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This short study concerns my experiences in dealing with an adopted service user who wishes to establish contact with her birth mother. The essay takes up the case of J, a 46 year old divorced lady who finds out about her history of adoption after the death of her adopted parents. J tries to directly establish contact with her biological mother, who refuses to meet her, leaving J traumatised and emotionally devastated. The case scenario is provided in the appendix to this essay and is considered as read.

This reflective and analytical account concerns (a) my experiences in dealing with J’s problems and needs, (b) my thoughts and theoretical knowledge of social work theory and practice with regard to children who are put up for adoption at birth, (c) their various emotional and physical challenges, and (d) the desire that is sometimes manifested by them during various stages of their lives to establish contact with their biological parents. It makes use of established social work theories like the attachment theory and the separation anxiety theory.

I also take up the growing prevalence of the use of social networking sites by adopted children to establish contact with their long separated birth parents, and the social work mechanisms available in the UK to facilitate meetings between adopted children and their birth parents.

The Challenges of Adoption

J was put up for adoption at birth and was adopted by foster parents. She grew up in her foster home in the company of her siblings, who were the birth children of her adoptive parents. The fact of her adoption was however concealed from her by her adopters. J grew up with some feelings of unease between her and her siblings and adoptive parents and suffered from low self esteem when she was young. She also displayed some behavioural problems and found it difficult to establish friendships with other children.

Adoption is undoubtedly an important and beneficial social process. It serves the critical needs of different individuals (Howe and Feast, 2000, p 34). It relieves natural parents of the onerous responsibilities of bringing up children when their circumstances make it impossible for them to do so, on account of social and economic reasons. It ensures safety, security, physical and emotional nourishment, education and improved life chances for unwanted, orphaned or abandoned children (Howe and Feast, 2000, p 34). It also fulfils the needs of childless couples, single people, and families for a child. Whilst adoption is undoubtedly an important social process, it brings along with it different types of social, economic and emotional challenges for all involved people, the child placed for adoption, the birth parents and the adopters (Howe and Feast, 2000, p 34).

Adopted children, numerous studies have revealed, are prone to the adverse consequences of attachment disorders and separation anxiety (Cassidy & Shaver, 1999, p 11). John Bowlby, well known for his advancement of the attachment theory, explains the critical importance for infants to develop secure attachments to their primary care givers. Bowlby states that attachment processes between infants and caregivers are biologically based, chosen by evolution to maximise survival chances, and aim to provide infants with feelings of security (Cassidy & Shaver, 1999, p 11). Such security provides infants with the foundations required to explore their environments, with the full knowledge that their caregivers will be able and available to provide them with protection in the face of adversity or stress (Cassidy & Shaver, 1999, p 11).

The separation of children from their primary caregivers often results in feelings of separation anxiety and the development of attachment disorders if their attachment needs are not met or resolved effectively (Blum, 2004, p 538). Studies on adopted children show that positively formed attachments between children and caregivers improve chances of well adjusted lives, irrespective of the biological relationships of attachment figures with children (Blum, 2004, p 538). Whilst it is known that J was put up for adoption at birth, the exact age at which she was adopted is not clear. Research shows that that children adopted after 6 months of age are at greater risk for development of attachment disorders (Blum, 2004, p 538). Such attachment disorders can lead to emotional disturbance, eating disorders, bedwetting, lack of performance at school, difficulty in development of positive relationships, withdrawal from society and poor life outcomes (Blum, 2004, p 538).

The adoptive parents need to take special care to ensure good adjustment of their adopted children. It is important for them parents to meet the needs of infants for love and nurturing on a consistent basis (Brisch, 1999, p 79). Adoption requires an active role from adoptive parents who assume the role of caregivers. As adopted infants explore their new and alien environment, adoptive parents must provide the required guidance, supervision and structure to ensure their safety (Brisch, 1999, p 79). Caregivers must also have the capacity and ability to provide levels of stimulation that do not overwhelm or stifle the infant’s developmental level. They must be attentive to the internal world of infants by being emotionally available to help them during periods of frustration, rejoice in their achievements and share their joy of exploration (Brisch, 1999, p 79).

Secure attachments create positive feelings in children that relationships can be helpful, fulfilling, and valuable and provide adequate protection in an occasionally overwhelming world (Blum, 2004, p 545). Whilst secure attachments do not secure immunity from subsequent psychopathology, childhood security is certainly related to (a) increased capacities for stress management and ability to rebound after periods of psychological disturbance, (b) capacity to manage family stressors, (c) increased self-esteem, (d) good peer relationships, and (e) good psychological adjustment (Blum, 2004, p 545).

Contemporary psychiatric theory states that adopted children often need therapeutic parenting, rather than normal domestic environments. Such parenting should be based on principles like sensitivity, responsiveness, following the lead of the child, the sharing of congruent and inter-subjective experiences and the creation of an environment of safety and security (Goldsmith, et al, 2004, p 2). Parents, in order to engage in such therapeutic parenting, require to be committed to adopted children, have reflective abilities, good insightfulness and secured mental states with respect to attachment (Goldsmith, et al, 2004, p 2).

With J showing evidence of emotional disturbance and behavioural problems during her childhood, it is possible that her parents, whilst providing her with a normal and secure domestic environment, did not place great emphasis in responding to her specific emotional needs. Their concealment of her adopted status is possibly an indicator of their concern for the child and their desire to protect her emotions and feelings. Contemporary psychological and social theories however recommend that children be informed of their adopted status (Hollingsworth, 1998, p 303). Such information, when provided with sensitivity and in appropriate circumstances and environmental surroundings, prevents adopted children from experiencing emotional traumatisation when they otherwise inevitably come to know of their history of adoption and helps them in adjusting to their new homes (Hollingsworth, 1998, p 303). Knowledge of birth parents is also important, both for the adoptive parents and the adopted children, in order to effectively cope with possible medical problems (Hollingsworth, 1998, p 303).

J came to know about her adopted status by accident when she was 42, after the death of her adoptive parents. The knowledge left her emotionally traumatised and brought back memories of her childhood and of feelings of strain in her relationships with her adoptive parents and their birth children. It is however but fair to realise that J’s parents very possibly had her best interests at heart and were also unaware of the future impact of not informing her of her adopted status.

Reunion of Adopted Children with Birth Parents

J, on knowing of her adopted status and the name of her birth mother, became emotionally disturbed because was not informed of the facts of her adoption, or about her birth parents. Adopted children, as they grow older, often become curious about their birth parents, especially so in situations of little or no contact (Adoption UK, 2010, p 1). Studies by Adoption UK, a national charity operated by adopters, reveals that all adopted children do not wish to know or contact their birth parents. Such desires are essentially personal, with some adoptees wishing to know more and others having little interest (Adoption UK, 2010, p 1). It is however also true that people who are not interested in contacting their birth parents when they are young, change when they become older, especially after they become parents and experience desires of knowing, contacting and establishing relationships with their own birth parents (Adoption UK, 2010, p 1).

The emergence of social networking sites like Facebook and My Space have made it far easier for adopted children, who wish to know more about their parents, to establish contact with their birth families (Fursland, 2010, p 1). Such accessibility has introduced significant complexities in the social relationships of adopted children with their adopted and birth parents and is creating difficult challenges for social workers when they are asked for assistance by individuals in need (Fursland, 2010, p 1).

Establishment of contact between adopted children and birth parents is an extremely sensitive issue and needs to be handled with care and sensitivity (Adoption UK, 2010, p 2). Adoption reunion can be a truly enriching and joyful experience, full of anticipation, twists and turns, joy, confusion, excitement, and fear. However reunion, like adoption, is not simple and can turn out to be a difficult, complex and sometimes saddening event (Adoption UK, 2010, p 2). Reconnecting with birth parents and children is rarely seamless and easy. It requires dedication, motivation, and a leap of faith (Adoption UK, 2010, p 2).

Adoption reunions often give rise to complicated issues that have been dormant for decades and have to now be dealt with and resolved. Many birth parents may have never have shared their child’s adoption with anybody else (Howe and Feast, 2000, p 57). Some birth mothers protect their secret because they are afraid of how others might or will react. For some mothers it is a matter of shame and they are instructed not to reveal their secrets to others (Howe and Feast, 2000, p 57).

