Council Tax and subsistence/living costs (DWP, 2009).

The initial referral came from a caseworker who works for the agency and at the Children’s Centre. The agencies work in partnership. He approached me and raised concerns with safeguarding issues as mentioned above. However, a referral had to be made before the agency would accept Sam as destitute. It was essential that the referral was made as the agencies policies stated that they could only accommodate 4 people at one given time in the houses they owned across the City. The agency I worked for worked across two settings and worked in partnership in the City. It provides short-term respite accommodation for homeless and destitute women and men. Sam’s circumstances were unique as unlike other residents, she did have a source of financial income, whereas many women did not have a fixed income and had to rely on charitable donations. However, in recognition of the fact that Sam was imminent to give birth and was homeless, the agency agreed to admit her in the short-term in the first instance, thus offering her security, shelter, food, water and safety temporarily. In the longer term, she was afforded a short-term licence agreement that ran until the 2nd December 2009. The agency was of the view that Sam would have to explore other avenues of support and accommodation. I advocated this procedure to Sam in a house meeting and found that she had yet to find alternative accommodation. I understood she was pregnant and that she was not sure where to start looking or what resources were available. I went back to the office and explained this to the agency. I researched and made phone calls on how I could advocate further help for Sam and made the support worker and colleagues aware that she was concerned about her well-being and from this knowledge, a panel meeting was arranged and the licence agreement was later extended until the 12th January 2010 due to the birth of Sam’s daughter.

According to Cohen (2004) he states, “All persons have a right to well-being, to fulfilment and to as much control over their own lives as is consistent with the rights of others” which means that as every human being has fundamental values that they should be treated with respect and as individuals regardless of their circumstances. At point of contact, Sam was destitute, as she had separated from her boyfriend, who resides in Ireland. Sam had been residing as ‘hidden homeless’ which means that there is no accommodation that she is entitled to reside in or it is not reasonable for her to continue residing in that accommodation (www.crisis.org.uk, 2008). She was living in the City on a friend’s couch, but had been asked to leave due to objections with the friend’s landlord and overcrowding. It became apparent that Sam would require her own accommodation to return to following discharge from hospital once her baby had been born, and tenable longer-term accommodation thereafter. I met with Sam and built up a good working with her following the referral to the agency. I felt this because Sam would contact me at the office if she had any queries about the house and would ask for me if she wanted help or advice. We negotiated convenient times to attend house meetings and I felt she trusted me as she opened up about her personal experiences such as her experience with her ex-partner.

According to Howe (2008) ‘relationship based practice is when relationship-gifted workers are interpersonally skilled and they make the most effective and human practitioners, whether the basis of their practice is behavioural, cognitive, task orientated, psychodynamic or person-centred’. Moreover, Trevithick (2003) argues ‘relationship-based practice is at the heart of social work’. I felt working with Sam in a crisis intervention enabled me to engage with her as I aimed to reduce her stress by communicating effectively the next steps and open and honest with how long she would be able to reside at the accommodation the agency provided her with. I was genuine with her in terms of stating what the agency could provide her with and what resources were available. For example, Sam needed a pram, so we organised one for her and I reminded the support worker to drop this item off at the house as she had access to a vehicle. I also made her aware of the challenges she may face by living independently once the Social Services department provide her with an assessment and if accepted, I discussed the benefits that may be available to her, so she was aware of the process. This demonstrated significant levels of emotional intelligence, which means, “having self-awareness, emotional resilience, motivation of self and to instil in others. It also recognises the skill to have empathy and sensitivity, to be conscientious and intuitive regarding decision-making and also to know how influences and building up rapport with service users are important” (Goleman, 1996,p.2).