The National Adoption Standards for England, (Department of Health, 2001), along with the Adoption and Children Act 2002, provided birth parents in England and Wales entitlement to a support worker, apart from the child’s social worker, from the point of identification of the adoption plan for the child (Goldsmith, et al, 2004, p 4). The Standards state that birth parents (a) should be able to access different types of support services, including counselling, advice and information before and after adoption, which recognise the long term implications of adoption, and (b) should be treated with transparency, fairness and regard during the adoption process (Goldsmith, et al, 2004, p 4).

Most adopted children now have plans for direct or indirect post-adoption contact with birth relatives. Agencies are required to identify contact arrangements in adoption plans and consider post-adoption support requirements of all concerned (Goldsmith, et al, 2004, p 4). Existing regulations like The Adoption Support Services Regulations entitle adopted children, adoptive parents, and birth relatives for need assessment regarding contact arrangements and mandate agencies to maintain services to help such contact arrangements (Adoption UK, 2010, p 2).

Helping J

J contacted us for support on making contact with her birth parents. The Adoption and Children Act of 2002 has established a framework that provides adopted people, who are more than 18 years old and their birth relatives, rights to request for intermediary services if they wish to make such contacts. Such intermediaries are provided by registered adoption agencies, (either voluntary or local authority), or registered adoption support agencies and act as mediators between adopted people and their birth relatives. It is recommended that people wishing to make contact with birth relatives do so through intermediaries. J was informed about the intermediary process and services that could be provided by me in mediating with her birth mother but decided to contact her directly.

When J contacted our agency and the case was assigned to me to help her with her emotional challenges and her desire to establish her birth mother, I engaged her in a long discussion in order to assess her emotional status, her views about her adopted childhood and her desire to meet her birth mother. I met her at her home on two occasions after taking prior appointments in order to ensure that she was prepared for the meeting and would be able to convey her thoughts better in familiar surroundings.

I took care to adopt the person centred approach and deliberately avoided all judgemental feelings about her background as a relinquished and adopted child. The adoption of a person centred approach is necessary for the true implementation of anti-oppressive and anti-discriminatory approaches and I was able to understand J’s emotional and mental condition with greater clarity and empathy (Mearns and Thorne, 2007, p 9). Whilst my choice of open and close ended questions did help her in opening up and in shedding her inhibitions and reservations, I found her to be disturbed about her adopted status. She appeared to be disturbed with her adoptive parents for their concealment of information about her birth, her birth parents and her adoption, and kept talking of small incidents of her childhood about her parents and siblings. She also spoke about her behavioural problems, her disturbed sleep and her difficulties in making friends at school.

J was however determined to establish contact with her mother and decided to contact her as soon as she found out her contact details. I offered to act as intermediary and contact her mother in order to assess (a) her views on the relinquishment of her birth child, (b) her current emotional status and (c) her attitude towards establishing contact with J. The lady (J) was however unwilling to wait even for a few days and was convinced that her mother would like to meet her as much as she did. I did mildly explain to her that her mother could have different opinions on the issue and even offered to expedite the process. Whilst J did provide some indication of being ready for my help at the closure of our second meeting, she subsequently changed her mind and established direct contact with her birth mother. Her birth mother, from what J told me later, was absolutely surprised at receiving the call and was taken aback by the development. She responded to J’s introductory communication with brusqueness and asperity, informing her that she did not wish to respond to her overture or to establish contact.

I do feel that J acted with great haste and the result of the initiative could well have been very different with the use of an intermediary. I would have telephoned J’s mother and asked for a personal meeting. I would have again adopted a person centred approach, refrained from being judgemental, and would have engaged her in discussions about her reasons for relinquishing her birth child. I would have then gently brought up the matter of J, her adopted childhood, the concealment of information about her adopted status, and her current emotionally disturbed condition. I do feel that such an approach would have yielded a better response from her mother than J’s arbitrary method of establishing contact.

Conclusions

This reflective account details my experiences of dealing with an adopted service user, who tried to unsuccessfully establish contact with her birth mother. Modern day theory on social work and psychology stresses upon the complexity of adoption and the various challenges that the process brings up for the adopted children, the adopters and the birth relatives. Adopters have particularly significant responsibilities in ensuring, possibly through the use of therapeutic parenting methods, that their adopted children do not suffer from separation anxieties and do not develop attachment disorders. It is important for social workers to understand the emotional implications of these complexities and consider the emotional needs of all involved people with empathy and understanding.

It is also important, as my experience with J reveals, for adoption reunion processes between adopted individuals and their birth relatives to be handled with great care and thought. I do feel that I should have been more persuasive and possibly more forthright, without being judgemental, with J on (a) the possibly very different perceptions of her birth mother towards the meeting, (b) the compulsions that forced her to relinquish her birth child for adoption and (c) her current emotional condition and social environment.

Such an action would have possibly produced better results at the end. My knowledge of social work theory and practice has been significantly enhanced by my experience with J and will help me to deal with such situations much better in future.

Word Count: 2625, without citations and bibliography
Bibliography
Adoption UK, 2010, Wanting to know more – or not, Available at: www.adoptionuk.org/information/217131/wanting_to_know_more/ (accessed January 30, 2011).

Blum, H. P., 2004, “Separation-Individuation Theory and Attachment Theory”, Journal of the American Psychoanalytic Association, (52): 535-553.

Bowlby, J., & Parkes, C. M., 1970, “Separation and loss within the family”, In E. J. Anthony & C. Koupernik (Eds.), The child in his family: International Yearbook of Child Psychiatry and Allied Professions, pp. 197-216, New York: Wiley.

Bowlby, J., 1973, Attachment and loss, Vol. 2: Separation, New York: Basic Books.

Brisch, K. H., 1999, Treating attachment disorders, New York: Guilford Press.

Cassidy, J., & Shaver, P. R., 1999, Handbook of attachment: Theory, research, and clinical applications. New York: Guilford.

Feast, J., & Howe, D., 1997, “Adopted adults who search for background information and contact with birth relatives”, Adoption & Fostering 21:2, pp 8-15.

Fursland, E., 2010, “Facebook has changed adoption forever”, www.guardian.co.uk, Available at: www.guardian.co.uk/…/19/facebook-adoption-tracing-birth-mother (accessed January 30, 2011).

Goldsmith, F. D., Oppenheim, D., & Wanlass, J., 2004, “Separation and Reunification: Using Attachment Theory and Research to Inform Decisions Affecting the Placements of Children in Foster Care”, Juvenile and Family Court Journal, pp. 1-12.

Hollingsworth, L., 1998, “Adoptee dissimilarity from the adoptive family: clinical practice and research implications”, Child & Adolescent Social Work Journal 15, (4): pp 303-19.

Howe, D., & Feast, J., 2000, Adoption, Search and Reunion: The long-term experience of adopted adults, London: The Children’s Society.

Mearns, D., & Thorne, B., 2007, Person-Centred Counselling in Action, 3rd edition, London: Sage Publications.

Levant, F. R., & Shlien, M. J., 1987, Client-Centered Therapy and the Person-Centered Approach: New Directions in Theory, Research, and Practice, USA: Praeger Paperback.
Appendices

The rate of teenage pregnancy has decreased greatly within the past years but it is still an immense problem which needs addressing. Pregnancy rates in the United States are still higher than those in other industrialized nations aa‚¬” this is the case even though American teens are no more sexually active than teenagers of other nations. Recent statistics concerning the teen birthrates are alarming. About 560,000 teenage girls give birth each year. Almost one-sixth of all births in the United States are to teenage women and eight in ten of them are of unintended and unanticipated pregnancies. By the age of eighteen, one out of four teenage girls will have become pregnant.

The rate of teenage pregnancies may be high among low income African-American, Hispanics, and those in inner city ghettos; it is higher still among poor, white, young women who live in small cities. The question of which teenager is most likely to become pregnant can be answered by knowing attitudes towards the social consequences of adolescent parenthood. Those individuals understanding that parenthood at an early age will limit their chances of education; will most likely be influenced to not have an unplanned pregnancy, if they are highly motivated to become professionals in the future. The higher a woman’s level of education, the more likely she is to postpone marriage and childbearing. Adolescents with little schooling are often twice as likely as those with more education to have a baby before their twentieth birthday. Some 58% of young women in the United States who receive less than a high school education give birth by the time they are twenty years old, compared with 13% of young women who complete at least twelve years of schooling. Young women who become pregnant who become pregnant during high school are more likely to drop out due to the excessive workload which is hard to balance. A teen mother leaves school because she cannot manage the task of caring for a baby and studying, and a teen father usually chooses a job over school so that he can pay bills and provide for his child. Teen mothers usually have fewer resources than older mothers because they have had less time to gather savings or build their resumes through work experience, education, or training. Because of this, teen mothers are generally poor and are dependent on government support. The welfare system is usually the only support a teen parent will receive. Welfare benefits are higher for families with absent fathers or dependent children.

Emotional stress is also another issue which teenage mothers have to deal with along with financial strains. Teen mothers may have limited social contacts and friendships because they do not have time for anything other than their baby. Lack of a social life and time for herself may cause the teenage mother to become depressed or have severe mental anxiety. Depression may become worse for a teenage mother because she usually does not know much about child development or about how to care for their children. Children who are born to teenage mothers usually suffer from poor parenting. Also, children of teenage parents start being sexually active before their peers and they are more likely to become teenage parents themselves. These children may also suffer from financial difficulties similar to that of their parents. Children whose mothers are age seventeen or younger are three times as likely as their peers to be poor, and are likely to stay poor for a longer period of time. Children born to teenage mothers are also at an intellectual disadvantage.

Teen mothers face greater health risks than older mothers, such as anemia, pregnancy induced hypertension, toxemia, premature delivery, cervical trauma, and even death. Many of these health risks are due to inadequate prenatal care and support, rather than physical immaturity. The teenage mother is more likely to be undernourished and suffer premature and prolonged labor. Death rate from pregnancy complications are much higher among girls who give birth under age fifteen. Poor eating habits, smoking, alcohol and drugs increase the risk of having a baby with health problems. The younger the teenage mother is, the higher the chances are that she and her baby will have health problems. This is mainly due to late prenatal care, if any, and poor nutrition. An adolescent mother and her baby may not get enough nutrients and, because the mother’s body is not fully mature, and thus she may have many complications throughout the duration of her pregnancy.

Along with the mother, the children of teenage parents too often become part of a cycle of poor health, school failure, and poverty. Infants born to teenage mothers are at a high risk of prematurity, fragile health, the need for intensive care, cerebral palsy, epilepsy, and mental retardation. Low birth weight is the most immediate health problem. Babies born to teenagers are often born too small, too soon. The death rate for babies whose mothers are under fifteen years of age is double that of babies whose mothers are twenty to thirty years old.

Some research indicates that the percentage of teenage birthrates has declined simply because fewer teenagers are having sexual intercourse and more adolescents are using contraceptives. Researchers say that the recent trends in sexual activity and contraceptive use are the result of a number of factors, including greater emphasis on abstinence, more conservative attitudes about sex, fear of contracting sexually transmitted diseases, the popularity of long-lasting birth control methods such as the contraceptive implant, Norplant, the injectable Depo-Provera, and even because of the economy. In addition, researchers state that young people have become somewhat more conservative in their views about casual sex and out-of-wedlock childbearing. Some attribute this change in attitude mainly to concern about sexually transmitted diseases. Others say that it is because of the involvement of conservative religious groups in the public debate over sexual behavior. Many researchers believe that the strong economy and the increasing availability of jobs at minimum wage have contributed to fewer births among teenagers. Americans, however, seem to be against some of the methods used by these various organizations to reduce the teen pregnancy rates. The most controversial aspect of adolescent pregnancy prevention is the growing movement to provide teenagers with easy access to contraceptives.

Teenage pregnancy does cause many problems for the mother, child, and economy. There are, however, some incidences where the mother overcomes this down-hill trend and makes a successful life for her and her child. The outcome of teenage pregnancy turns out better if the mother goes back to school after she has given birth. Staying in school may help to prevent teenage mothers from having a second pregnancy. The outcome is also better if the mother continues to live with her parents so that they can help to raise the child. Young, teen mothers need health care for themselves as well as their children. An adolescent mother also needs a great deal of encouragement to get her to remain in school. Single teenage mothers also need job training so that they can get a good job to support themselves and their children. Teen mothers need to be taught parenting and life-management skills and also need high quality and affordable daycare for their children.

Schools that provide daycare centers on campus reduce the incidence of teenagers dropping out of school. These school programs also decrease the likelihood that the teen mother will have more children. Because the government has begun to take action in preventing teen pregnancies, the rate has continued to decline. The large numbers of young people in America–as well as the values, health, education, skills they gain–will greatly affect the future of society.

The levels of education available to younger individuals is much greater than that which was available to their parents and the expectation is that young people take the opportunity and initiative to obtain higher levels of education. The numbers of women become pregnant during their teenage years is declining, although slowly, as many young women recognize the impact which childbearing has on education. It has also decreased as parents and communities discourage sexual activity, marriage and motherhood at young ages. These recent trends will most likely educate young adolescent teenagers about the consequences and risks of teenage pregnancy and reduce the incidence of teen pregnancy and childbirth altogether if continued.

Social work practice has shown that understanding different psychological, sociological and biological theories can help in working effectively with families going through difficulties (Adams, Dominelli and Payne, 2009). This assignment will discuss relevant theories that would enable a social worker to better understand and assess this family’s circumstances and behaviour.

A brief history of Sam states that he was previously adopted by the family when he was 4 years old. One of the theories to consider within this case study is the Attachment theory. It has become more relevant in social work, especially when applying to adoption and fostering. Walker (2008) has highlighted the relevance of attachment theory to child protection in social work. Social work now understands the importance to assess the capacity of carers that would substitute the previous that would provide a secure base. Bowlby (1988) states that children would then develop and grow if they have this secure base. A possible problem would be that Sam has already entered the care system. He may have already experienced significant loss or trauma. This would affect his relationships with others. Children who have experienced significant loss or trauma will need help from their substitute carers to manage their feelings, which could be too strong for the child to manage alone. Therefore their carers need to have resolved any issues similar to the child’s in order to be affectionate and cognitively aware when the child remembers their experiences. (Walker, 2008)

Attachment was originally used to describe affectional bonds between children and their main care givers. The term has now been expanded to include other periods of development like adulthood. (Adams et al, 2009) The primary function of the attachment relationship is to ensure closeness to the caregiver for food and safety. (Brodzinsky and Schechter, 1990)

A large amount of research has found that attachment at infancy has a huge effect on the child’s psychological functioning. Researchers Hazen and Durrett (1982) found that toddlers more securely attached as infants are more willing to explore their environment, than those who were more anxiously attached to their caregivers. Other researchers have found that there is a continued link between behaviour from childhood when involving terms of attachment. (Brodzinsky et al, 1990)

As Sam was adopted at a later developmental stage this would have an effect on his attachment. The foster home or placements before adoption is critical in that he needs support from the carers both psychologically and emotionally if he has experienced trauma or neglect. Children can have numerous attachments but according to Brodzinsky et al (1990) if they have suffered abuse or neglect in early infancy then this may affect their level of basic trust.

Bowlby described the attachment system simply. If the child perceived its attachment figure as accessible it will have confident behaviour. However if the child doesn’t believe this they will exhibit anxiety. This behaviour may have been produced by Sam up until he ‘gave up’. Sam may not believe his attached figure is still accessible as she’s caring for a newborn. Bowlby believed that after this time he may experience depression and despair.

Work by Tizzard (1977) found that children adopted from age’s two to four showed that on average demonstrated no more problems that those children living with their family. They were however more likely to be over friendly and have attention seeking behaviour. (Berryman, Smythe, Taylor, Lamont and Joiner, 2002)

Some researchers have found that there is an over dependence on using the attachment theory in adoption cases. Barth, Crea, John, Thoburn and Quinton (2005) found that the scientific base of attachment theory is limited when underpinning theory for future interventions. Barth (2005) did state that social workers needed to understand what works when using the attachment theory in adoption cases but to use what works and develop an intervention that has a more appropriate evidence based approach.

Applying Attachment theory to practice involves looking at the child’s present relationships, relationship history and the context of their life and concluding which particular stresses may affect their behaviour the most. In this case looking into Sam’s school life and financial problems the family may be having. Social workers work with families to provide support and psychotherapy. In this case they should help provide support in getting the family help regarding emotional support and financial. According to Payne (2005) understanding how attachment experiences can relate to difficulties they are currently facing is one of the therapeutic tasks Bowlby highlighted. A criticism highlighted by some psychologists is that the theory uses ideas from different theories. Bowlby didn’t set exact ideas of how to practice this theory, although Payne (2005) does recognise that the theory does have a good basis for explaining childhood problems.

When practicing this theory social workers must understand the importance of linking it to other theories as they support further work for example the cognitive behavioural supports the idea of using therapy as a learning tool much like what the Attachment theory describes.