As cited in the British Journal of Social Work, it also underpins requirements for practitioners “to develop and maintain effective working relationships, to be able to reflect on my own background experiences and practice that may have an impact on the relationship” (Morrison, 2007, p.2). For example, recognising to self-disclose about my own independency only when it was necessary as I did not want to project or share my own values unnecessary as Sam’s circumstances were unique to her and I understood that I could empathise with her however, only she would know how she feels in this situation. We discussed her feelings and she stated she was concerned about herself and her daughter, so I reassured her by getting in touch with the caseworker who had made the appointment with the social services for an assessment and to re-confirm when this would be conducted in order to see if she is eligible for the resources available. I explained the procedures to Sam, and she understood. She expressed her gratitude to myself and the agency.

As I met Sam on several occasions at the agency and on the day that she was accommodated into the house. I began to analyse her situation in greater detail because we needed to get her involved in the decision-making process. This means that service users are informed and involved in the decision that are made in partnership (O’Sullivan, 2005,p 135-136) and the effective way to do this, was to hold house meetings and discuss her accommodation situation in a comfortable setting. Saleebey, (2006,p.108) informed my practice in this intervention as he supports an empowering approach to social work practice as it focuses on clients strengths and potential rather than on the disadvantages and the misfortunes of their circumstances. He also recognises that the social worker is viewed as the ‘expert’ and that service users are viewed as the ‘victim’ of their own disadvantage. However, as his strengths perspective challenges the traditional anti-discriminatory and anti-oppressive practice it identifies aspects of structural inequalities as the significant element of clients situations.

Furthermore, Saleeby (2006, p.108) states the strengths perspective challenges clients to acknowledge that the social worker will represent them in the assessment and the intervention process as the social worker is viewed as the expert, however it also attempts to work in partnership with service users to support and gain services to meet their identified needs. The strengths perspective also focuses on the resilience of service users and aims to provide strategies to empower and promote positive outcomes for them. Furthermore, Beresford (2000, p.108) argues this perspective as viewing the service user in a one-dimensional aspect, which reduces their identity to essential categories such as ‘elderly, disabled or black service users’, thus resulting in the support of universal services to meet their needs. He also argues that service user’s and oppressed groups should be involved in the design and delivery of their services to meet their identified needs and that service user’s voices should be used in structure of theory and practice.

I felt that the strengths perspective engages with Sam’s circumstances as the agency and I were the expert in providing the assessments and advice for Sam and worked in partnership with her to find her a possible outcome because the caseworker had contacted the Social Services and had an assessment booked in for her. He informed me about this and I contacted Sam and made her aware of the appointment and the assessment procedures.

Criticise the above and get evidence to state that another theorist states the su is the expert.

Concerning critical reflection, it is an integral part of social work as it is a route to provide efficient performance and enhances social work expertise (Adams, et al,. 2002, p. 1). They also critique that it enables social workers to question the knowledge and involvement with clients. During this intervention with Sam there were many occasions that professionals and I had to critically analyse Sam’s circumstances in order to develop a plan of action that would meet her identified needs such as creating opportunities for her to take herself and her baby to groups so she could interact with other mothers at the Children Centre.

Put in values/reflect on self/what I learnt from this process/impact on own identity

Furthermore, I had arranged appointments for her to seek assistance with her receiving help and advice in relation to her visa options with a caseworker who worked for the partnership agency. The partner agency dealt with all persons from abroad and people who required legal advice regarding their visas. The outcome was that she should return South Africa and then re-apply on another work-visa and or commence work again in the UK and then apply for the visa to be extended. Sam did not want to take up any of these options, as she did not have the money to leave her new born in a child care facility. She also stated she did not want to return to South Africa because her parents were not aware that she had a baby and because she is of a strict religious background. She stated that her parents were likely to arrange her marriage to an old man that she had said “no” to on several occasions when she was living in South Africa. It seemed her parents had power and control over her life.

Put in power and anti-oppressive practice theories hereaˆ¦ Values, non-judgemental, empathic

I discussed and arranging convenient house meetings to discuss her options in taking the next step. Therefore, I asked her to contact Right Move estate agents and private property owners to see if she can find herself long-term accommodation for her and her daughter. Adams et al (2002, p.1) states critical reflection can sometimes be transformed in our own understanding, thus changing the part of the situation by enabling the client and the professional to reflect on what has occurred. For instance regarding Sam, she did not want to call and arrange appointments because she stated when she initially looked for a room in a house share, that the landlord of the property stated that the tenants already residing in the house did not want a mother with a baby living at the property. Therefore, this disempowered her in seeking other properties. At the house meeting, after Sam and I had further discussions we looked online for flats and we found several studio flats she could rent. She did not want to make the phone calls, so in order to empower and enable her in doing this herself for today and future reference. I made the first phone call and then handed her the telephone as she did not have credits on her phone and encouraged her to query about the properties in the same manner I had done. She queried the availability of these properties, however after finding that the landlord wanted a deposit, one as to Sam could not afford, the only solution was to seek refuge from the Neighbourhood Office and present herself homeless. She would then be put up in a shelter. I learnt that this process was going to be challenging and more reflection on this matter would be necessary.

What is more, critical reflection can be ‘deconstructed and reconstructed’ to give us access in advancing our practice. Therefore, this continuous process provides good practice and development. Yip (2005) “encourages social work students to undergo self-reflection as it is a process for self-observation, self-evaluation, self-dialogue and self-analysis”. Furthermore, he states, “under the appropriate conditions social workers can reflect constructively which, results in enhancement”. Whereas, he also critics on the basis that if “social workers were under inappropriate conditions such as lack of supervisory sessions, hostile environments, then social workers would not be able to reflect constructively and this can create problems for the professional and personal development of the social worker”.

However, Schon, (1983) describes ‘reflective practice as a non technical, non rational process which means that he is keen to make sense of the relationship between professional knowledge and practice by knowing-in-action. This is when thinking is understood in what we do, also he states ‘reflective in action is where thinking is conscious but does not interrupt or actions’ and reflection on action is where thinking takes place after the event in order to understand our actions, predominantly in why we acted and what we learnt from this action’. Eraut (1995) critiques Schon’s theory as he states that “a practitioner cannot reflect in action as you leave the space, if not physically, certainly cognitively” Furthermore, Fook and Gardener (2007,p364) argue that critical reflection is the reflective practice which focuses on the power dimensions of assumptive thinking and therefore how practice might change social situations’. Although, Ixer (1999, p.513) argues this concept of critical reflection and argues whether social work programmes should be assessing reflection at all”.

Overall, reflecting on this intervention allowed me to assess and analyse Sam’s situation thoroughly because of her uniqueness to the agency as she had no recourse to public funds, which made it challenging in assisting her find her own solution. However, communicating effectively and working in partnership with her and the agency employees empowered Sam in coming up with a resolution for her to follow through. As social work, values have unique contributions to social work practice and assessing critically ensures that social work perspective and social work values contribute fully to the provisions of care. Furthermore, the ability of social work will depend on more than knowledge and skills; it is also about recognising practice that is mutually required in negotiating

work with various organisations and professionals. Moreover, the ability to effectively communicate and contribute will also depend on the self-esteem and the status of the social worker. In addition to this, being able to effectively research and apply effective education will be found more reliably in the ability to improve the quality of the service users and carer’s experience of assessment and it’s outcomes. This is because professional competence in assessment requires critical analysis of self in practice and these development of skills and knowledge base are required to become an emotionally capable, objective practitioner.

This assignment will discuss the case study given whilst firstly looking at the issues of power as well as the risk discourse and how this can be dominant within social work practice. Further to this a task centred approach will be explained and how it could be used when approaching this case study. Finally the strengths perspective will be explored and how this could effect change, and bring about social justice principles.

Thompson (2000) discusses that power can be a complex issue that operates on different levels. He further discusses that many service users who come into contact with social services are generally in a relatively low position of power, and that this could be due to, for example; social divisions such as, class, race, ethnicity, gender, or religion.

When looking at issues of power, it could be said that Ms. Evans who defines herself as Asian is being oppressed by many power differentials that would need to be considered. For example; Ms. Evans is currently living in naval married quarters and feels she has not been accepted into the community. It could be argued that she is living in a predominantly male domineered, white environment. Thompson (2000:56) highlights patriarchal ideology and how male dominance ‘serves to maintain existing power relations between men and women’, he also highlights how we should ‘resist the pressure to make people conform to ‘white malestream’ norms’ (Thompson 2000:141).