Sam has shown a change in behaviour since his baby brother was born. He’s been rude to teachers, argues at home, he’s not eating properly and is withdrawn from his family. This change in behaviour may be because of a number of reasons however it is important to highlight that even though he displaying avoidant behaviour now he can still be securely attached. Avoidant behaviour means he is more likely to be withdrawn although still securely attached. However some of his behaviour shows signs of stronger avoidance. Sam is fighting at school, one example of avoidant of behaviour is bullying and focusing on those weaker than him, he has showed signs of this towards his baby brother which is a cause of concern. (Walker, 2008)

Social workers should be aware of this change in behaviour. Children who have experienced neglect or trauma will present challenging behaviour to their care givers, these carers then need to be more understanding as this behaviour may be due to past experiences and high levels of anxiety. (Berryman et al 2002)(Walker, 2008)

When working with Sam at assessment level its essential that the social workers use anti discriminatory practice they need to be non judgemental. It may be that they have seen cases like this several times, but to understand that each case is different and assessing Sam with no assumptions and treating him as an individual is an important attitude that the social workers would need to have.

The history given has shown that the parenting styles may have changed recently, as Sam has been more disruptive his parents have been firmer, sending him to his room. This authoritarian parenting style produces children that are anxious, aggressive and have low self esteem, all behaviour styles that Sam has presented. (Baumrind, 1966) This may not be the best way to deal with his behaviour, especially as he has become more withdrawn from the family and not eating. This may highlight an underlying problem for example an eating disorder or ADHD.

Research by Harris (1998) a major critic of the attachment theory found that Nature is an assumption. Society assumes that parents who are kind and honest will have kind and honest children. Harris believes that peers may have more of an effect on the child’s personality. Using the example of identical twins, she highlights that when living in different homes they will more likely have the same habits. She also highlights that children who live in high crime areas will be more susceptible to committing crime themselves. Personality also comes from genes, as shown in separated twin studies. In this case it’s important to investigate Sam’s friends at school and also his maternal mother to find out what could be influencing Sam’s behaviour.

Once more social workers when working with Sam would need to understand that although society can make assumptions social workers cannot. When working with Sam it’s also worth noting that the social workers must have controlled emotional involvement. Sam may explain situations which could be very emotional the social workers would need to have the capacity to be sensitive when working with him.

An additional theory that social workers should consider when assessing Sam is the Social Readjustment rating scale. Invented by Homes and Rahe (1967) the higher the number you have when counting the number of life events you have faced the more likely it is that you will have an illness. The scale denotes that if you have a score higher than 150 then you have faced mild life stress. Using the scale Sam’s social rating scale was 153. This scale is useful when considering the life events that Sam has faced in a relatively small space of time. However Lazarus and Folkman (1984) found that this approach is narrow and has the ability to ignore difference between individuals when considering their vulnerability to these life events. Lazarus et al also found that the Social readjustment rating scale ignores chronic stressors which may distress individuals greatly over a length of time.

An approach to understanding stress was produced by Lazarus, DeLongis, Folman and Gruen (1985) they consider stimulus and response, coping style and defence mechanisms. Called the Model of Adoption adjustment it focuses on two types of coping, problem focused and emotion focused. The emotion focused strategies can involve attempts to reduce the individuals stress with behaviour such as avoidance, distancing or selective attention. These changes in behaviour help in reappraising the life event and redefining it as less intimidating than the individual previously thought. This type of cognitive appraisal process and coping strategy Lazarus et al argues can be influenced by environment. Using this approach can help investigate other factors. This cognitive appraisal process provides the bases of highlighting differences between individuals and what their psychological stress reactions are in response. (Lazarus et al, 1985)

As Sam has faced so many life events it’s important for social workers to understand how much they can affect his psychological well being and behaviour and to understand the importance of recovery in these very traumatic situations. This approach can help expand the social workers understanding of how much these events could be part of the cause of his change in behaviour. Criticising different aspects of these similar theories can establish how useful it would be to individuals and how differently each individual responds to certain stressors.

Applying the Model of Adoption adjustment theory to practice would involve investigating Sam’s relationships and past history of emotional events to gain a better insight into how well he has used emotion focused or problem focused strategies and what his psychological reactions have been in response to the events he has faced.

Bronfenbrenners Ecological theory is another theory the social workers should consider when assessing this case study. This theory takes into account the relationship between the family, immediate environment and also the larger environment. It understands a structure of five layers. These layers involve different systems which would all affect Sam differently. The microsystem contains direct relationships and interactions of the child, the structures in the microsystem can be the family and school. Bronfenbrenner believed that the relationships between this system impact away and toward the child. For example the child affects the behaviour of the parent and the parent affects their behaviour onto the child. The mesosystem includes the child’s connections between the microsystem’s structures, e.g. Between Sam’s parents and their community neighbourhood. The exosystem identifies the child’s larger social system, although Sam will not directly function with it. For example Sam may not be directly involved with his father’s work hours but may be affected by its interaction within his system. The fourth layer, the macrosystem involves the wider society. (Payne, 2005) (Adams et al, 2009)

The ecological theory focuses on the unique influences of the service user and the relevance of the immediate environment as well as larger society. It focuses on the service user as the centre of the process.

Assessments use an ecological framework as a basis although in practice Francis et al (2006) argue that comprehensive assessment tools may affect crisis intervention assessments because this assessment is very time consuming. This theory provides a basis on which social workers can work from to consider the impact that these layers would have on Sam’s relationship and behaviour.

In this case it would be sensible to consider this theory. Sam has faced multiple life events each could affect his behaviour. This approach recognises that multiple factors could be affecting Sam’s behaviour. It provides a holistic framework to understand these factors, then analyses them and finds solutions. A major criticism involving social work using this approach is that as the assessment is so lengthy and needs a lot of organisation to produce a solution. Many social workers have shown a poor record of good quality assessments. (Petch, 2002) Some social workers seem to focus on the immediate future of the child rather than long term solutions. The GSCC (2004) have produced aims because of this to highlight that it is important that practitioners understand that it’s a central part of their core principles. It’s important to note the use of Anti discriminatory practice within the use of assessments using an ecological approach. Understanding that individuals all have different cultures, behaviours and history is essential especially when Sam is vulnerable both as a child and as a previous service user who may have experienced past neglect or trauma.

Jan (mother)

A brief history of Jan explained that she has previously used IVF treatment a number of times with no successful pregnancy. After realising the emotional and financial difficulties that may follow if they decided to carry on trying they applied for adoption. They were matched to Sam, who was four at the time and despite initial reservations he seemed like the ‘model child’. Jan then gave up work to care for him. At 24 weeks she found out she was pregnant which she was told by doctors would be virtually impossible. Jan has found motherhood a struggle and has stated she feels useless. Her Parenting style towards Sam has changed as she has been stricter because of his behaviour change. She is also worried about the health of her baby.

Attachment is also an important theory to consider for this individual. Research on Attachment in adults focuses on the assumption that the same bonds between parents and children are responsible for the bonds between adults in personal relationships. (Bowlby, 1988) If this were the case then the relationship between these individuals should reflect how they attached when they were younger; younger children may have secure attachments. Therefore when they grew up have equally secure romantic attachments. However if they had less stable attachments when they were younger they may have less secure relationships when they reach adulthood. Similarly children who have secure attachments but have had inconsistent secure attachments as they grow up may well have a change in their attachment pattern.

Jan and her husband Tony seem to have some relationship problems. Tony isn’t able to provide the level of emotional support that she needs because of the increased hours he has to work. Jan may be slightly insecure about her relationship with Tony it’s important to explore this relationship at both an individual level and together to work out solutions together. To provide support and work out what each individual needs both emotionally and psychologically, especially as Jan seems to be becoming more upset about her situation and because she doesn’t seem to have anyone to turn to for help.

Jan’s relationship with her mother seems problematic. Firstly she seems over dependent on her mother, who she expected to help with the baby. The relationship she has with her mother may have consequences on how she attaches to future individuals affecting both her attachment with her husband, the attachment she has with her baby and with Sam.

As Jan didn’t realise she was pregnant until she was 24 weeks pregnant she didn’t have as much time to become emotionally and psychologically ready to prepare to have her baby. A paper by Bernstein, Lewis and Seibel (1994) found that women who were previously infertile have difficulty transitioning to parenthood some women may show high levels of anxiety, avoidance behaviour and problems with preparing for a newborn. They found that guidelines need to be developed to meet the needs of these women who have become pregnant after infertility. Not only could the attachment between her partner and mother be problematic but as these papers suggest the attachment between her and the newborn may be the most affected because of her infertility the effects it has on her emotionally, psychologically and biologically. Creating further levels of anxiety and producing negative behaviour.