Healey (2005) discusses anti-oppressive practice and how this looks at the personal, cultural and structural objects that can shape the problems that service user’s experience. Healey (2005) further discusses that through anti-oppressive practice social workers aim to promote service user empowerment by encouraging them to talk about and share their feelings of powerlessness, to help them understand how cultural and structural injustices can shape their experiences of oppression. Therefore when working with Ms. Evans and her family I would need to incorporate anti-oppressive practice in order to empower, and enable her to share with me her feelings and experiences of powerlessness in order to gain a better understanding of the families situation.

However Thompson (2000) highlights, social work intervention involves the exercise of power, which if used negatively can reinforce the disadvantages that service users experience. Used positively however power can help to enhance the working relationship, the outcomes, and empower the service user, as Healey (2000:202) writes ‘postructuralists see power as an ever-present and productive feature of social relations’, and Foucault cited by Healey (2000) highlights the need for us to recognise the productivity of power, and argues that by focussing on power as only being oppressive ignores the positive dimensions of power.

Ms. Evans has been referred to social services via the Health Visitor; this could be making her feel disempowered and nervous about the forth coming intervention of social services. Therefore when working with Ms. Evans and her family I would have to recognise the power imbalances between us, (Thompson 2000). I would need to be sensitive to the issues of power and imbalances by being clear with Ms. Evans on my role and purpose, explaining professional boundaries and responsibilities (Trevithick 2005). I would also need to consider my use of language and how as Dalrymple (1995) cited by Healey (2000:184) explains ‘the way in which language can reflect power differentials and have an impact on the people with whom we are working’.

As well as recognising power issues and imbalances, as the social worker l would also need to undertake a risk assessment. As Thompson (2000) highlights, to assess the degree and nature of any risk to which Ms. Evans and her family could be exposed to. Assessing exposure to risks or a person, who is vulnerable to it is central to assessment within social work practice (Davies 2005). Stated in the Codes of Practice, ‘as a social care worker, you must respect the rights of service users while seeking to ensure that their behaviour does not harm themselves or other people’ (GSCC 2007:4). This includes ‘following risk assessment policies and procedures to assess whether the behaviour of service users presents a risk of harm to themselves or others’ (GSCC 2007: 4.2).

Therefore when working with Ms. Evans and her family I would need to be aware of my organisational and statutory duties as there are substantial policies, guidance, and frameworks to inform my practice on risk assessment. When working with children and families as Brayne (2005) highlights, I would need to be aware of the law, which under the Children Act 1989 states; my primary responsibility would be when working with Ms. Evans and her family to that of the child, or children.

Ms. Evans has stated that on occasions she and her family have experienced verbal abuse, which would need to be investigated further to decide on any risks this may pose to the family. However she has been described by the Health Visitor as suffering from post natal depression, and finds it difficult to care for her children, aged seven, five, and a ten week old baby who has spinal bifida. Therefore it could be said that my primary statutory concern would be, to what extent is her post natal depression effecting the care and welfare of her children, and does this pose any risks that need to be identified.

Risk assessment and the management of risk have become dominant in all areas of social work. Kemshall (1997:123) cited by Davies (1997:123) highlights that within social work risk assessment and risk management have become key issues and are often central in the decisions, ‘to allocate resources, to intervene in the lives and choices of others or to limit the liberties of activities of clients’. Risk assessment has become a dominant discourse within social work ‘because social workers are employed within a risk society, which searches for ways to identify and manage risk effectively’. (Higham 2005:182)

However as stated in the codes of practice, social workers should also ‘recognise that service users have the right to take risks, and help them to identify and manage potential and actual risks to themselves and others’ (GSCC 2007: 4.1). Higham (2006:182) discusses how ‘service user’s strengths that are likely to diminish the predicted risks’ should be assessed in keeping with the social work value of empowerment. Pritchard (1996) cited by Davies (1997:124) discusses how service users should not be denied the opportunities to take risks or exercise choice, and states that, ‘risk-taking is an important feature of all our lives’ (Davies 1997:124). However, as Thompson (2000) explains, the balance between care and control within social work can be difficult to maintain.

By approaching this case with a task centred approach would as Healey (2005) explains, mean focussing on enabling Ms. Evans to make small and meaningful changes in her life, that she has recognised, acknowledged and wanted to work on. Coulshed (1998) highlights that within this approach the service user is the main change agent, helping the worker to assess what the priorities for change ought to be. She further explains that because the worker is as accountable as the service user in carrying out agreed tasks this lessens the sense of powerlessness that the service user maybe feeling.

A task centred approach works on a specific set of procedures whereby the service user is helped to carry out problem-alleviating tasks (Coulshed 1998). Healey (2005) explains that it consists of the pre-intervention stage, followed by four sequential but overlapping steps. Therefore firstly I would need to understand and establish the source of referral (the Health Visitor) and negotiate with them any expectations and views. However as Healey (2005) states, by understanding the views of the referring agency does not mean that this has to be the focus of work, as I would need to work with Ms. Evans on defining the target problems.

Mutual clarity between Ms. Evans and me would need to be addressed, discussing any limits or boundaries, explaining confidentiality, my role, as well as any legal or other obligations. Working in collaboration with Ms. Evans I would seek to explore and prioritise Ms. Evans views of her problems, as the service user involvement in identifying the target problems are ‘critical to concentrating their efforts on change’ (Healey 2005:119). Epstein and Brown (2002) cited by Healey (2005) suggest a maximum of three target problems, as it is not necessary to address all problems identified. Success in a few can have a ‘knock-on effect for other problems in a service user’s life that may enable them to live with these problems or to deal with them’ (Healey 2005:113).

However as Healey (2005) writes, although within a task centred approach the service user’s definitions of their problems should prevail, in circumstances where the worker is duty bound to insist on considering certain problems, or a judgement has been made of a potential risk that the service user may pose to themselves or others, than these issues should be clearly raised.

An explicit agreement (contract) would need to be mutually clarified. This would include times, location of meetings, and detailed information on the goals of intervention, whereby the service user should be responsible for deciding the order in which problems should be addressed (Healey 2005). It should also include any goals the social worker has on behalf of their agency or statutory duties. For example when working with Ms. Evans, goals for intervention might include her health status to be investigated in relation to her post natal depression.

As well as this a statement of tasks would be listed to address target problems and to develop the service user’s problem-solving skills (Healey 2005). This is the key intention of task centred practice, ‘hence we must resist any temptation to do ‘for’, rather than do ‘with’ the service user’ (Healey 2005:122). An example of one task could be; Ms. Evans to gain more information on spinal bifida and then forward this to her partner, as she feels that he has not accepted their daughter’s condition, and this could be a fear of the unknown.

In supporting Ms. Evans in her task performance I would encourage, and help build on her strengths maybe through rehearsing set tasks with her in the form of role play (Healey 2005). This would enable for any strategies necessary to be put into place to help Ms. Evans overcome any obstacles that she may feel could hinder the completion of a certain task.

Task centred practice is a systematic process, therefore throughout my work with Ms. Evans I would need to regularly review performed tasks in order to acknowledge any gain made, as well as address any tasks that have not been performed. This would give me the opportunity to address any issues with Ms. Evans and to explore ways if deemed necessary to revise our contract.

Finally integral to the task centred structure is the need for a well planned termination. Healey (2005:124) writes that a ‘clear and looming deadline is vital for concentrating worker and service user efforts on change’. Within the termination meeting I would review with Ms, Evans the overall progress of our work, and how in the future she might maintain any progress that has been made (Healey 2005).