Social workers assessing and working with Jan who have been involved in IVF or have experienced it themselves may be too embroiled in the situation as the social workers may unintentionally direct Jan into making decisions. It would be more responsive as a social worker to understand this and move away from this case.

The Spoilt identity theory is an important sociological theory to consider when understanding Jan’s behaviour. Goffman’s (1990) spoilt identity theory or social stigma explores behaviour and how certain behaviours or attributes can be socially shameful. The Collins dictionary describes stigma as distinguishing mark or social disgrace. Goffman (1990) refers to stigma as an attribute that is discrediting.

This theory is significant to this case as Jan has had to deal with a number of life events especially one that is socially discrediting. Stigma theory predicts that childless women deviate from ordinary and normal life courses and are deeply discredited by society. Jan had expectations before she got married that she would have children by birth and became increasingly obsessed with having a child because of the amount of IVF treatment she used. A recent paper by Whiteford and Gonzalez (1995) posed the question “Why do some women become consumed to give birth to a child, even to the detriment of their own health, marriage and financial status?” They found that society was the main cause that pressures women into having children. That the women used within their research suffered because they had internalised the norms within society and because of this described their selves as defective. As well as society it is also the mediatisation of intervention that has also affected women infertile. Media is constantly highlighting how many infertile women are now with child because of medical interventions what this does psychologically to the women still not able to become pregnant is even harder to comprehend.

When infertility does affect you the individual is then not living one’s life via the social “norms”. It affects women differently compared to other stigmas as infertility stigma is not a physical one like a limp. Looking at a woman who is infertile would not tell you that she is, it’s their own knowledge that has such a profound effect on their psychological wellbeing.

It can create stress and crisis to both the individual and family, affecting them financially, emotionally and physically. Jan and her husband have both been affected through this trauma and it may benefit both of them if they have counselling together, even though they have now become pregnant and had a child it is still affecting their relationship. The husband has to work long hours to be able to afford living costs because of the cost of treatment for the IVF.

Post natal depression may also be affecting Jan. Since she has had her baby she has become emotional and found motherhood a struggle feeling useless and low. Biologically speaking post natal depression is a form of depression. Depression usually develops within three or four weeks after childbirth it has the same symptoms is depressive disorder these include increased sleeping, lethargy and affected appetite. New mothers would also be anxious about the baby and have thoughts about her failure as a mother which Jan has showed signs of. Jan has faced a number of life events which may increase the risk of post natal depression.

Fortunately there are a lot of different types of diagnosis for post natal depression. The Edinburgh post natal depression scale and the Hamilton rating scale for depression which uses a point system to assess their level of depression.

There is a wide range of treatments for post natal depression the type the patient needs would be dependent upon the severity of their depression. Firstly support and advice is offered to give the family an understanding of how they can recover. Independent advice is given regarding any social problems that may be affecting their relationships. Antidepressants may be prescribed, these would then allow the body to function more normally. Although there are several types of side effects which may cause further problems.

Counselling and psychological treatments may be the best form of treatment as they look at the individual wholly and what within their lives could be affecting their depression. Cognitive behavioural therapy helps indentify thought patterns which could make the patient more depressed. It achieves changes in the way people think. Interpersonal therapy may also be useful to consider in this case as this therapy identifies problems within relationships and relates it to the individual’s depression. There will always be positives and negatives of using these different treatments post natal women may find it hard to commit to psychological therapy because of the time commitments and may find it easier to just use prescribed medication. The main criticism with this treatment is that it doesn’t look at the patient’s problems holistically if there are problems within the relationships facing them now and finding solutions rather than putting them off would be more beneficial in the long run. According to research by Dennis (2005) the most promising intervention is intensive professional post natal support.

Whilst working with Jan and her family it’s essential that the social workers give purposeful expression of feeling, giving them the chance to say what they want from the social workers and what they really need and feel about everything that’s affecting their relationships and what they want their goals to be.

Considering each type of theory for this case study then establishing how they all correlate to one another is the best way to understand how to find solutions for these individuals. Understanding biological, sociological and psychological theories and human growth and development plays an essential part in assessing and intervening in a positive way. The International Federation of Social Workers guideline states that “The social work profession draws upon theories of human development and behaviour and social systems to analyse complex situations and to facilitate individual, organisational, social and cultural changes.” (2000) Considering each type of theory gives a broader understanding of individual’s experiences and how social workers can find solutions when they are needed. Social workers need a broad knowledge base of professional experiences, evidence based research and service users experiences to gain the best understanding of that situation.

The Experience of Domestic Abuse Amongst South Asian Women – How issues of domestic abuse arise in Asian families – is it prevalent amongst Asian communities more than Western European communities, or is this a myth created by media – what are underlying cultural issues (ie. Forced marriages, honour killings/violence, mental abuse, physical abuse, rape, etc) – how does the community/family respond to domestic abuse when it is perpetuated, how are the women treated, is their support from within the community for these women

Domestic violence can have an enormous effect on your mental health. It is now well accepted that abuse (both in childhood and in adult life) is often the main factor in the development of depression, anxiety and other mental health disorders, and may lead to sleep disturbances, self-harm, suicide and attempted suicide, eating disorders and substance misuse. (See References.)

Abused women are at least three times more likely to experience depression or anxiety disorders than other women.

One-third of all female suicide attempts and half of those by Black and ethnic minority women can be attributed to past or current experiences of domestic violence.

Women who use mental health services are much more likely to have experienced domestic violence than women in the general population.

70% of women psychiatric in-patients and 80% of those in secure settings have histories of physical or sexual abuse.

Children who live with domestic violence are at increased risk of behavioural problems and emotional trauma, and mental health difficulties in adult life. (See also Children and domestic violence.)

An audit in Greenwich found that 60% of mental health service users had experienced domestic violence. Another survey of women using mental health services in Leeds found that half of them had experienced domestic violence and a further quarter had suffered sexual abuse.

How your mental health can be used to abuse you further

If you have a mental health diagnosis, your partner may have used this to abuse you even more. For example, by:

Saying you couldn’t cope without him.

Saying you’re ‘mad’.

Not allowing you to go anywhere alone because he is your ‘carer’.

Speaking for you: “You know you get confused/you’re not very confident/you don’t understand the issues”.

Telling you you’re a bad mother and cannot look after the children properly.

Forcing you to have an abortion because ‘you couldn’t cope’.

Threatening to take the children away.

Threatening to “tell Social Services” – the implication being they will take the children away.

Telling the children “Mummy can’t look after you”.

Deliberately misleading or confusing you.

Withholding your medication.

Withholding or coercing you into using alcohol or drugs.

Undermining you when you disclose the abuse or ask for help: “You can’t believe her – she’s mad”.

These tactics will almost certainly add to your emotional distress and exacerbate any existing mental health issues.

If you have been diagnosed with a mental health disorder, you will be in a particularly vulnerable position, and are likely to find it even harder to report domestic violence than other women. You are likely to suffer from a sense of shame because of the stigma attached in our society to having mental illness of any kind, and you may feel even more powerless. Furthermore, the response of the service providers is also likely to be more problematic, due to the stigma of being ‘mentally ill’:

They may not believe you when you disclose abuse.

They may see you only when your partner is present.

They may accept your partner’s account at face value.

They may feel sympathy for your partner – “After all he has had to put up with” – or blame you for the abuse.

They may judge you (particularly if you are self-harming or have attempted suicide, or if you use alcohol or drugs).

Don’t blame yourself! Your mental health difficulties are not your fault, and you are not responsible for the abuse: the abuser is. You are entitled to help as much as any other abused woman, and if you have additional support needs, you should get help with them too.

Some refuge organisations are unable to offer accommodation to women with severe mental health needs because they have insufficient resources to provide suitable support. However, other refuges will be able to accommodate you – and all refuge organisations should be able to find you somewhere else to go. If you have decided to leave your abuser, you could ring the Freephone 24 Hour National Domestic Violence Helpline on 0808 2000 247, run in partnership between Women’s Aid and Refuge, which will be able to put you in touch with a refuge organisation that can provide accommodation that meets your support needs.