Healey (2005) explains that a task centred framework provides a ‘shell’ in which other theoretical perspectives can be incorporated. Incorporating a strengths perspective would, like task centred practice focus on, building a ‘service user’s capacity to help themselves’ and ‘to promote a mutual learning partnership between workers and service user’s’, (Healey 2005:158) keeping within the social work values of empowerment, respect and service user self-determination. According to Healey (2005) the strengths perspective concentrates on enabling service users and communities to work towards their future hopes and dreams, rather than looking at past or present problems.

Saleeby (1997:4) cited by Healey (2005:152) states that the strengths perspective formula is straightforward, where workers are required to ‘mobilise’ service users strengths in order to enable them to achieve their goals and objectives, which would lead to the service user having ‘a better quality of life on their terms’ (Healey 2005:152). Some of the key assumptions of the strengths perspective are, ‘all people have strengths, capacities and resources’, and people generally demonstrate resilience, rather than pathology when facing adverse life events. (Healey 2005:157).

Healey (2005) discusses the practice principles and how the social worker should adopt a positive and optimistic attitude towards service users, working in partnership with them so solutions to problems are developed collaboratively. Healey (2005:162) further states that the formation of a good working partnership can increase ‘the resources available to solve the problem at hand’. Therefore when working with Ms. Evans I would focus on listening to her story, identifying her capacities, strengths, and resourcefulness which could contribute to positive changes. I would clarify any strengths with her as Healey (2005:162) explains, service users ‘can grow when others particularly ‘helpers’ actively affirm and support their capacity to do so’.

My role as the social worker would be to facilitate Ms. Evans capacity to acknowledge, and use existing strengths and resources which would enable her to develop new ones. These strengths could be for example; the skills she has developed from parenting, most of which due to her partner being in the Navy she may have done independently. Ms. Evans defines herself as Asian and that Islam is important to her, therefore, another strength could be that of adaptability, and having the inner strength to explore new experiences, as she may have moved from an Asian community to be with her partner in the naval married quarters.

According to Saleeby (1996) cited by Healey (2005:164) ‘belonging to a community is the first step towards empowerment’. Therefore by working towards social justice principles I would explore with Ms. Evans what formal and informal help was available to her within the community. For example, a mother and toddler group, which would enable her to become part of the community that she feels she has not been accepted into. Healey (2005:164) explains ‘community support can build and draw on the capacities of service users to help themselves and to help others’.

I would also discuss with her the help she is already receiving in relation to her baby and her diagnosis of spinal bifida, which could mean the family are entitled to both financial and practical help. This could include a family support carer to give some respite, which would allow Ms. Evans some time to pursue her own interests, such as her religion. Further to this I would need to recognise any strengths and assets within Ms. Evans social networks, such as people she may feel can be supportive, maybe discussing with her possible personal support from family and friends (Healey 2005).

In conclusion this assignment has discussed the issues of power and how social workers need to be sensitive to and recognise power imbalances. .Following this, risk discourse has been explained, as well as a task centred approach to the case study. Finally the strengths perspective was incorporated which focuses on the capacities and potentialities of the service user.

Wales is a diverse country with its own national identity, language and multicultural society, however Wales also has defined issues. Within the following assignment I plan to look at the impact of poverty, discrimination and social exclusion within Wales and the role of the social worker in addressing these issues. I will then explain the role of anti-oppressive practice in creating social inclusion.

To understand the impact of poverty, discrimination and social exclusion I need to explain what is meant by these issues. People often think of poverty and social exclusion as a financial issue which affects people who are unemployed living on benefits but in reality it encompasses a far wider range of individuals (The Bevan Foundation 2009). Definitions of poverty, discrimination and social exclusion vary but I think the definition given by European Commission covers the wide spectrum of issues. It states:

“People are said to be living in poverty if their income and resources are so inadequate as to preclude them from having a standard of living considered acceptable in the society in which they live. Because of their poverty they may experience multiple disadvantage through unemployment, low income, poor housing, inadequate health care and barriers to lifelong learning, culture, sport and recreation. They are often excluded and marginalised from participating in activities (economic, social and cultural) that are the norm for other people and their access to fundamental rights may be restricted.”