Mental health services

Despite the frequent overlap between domestic violence and mental ill health, mental health professionals seem generally to ignore the issue of abuse. They are unlikely to ask you about it and may therefore be unaware of it. You yourself may feel unable to disclose the abuse to your GP or to your community psychiatric nurse (CPN) or your psychiatrist (if you have one). So you may find that the reasons for your depression or other difficulties are ignored. You may feel blamed for the abuse. And you are very likely simply to be offered medication (such as tranquillisers, anti-depressants or sleeping pills) instead of being given an opportunity to talk about what is happening or has happened to you.

When mental health professionals do take domestic violence into account, they may still disagree about the causes of your condition and how to treat it. For example, some psychologists believe that the diagnosis of post-traumatic stress disorder (PTSD), most often associated with wars or natural disasters such as fire or earthquake, or experiences such as torture or being held hostage, can be appropriately applied to survivors of domestic violence. Other people argue that anxiety and depression, and even self-harm or suicide attempts may be the normal response to the experience of long-term abuse.

While depression tends to ease when women are no longer being abused this will not happen immediately. It may take a long time for you to come to terms with what has happened. You may suffer continued abuse and harassment long after the relationship itself has ended – and you are likely to live in fear of it for much longer. You may also experience flashbacks long after the violence has ceased.

See Surviving after abuse: Looking after yourself and moving on for some suggestions on how to deal with this.

Counselling

All women who are experiencing or have experienced domestic violence will need emotional support of some kind, but their needs will vary. All women need to be listened to with respect and without being judged when they choose to talk about their experiences. They want to be believed – and to feel they have been understood. Mutual support from other women who have had similarly abusive experiences can be very valuable: it will help you to feel less isolated and to recognise that none of the abuse you experienced was your fault. You will get this kind of support if you go into a refuge, or if you use a Women’s Aid outreach service, or join a support group.

Some women may benefit from more formal counselling or psychotherapy – though not usually while they are still living with their abuser or immediately after escaping from the violence, when physical safety and practical issues are likely to be of greater concern. If you decide you would like some counselling, the following information may help you.

Counselling is a two-way relationship, in which the counsellor listens to whatever you want to say, in confidence and without making judgements. Counsellors are not supposed to give advice, but they may ask questions or challenge you in ways which may help you to look more carefully at some of the assumptions you may have taken for granted. Usually you will have regular sessions, for an hour or slightly less, each week or every two weeks. Psychotherapy tends to be more intensive than counselling, and may continue for a longer period of time, as issues are explored in more depth. Some people, however, use these terms interchangeably.

The aim of counselling is to help you understand yourself better and come to terms with what has happened to you. Good counselling will help you to break away from past abusive relationships and work towards living in a way which is more satisfactory and fulfilling for you. It can also help you to build up your self esteem. However, counselling is not for everyone – and you have to decide whether it is right for you and whether this is the right time for it.

If you decide you want some counselling, it is important that the counsellor or therapist you choose is right for you, and that she is appropriately qualified and experienced. She should also have a good understanding of domestic violence and its effects, and should take care not to appear to blame you or make you feel guilty in any way for the abuse you experienced. Styles of counselling differ a lot – depending in part on the theoretical approach of the counsellor or therapist – and you may find some approaches more helpful then others.

In some parts of the country, there are counselling services specifically set up by women for women, and many of these have a particular focus on issues of violence and abuse. Some also offer support groups for survivors of domestic violence. Some of these are listed at the end of this section. If you contact your local Women’s Aid organisation, they may be able to put you in touch with a counselling service or support group in your area. Some counselling organisations offer sessions that are free of charge; others charge a fee dependent on your income.

Your GP surgery may have a counsellor to which your doctor could refer you, or he or she might refer you to an NHS psychologist – though there could be a long waiting list. NHS services will be free of charge, but may be time-limited. Alternatively, you could contact an organisation such as the British Association for Counselling and Psychotherapy (BACP) which can give you a list of trained and accredited counsellors in your area. These will charge an hourly fee, though some may have concessionary rates for those on low incomes. In each case, it is important that you feel happy with your counsellor, and are able to build up a rapport and a sense of trust in the relationship.

Further information

Freephone 24 hour National Domestic Violence Helpline on 0808 2000 247, run in partnership between Women’s Aid and Refuge: They will be able to put you in touch with your local Women’s Aid organisation or other domestic violence service.

Saneline: For anyone concerned about their own mental health or that of someone else. Local rate helpline: 08457 678 000, open 1pm – 11pm every day. Website: www.sane.org.uk

Samaritans: Provides a listening service for those in distress or considering suicide. 24 hour helpline: 0845 790 9090.

Rethink (formerly the National Schizophrenia Fellowship): Rethink provides a wide range of services throughout the UK, including supported housing, helplines, employment projects and support groups. To contact the Rethink National Advice Service, please call 020 8974 6814. The Service is available from Monday to Friday 10am – 3pm, except Tuesday and Thursday 10am – 1pm. Website: www.rethink.org

Mind: Mind offers information and support on mental health issues, and where to get help. The national information line can put you in touch with local Mind groups, which may run local helpines, support groups and other activities. Mind also produces a wide variety of leaflets and other publications on mental health issues. Mindinfoline: 08457 660 163, Monday – Friday 9:15am – 5:15pm (not bank holidays). Typetalk for callers with hearing or speech problems who have access to minicom: 0800 959 598. Email: [email protected] Website: www.mind.org.uk

Threshold: The helpline, due to lack of funding, can only provide information and a signposting service to women, their carers and workers during 10am – 1pm on Tuesdays. Women’s Mental Health Infoline: 0808 808 6000, Answerphone at other times. Email: [email protected] Website: www.thresholdwomen.org.uk

No Panic: Provides a free information pack, and their answerphone refers callers to other numbers where they can talk to one of their volunteers for support. Also refers to local services when available. Freephone: 0808 808 0545, 10am – 10pm, for those suffering from anxiety disorders and panic attacks.

Depression Alliance: Depression Alliance has a national network of self-help groups. It also offers a correspondence scheme. It does not offer a helpline scheme. Phone: 0845 123 2320 (local call rates) for a free information pack and to find out contact numbers for services locally. Email: [email protected] Website: www.depressionalliance.org

National Self-harm Network: For those who self-harm or for those supporting them. The network offers information (and debunks myths) about self-harm and lists organisations which provide support. Website: www.nshn.co.uk

Bristol Crisis Service for Women: This service is for women in emotional distress, particularly those who injure themselves. The service provides a range of booklets on topics such as self-help for self-injury. Although Bristol-based, it serves the whole of the UK, and can refer to local services if needed. Address: PO Box 654, Bristol, BS99 1XH. Helpline: 0117 9251119, Friday and Saturday 9pm -12:30am; Sunday 6pm – 9pm.

Rape and Sexual Abuse Support Centre (RASASC): Helpline will take calls from women nationwide, and refers to local services if appropriate. Also offers face-to-face counselling and group counselling for women in Croyden who have been raped or sexually abused. P.O.Box 383, Croydon, CR9 2AW. Helpline: 0845 122 1331, weekdays 12 noon – 2:30pm and 7:00pm -9:30pm; weekends and bank holidays 2:30pm – 5pm. Minicom: 020 8239 1124. Email: [email protected] Website: www.rasasc.org.uk

Young Minds Parents’ information service: Provides help for parents concerned about a young person’s mental health. Has a variety of leaflets and booklets, including one which explores how divorce and separation affect children and young people. Phone: 0800 018 2138, Monday – Friday 10am – 1pm; Tuesday and Thursday 1pm – 4pm; Wednesday 1pm – 4pm and 6pm – 8pm. Website: www.youngminds.org.uk

Counselling services for women

British Association for Counselling and Psychotherapy: This is the professional body for general counselling services, and can give you names of qualified and BACP-accredited counsellors in your area. The website includes a note on ‘Finding the right therapist’, as well as a directory of therapists throughout the UK. Phone: 0870 443 5252. Email: [email protected] Website: www.bacp.co.uk

Womankind Helpline: Offers face-to-face counselling and support groups for women in the Bristol and South Gloucestershire areas. Phone: 0845 458 2914, Monday – Friday 10am – 12 noon; Tuesday and Wednesday 1pm – 3pm; Monday and Tuesday 8pm – 10pm. Answerphone at other times. Website: www.womankindbristol.org.uk

The Maya Centre for women living with violence: Services are provided free for women on benefits or low incomes who have not had the opportunity to use other counselling services and have not had the benefit of degree-level education. Phone 020 7281 2728. Address: Unit 11, City North Trading Estate, Fonthill Road, London N4 3HN. Email: [email protected]

Women’s Therapy Centre: For psychotherapy by women, in the London area. Phone: 020 7263 6200. Address: 10 Manor Gardens, London N7 6JS. Email:

[email protected] Website: www.womenstherapycentre.co.uk

Woman’s Trust: Provides free one-to-one counselling and weekly support groups for women who have been abused. It also offers an advocacy service, currently for abused women in the Westminster, Kensington, Chelsea and Greenwich areas, which is also free of charge. Emergency 24 hour help phone: 0774 708 0964. Office phone: 020 7 0340 304. Address: Lighthouse West London, 111-117 Lancaster Road, London, W11 1QT.