Wales is the poorest country within the United Kingdom, due to the closure of much of its industry causing high unemployment, cuts in public spending, benefit changes and an aging population, it is thought that 600,000 approximately quarter of population live in poverty, even areas which are considered to be affluent are not as rich as many parts of the rest of the United Kingdom (Joseph Rowntree Foundation 2013). The Bevan Foundation defines groups of people within Wales who experience poverty, discrimination and social exclusion, these are ethnic minority groups, women, disabled people, children and young people and older people of pension age.

The BBC news and save the children have states one in three children in Wales live in a home earning 60% lower than the average income across the United Kingdom which is ?26000, as a result Wales has some of the poorest families who have stated they regularly go without food to ensure their children are able to eat and are finding it hard to purchase basis such as shoes and a warm winter coat. Some welsh parents on a low income have stated they are regularly stressed about money which impacts on their relationship with their children, this can have lasting effects on the child. Children who grow up poor are more likely to leave school without qualifications, have fewer life experiences, reduced aspiration, restricted ability to get a good job and can lead to lifelong problems with their physical, mental condition leading to shortened lives. Many of these families find themselves in the continual cycle of poverty and social exclusion, for example a child raised in poverty is more likely to leave school with low or no qualifications, which reduces employment opportunities available to them, which leads to low income which could lead to them living and bringing up their children in poverty and the cycle begins once again. These issues are then compounded by the discrimination of wider society who often view people living in poverty as ‘scroungers’ living off the state, this fed by the media reporting on people claiming large amounts of benefits and shows such as Benefits Street which the minority of people when the reality many people living in poverty are often working.

Poverty and social exclusion can be seen as an issue within large cities, there is a perception that only the rich live in rural areas, but these issues also affect Wales’s large rural areas. Pierson suggests exclusion within rural areas can be seen as an individual matter as people who currently living in poverty often live next door to someone whose home is their second or a multiple cars household, compared with people living in urban areas who live in socially deprived areas where their next door neighbour could be facing the same issues, taking this into account dealing with these issues could be harder to tackle. Pugh states it is often hard to recognising issues of social exclusion, poverty and discrimination within rural areas due to outsiders being unwelcome in smaller communities or due to the geographical areas of individuals. With the withdrawal or consolidation of services many services due to small amounts of people using them, many people are often left socially isolated. Pierson also suggests that people living in rural areas often face higher living expenses and they need to travel longer distances to purchases the basics. Young people living in poverty within rural areas often find themselves with low educational qualifications and a reduced or no opportunities for employment. Shucksmith suggests younger people and older people within rural areas often socialise more than in urban areas which can often influence their views on sexuality and social roles, this can cause discrimination or leave people unable to openly deal with l issues such as sexuality within the local community. Pugh states isolation within rural areas for people with mental health issues is often caused by peoples misunderstanding of their issues which can cause discrimination, people are often left not wanting to engage in communities where these views are present, this is often the views and experiences of homosexual men and women.

There is often an assumption within the care sector in Wales that most welsh speakers have the ability to speak English and therefore are able to receive services in English. As a result some areas of social care sector there is little or no provision for services delivered via the medium of welsh. Section one of the code of conduct ‘1.6 states respecting diversity and different cultures and value’ by not providing services for a service user in welsh the social worker is failing to meet the needs of the service user which could result in disempowerment. Welsh Government states in More than Just Words ‘Many service users are very vulnerable, so placing a responsibility on them to ask for services through the medium of Welsh is unfair. It is the responsibility of service providers to meet these care needs. Organisations are expected to mainstream Welsh language services as an integral element of service planning and delivery’.