Political and ethical values have great impact on Social Sciences. While conducting research, the researcher should always be aware of those issues that may arise during time of the research process. Ethics in social research means linking individual responsibility to broader moral principles and to professional codes of conduct. Research ethics helps: to maintain the profession integrity, maintain the standards that have been set already; protects the reputation of good research; acknowledges research context; seeks funding and approval for ethical research (Z, O’leary, 2004 p42). Thus, power, politics and ethics should be analysed thoroughly by the researchers during the research process.

Harm to participants: social researchers should try to minimize disturbances to both subjects and subjects’ relationship with their environment. Maintaining privacy and confidentiality of the participants are vital things in the research process. Researchers should be fully aware of data protection act 1998 and be recorded accordingly.

Informed consent: individuals should be powered to make free decisions and be given all the information needed to make good decisions. Researchers should explain about the research including who is undertaking and financing, and why it is being undertaken and how it is to be promoted.

Invasion of privacy: the anonymity and privacy of those who participates in the research process should be respected.

Deception: The involvement of research participants must be entirely voluntary. If the participants do not understand fully or remember, they might not do what is expected or withdraw due to misunderstandings. Thus, participants should be empowered by full information along with the nature of the research. Indeed, it protects participants as well as researchers.(Bryman, A, 2008, p118-129)

Similarly, professional practice and ethical standards should be maintained during the process of research by choosing relevant research methodology. Likewise, reporting should be accurate, fabrication and falsification of data are considered as misconduct and interpretation of the data should be according to the general methodological standards. Furthermore, the researcher- researcher relationship should be maintained by not misusing the authority or role given and researchers should not list authors in their report without their permission. The research in fact should be guided by the accepted ethical standards(S, Sarantakos, 1998, p20-25).

Meanwhile, the political dimensions of the research should also be maintained during the research process in order to avoid biasness. Likewise, the political consideration of research includes the issues of outsider pressures, researcher’s own political position, the applicability of research findings and use of them by those who are in power, choice of research topic and research procedures, sponsors’ influence, funding bodies and governmental policy towards social science research (Bryman A, 2008, p131), as well as credibility of findings all should be considered throughout the research process.(S, Sarantakos,1998, p27-29)

Two empirical research studies have been selected and analysed from political and ethical point of view .Those studies are : (1) Factors That Predicts How women Label Their Own Childhood Sexual Abuse, and (2)Family Environment in Hispanic College Females with a history of Childhood Sexual Abuse. Both journals are derived from the Journal of Child Sexual Abuse, vol 15(2) 2006 and; vol 16 (3) 2007 respectively. In both studies, all participants are females. Child Sexual Abuse (CSA) is a private crime, enshrouded in the “Syndrome of secrecy” (Furnish, 1991, p22). One’s personal appraisal of sexual abuse may depend on societal definitions that recognize extreme behaviours as abusive, but leave other behaviours.

Although centuries of novels and autobiographies have dealt with the subject of child abuse in all its forms, society has been slow in term of recognizing the frequency with this committed assault. Since the last 20 years, research has understood the importance of CSA as a public health problem, yet the actual extent of CSA remains unknown. It is because of the efforts of a small number of researchers. The issues involved have been ignored, and there is correspondingly little mention of them in historical and anthropological studies (The political Consequences of Child Abuse, Alice Miller, The journal of psychiatry 26 (2) Fall 1998). For example, in May 2008 the world woke to the shocking news that a 71 years old Austrian man had imprisoned his own daughter in a small soundproofed windowless cellar of his family home for 24 years. During this time he raped her repeatedly and fathered seven children with her. Although around 100 people live on and off that house, none reported their concern to the authorities, preferring to turn a blind eye to what was going on.

Moreover, most of the available information about CSA’s distribution and determinants has not been based on methodologically valid and reliable measures. The lack of accurate estimates inhibits the development of effective preventive and treatment interventions. Similarly, S, Sarantakos (1998) illustrates further that data and materials already collected can only become available to researchers if the government allows it. The political bias may arises when government and funding bodies set priorities on issues they wish to be studied, promoting only what they consider as important and suppressing research in areas which they do not wish to see explored. Priorities are often biased, and certain minority groups and problems are neglected and certainly disadvantaged. The government appoints assessors of research grant applications to select the proposals that deserved support. But who are the assessors and who determined the parameter of choice? (S, Sarantakos, 1998). For example, Child abuse, that is actually neglected. Empirical sociological research studies based on data collected from children themselves are relatively few (Amit-Talai and Wuff, 1995; Mayball 1994a).

The method used in the first journal “How Women Label their Own CSA” was cross-sectional followed by structured interviews. The study was supported by a grant from the Texas Academy of Family Physician foundation. The main objectives of the studies were: to compare victims of CSA who labelled their experiences as “abusive” with victims who did not, examining differences in abusive experiences, victim characteristics, perpetrator characteristics, and family relationships. Interestingly, it illustrates that despite the psychological impact of sexual abuse, many victims do not acknowledge that their experience were “abuse”. Abuse whether acknowledge or unacknowledged, is associated with more psychological and sociological adjustment problems (Varia et al, 1996). Layman et .al (1996) found that acknowledged victims of rape reported more post-traumatic stress disorder symptoms than unacknowledged victims, who had more symptoms than non-victims. Although CSA is widely prevalent in the United States, an estimated 16% of males and 27% of females report some experiences with unwanted sexual experiences during childhood (Finkelhor, 1994). Likewise, Stander, Olson, and Merrill (2002) discovered that self-identification as a victim of CSA was associated with threats-force, incest and younger age of onset. In addition to the characteristics of the abuse, other factors may affect how an individual defines the experience: victim characteristics (for example, gender, cultural background and education) and family environment. The study is a secondary analysis of the Childhood Experience and Adult Stress (CEAS) database conducted in the Family Health Centre of the University Health Centre-Downtown in San Antonio, Texas. In the study, 100 women were assessed for major depressive episode(MDE), panic disorder, agoraphobia, substance abuse, post traumatic stress disorder (PTSD), borderline personality disorder(BPD), bulimia and suicidal where only 68 women met criteria for at least one adult disorder; several had multiple co-morbidities.

Re-using the qualitative data has several ethical and legal concerns. These include the use of whether and, if so, when researchers should seek consent to re-use data in secondary studies (Alderson, 1998). This could be done at the time when data are collected. However, information on exactly how data will be reused, by whom and for what purpose, is likely to be scant at this time. Alternatively, consent could be sought retrospectively, when particular secondary studies are planned. But this requires that participants’ identity and contact details are known and can be used for this purpose. Re-contacting participants also presents researchers with logistical and ethical difficulties where people might have changed address or may have died; being re-contacted may also be unwelcome to some former participants. In addition, whether or not researchers decide to seek fresh consent for a secondary study may depend on the data collection and the type of planned qualitative secondary analysis (Sage, social research methods, 2008). Moreover, in the study, researchers didn’t do any attempt to re-contacting and taking fresh consent for the studies; which are relatively difficult task. Doing research under such situation brings conflict for future policy and practice. Likewise, the original study sought to identify predictors of mental health and mental disorders in women with a history of CSA whereas the second analytic research on the same data was to identify factors that predict how women label their own experience of CSA. Such research findings might not be reliable and replicable.

Similarly, it has been observed that several women in the sample had not labelled their childhood sexual experiences as “abuse”. Therefore, this analysis was conducted by using dependent variable “acknowledgement of abuse”, in an attempt to understand how women subjected to sexual abuse as children come to define their experiences as “abuse”. A variable is a concept that can take two or more values where dependent variable is affected or explained by another variable (S, Sarantakos, social research methods, 1998, p73). Measurement relates to variables. In the study, several variables were associated with labelling in the bivriate comparisons, but did not reach significance in the logistic regression: (1) racial/ethnic background, (2) use of force/threats, and (3) duration of abuse. Hispanic was less likely than non-Hispanic whites to acknowledge the sexual activities as abuse.