Social workers continually addressing issues cause by social exclusion, discrimination and challenge them sensitively and constructively which is a fundamental part of their role. This is reflected in the code of practice written by the care council of Wales, throughout the code it states people must treat people as individuals and acknowledge peoples beliefs in cultures and values. The care worker must not:

5.5 Discriminate unlawfully or unjustifiably against service users, carers or colleagues

5.6 Condone any unlawful or unjustifiable discrimination by service users, carers or colleagues

Thompson states the social worker must understanding and recognise the significance of discrimination and oppression in service users’ lives and circumstances. Discrimination occurs on 3 levels (PSC) which are interlinked, P refers to personal or psychological, this looks at the individual’s thoughts, feelings, attitudes and actions, thoughts about specific groups within society are often based on people’s individual experiences. C refers to someone’s culture which impacts on how people do, think or see things, culture can be very influential on what people see as the ‘norm’ within society. The final letter S refers to Structural levels this is social division and power within society. Honer states the social worker must also understand groups and individuals can face discrimination which can be very different and personal.

The role of the social worker is multifunctional dealing with poverty, social exclusion and discrimination with emphasise on a holistic, citizen centred support which empowers people to take control of their lives while promoting social change (International Federation of social workers). Thompson sees empowerment on three different levels Personal, cultural, structural, I think this can also been seen with Dominelli as they state empowerment can be carries out on two levels. The micro level is the work the social worker carries out with the service user enabling them to take control of their lives, and the macro level is the work the social worker carries out within the wider community and challenging social policy by bring issues to the attention of relevant authorities or pressure groups, increasing the social and political power of groups which are oppressed. Unfortunately this can be lost within current targeted directed practice. People are encouraged to achieve their full potential and promotes coping strategies to ensure people succeed.

Pierson states when working with service users who are socially excluded, there are 5 building blocks required, maximising income and securing basic resources for service users and their families. The social worker needs to have a good understanding of the current benefits systems and keep up to date with any changes. Strengthening social supports and networks, working in partnership with agencies and local organisations, creating channels of effective participation for service users, local residents and their organisations. Focusing on neighbourhood and community level practice. Dominelli suggests creating power in oppressed groups by bring together people are oppressed by the same issues e.g. single mothers, and giving them the power to speak up together.

Social workers have a responsibility of the law. The Equality Act 2010, The Disability Discrimination Act 1995 and the Human Rights Act 1998 are pieces of legislation which a social worker is able to use to address issues of discrimination, including disability, sex, race and religion when services are withheld.

Dominelli suggests oppression involves something which divides people into dominant or superior group and subordinate or inferior ones, this can result in the views and contribution of the oppressed being seen as invalid and the movements of the oppressed are often controlled by the dominate party.

To address oppression the social worker must work in an anti-oppression way which rejects oppression and the way in which it disables individuals. Anti-oppressive practice holds the view each individual, group or community are diverse, equal and able to achieve their full potential and create social inclusion. To achieve social inclusion the social worker must work in partnership alongside the service user, family, local community and with organisations who are able to provide support, address highlighted needs from a clear assessment process in a holistic manner to empower them using strength based practise. The social worker also needs to create a clear plan with agreed objectives and time scales within a person centred framework with regular reviews.

Dalrymple and Burke 2006 state:

Anti-oppressive practice is based on the belief that social work should make a difference so that those who have been oppressed may regain control of their lives and re-establish their right to be full and active members of society.

While promoting anti-oppressive practice it is important the social workers do not become accepting of any issues they continually deal with as there is a risk of seeing these issues as the norm when dealing with issues over a long period of time. Thompson also states the social worker must be aware of the power which can be held within the role and do not use this inappropriately when dealing with individuals who can be seen as being disadvantaged by their lack of power. The social worker must also ensure they do not reinforce any stereotypes or discriminatory roles such as people with a disability are unable to make choices for themselves or all women are responsible for childcare.

As can be seen there are issues which affect Wales, as part of it role the welsh Government has created specific strategies to deal with the economic and social issues which affect Wales, such as The Welsh Government document Tackling Poverty Action Plan 2012-2016 which outlines how the Assembly aim to tackle the issue of poverty. The plan has 3 main areas prevention, helping people into work and Mitigating the impact of poverty. It is the role of the social worker to implement some parts of these strategies and instigate social change by empowering service users. The role of social work within Wales is continually evolving due to changes in Government policy and social change, with the promise of further powers for the Welsh Government the future holds possible further changes to the role.