In the sample, only English speaking females aged 18-40 were approached where 65% of the women were from Hispanic family. Thus, these responses may have uniquely reflected local culture and values in a young adult cohort. The population of Sant Antonio has majority of Hispanic ethnicity and other dominant groups include non-Hispanic and African Americans. Those groups represented in the clinic population and in the sample were low income, which reflected the entire community. It is not appropriate to generalize whole population on the basis of findings of such limited study criteria. Furthermore, the sample included only those who were willing to tell and describe the childhood experiences of abusive activity in a face-to-face interview. One third of those who met the criteria were not willing to disclose and participate in the research. This is the fact that they may not have differed in the nature of their experiences because they did not differ demographically from the 100 participants.

The CSA screening consisted of three main questions about their childhood sexual patterns. Women saying “yes” to any of the question were asked to complete a structured interview concerning the sexual abuse experience and their childhood environment and taken informed consent as well. The family-of-origin questionnaire describes the household environment throughout childhood. The 25-item parental bonding instrument assessed the quality of the parent-child relationship during the subject’s childhood. The demographic questionnaire collected information on subject’s gender, age, marital status, household size, educational attainment, occupation, income, and racial /ethnic background. The study has several limitations. Firstly, the outcome variable, “acknowledgement of abuse” had a single question and therefore may lack reliability. Secondly, the use of multiple comparisons may have inflation alpha level. Thirdly, the sample was small and unique, limiting statistical power and generalizability. In fact, the sample differed from other studies demographically. Finally, researching about traumatic childhood experiences biased politically because of the unattainable objectives. Furthermore, interviewing adult can result in data biased by poor recollection, re-interpretation of events, and failure to disclose. The study was funded by the private sponsor of the same study, so the applicability of the findings are surely related to political factors and it will totally depend on the sponsor to apply findings.

The second journal “family Environment in Hispanic College Females with a History of CSA” sought to examine the family environments of a sample of Hispanic college women who reported childhood sexual abuse. The qualitative method with individual interview was used in the study. The main objective was to explore the relation of child maltreatment in ethnic diversity associated with cultural factors and prevalence through the study of Hispanic female college students .In the study, eighteen women, ranging from 20 to 49 years , were taken from a larger college sample. Those women were individually interviewed and administered the Family Environment Scale (FES, Moos and Moos, 1994). The qualitative methodology was employed to the study. The larger the sample size, the grater the precision (Bryman, A, 2008, p180). The sample size in the study were relatively small, in such circumstances, the scope of the findings of qualitative investigation is restrictive. On the other hand, the findings can not be generalized to other settings because of its subjective nature and small sample size. Furthermore, it is almost impossible to conduct a true replication.

The study illustrates that ethnic diversity and cultural factors which may affect the prevalence of such abuse, so, the victim’s emotional and behavioural response, as well as the disclosure of the sexual abuse should be ignored (Kenny and McEachern, 2000). Existing research that has examined Hispanic victims compared with victims from other ethnic group have found that Hispanic victims were more likely to have been abused by extended family members (Arroyo et al.1997) because of the given cultural value to the family with strict rules. However, good relationship among family members, caring each other, sense of obligation, loyalty and duty; because of those values placed in the family, they would not like to reveal the CSA, which would be marked as shame and guilt in the society. Furthermore, the participants were evenly distributed across all socioeconomic levels. However, it was impossible to analyze the data separately by Hispanic group because of small sample size.

The project received approval from the University Research review Board and committee for human Subjects. Since the beginning of the research project, frequent announcement were made in a number of educational classes during the year. Potential participants were instructed to call the author and take an appointment for the participation. The participants who were participated in the research process were granted extra credit to their academic career. It implicated that they are just attracting and motivating the participants to participate and their motive was just to finish the research. In such circumstances, the research findings will be politically biased due to motives of the research funding. It does not actually seem to produce knowledge and generate theory. Such research would definitely have negative influence to future researchers. (May, T, 1997)

Furthermore, the following questions can be asked in any piece of research: who funded it? How was it conducted and by whom? What were the problems associated with the design and execution and how were the results interpreted and used? This enables to understand the context in which research takes place and the influences upon it as well as countering the tendency to see the production and design of the research as a technical issue uncontaminated by political and ethical questions (May, T, 1997 p45-46) .For example, in the study, even after several announcement and with incentives (credit) there were only eighteen participants.

During the process, informed consent was taken assuring confidentiality prior to the interview. Individual interviews were chosen owing to the sensitive nature of the material .The interview consisted of open-ended and closed questions about the demographic information including the participant’s potential history of sexual abuse. Following the use of a closed question, such as “what age were you when the abuse began?” further questions were elicited for more information during the interview. Furthermore, after interview, Family Environment scale (FES) was provided to the participants and allowed as much time as they like to complete. It is unstructured and often reliant upon the researcher’s ingenuity where conducting a true replication is almost impossible. Furthermore, there are hardly any standard procedures to be followed (Bryman, A, 2008 p391). Not only that, the researcher him or herself is the main instrument of data collection, so that what is observed and heard and also what researcher decides to concentrate upon is very much a product of his or her predictions. For example, some researchers are likely to empathize with other issues; while others choose to focus upon what strikes them as significant. Similarly, the responses of participants to such a qualitative research are likely to be affected by the characteristics of the researcher (personality, age, gender, and so on). Because of the unstructured nature of qualitative data, interpretation will be influenced by the subjective leaning of a researcher (A, Bryman, 2008, p391). Because of those factors, it is difficult, not to say impossible-to replicate such qualitative findings.

The goal of the study was to learn more about the family experiences of the women who reported CSA to generate future directions for future research and contribute to the understanding of Hispanic women’s experiences with CSA. The FES measure consisting of 9-item subscale was used to measure the respondent’s perceptions of the topic. The results highlighted some important areas for future inquiry. Some of the hypothesis was confirmed. The first hypothesis, that this sample would report elevated scores on the EFS of family conflict and decreased scores on Organization, was not supported. They did not demonstrated elevated scores on the conflict subscale of EFS because of focus on general conflict among family members. The second hypothesis, the organization of these families found some support, but the study showed a rather hierarchical structure with the father or parents at the top in most families; for example; male authority 50% and 39% of mothers made decisions. The third hypothesis was regarding the issue of sexuality; these women would report repressed sexual attitudes in their homes seems to have been confirmed for example, majority of them reported that their parents did not discuss issue related to sexuality.

In the study, all women were from a voluntary college population that is not representative of the greater Hispanic population; hence, making generalization to other groups is difficult. Similarly, the study used non-contact sexual experiences, so, careful examination of definitions of sexual abuse used in other studies should be made before comparisons are conducted. Future studies should focus on disclosure process including family reactions and level of parental support following disclosure. Likewise, comparing the responses of these participants to those who are not college students would be helpful for future comparisons.

In conclusion, both studies used relatively small sample that contained especially Hispanic female individuals from varying subgroups. Making generalization to others is difficult. Both studies are retrospective in nature, which required women to recall past incidents of child abuse as well as other dimensions of their families, poses limitation. Re-evaluation of past experiences and error in recall may affect responding in unknown ways (Clemmons et al, 2003; Rafaelli and Ontai, 2004); some claims that retrospective studies probably underreport abuse (Bolen, 1998). Furthermore, interviewing adult about past experiences of childhood sexual abuse can result in data bias. In addition, it is difficult to measure validity and reliability of the research. To a large extent, both studies lack transparency from research process to findings. The power that exercised in the research and sponsors’ influences over procedures are highly remarkable in both studies.

The literature looks previous and existing literature on how effective the local authorities are at promoting the needs of black African children and their families who are involved in the child protection system. In previous years there have been deaths of African children such Victoria Climbie and khyra Ishaq. There have also been deaths of other African children in Britain linked to witchcraft. A theme echoed by the majority of the literature is that if social work practice and policy is to prevent these tragedies there is need to understand and acknowledge different contexts of culture and diversity. The main theme is how to provide social work interventions and family support that are culturally sensitive and competent to both children and their families who are at risk of significant harm. There is need for social work professional to understand parenting practices in African families and protect children hence every child matters was implemented. The laming report (2009) set out challenges faced safeguarding children such as, training and workforce issues still need to be resolved and data systems need to be improved and there is still need improve knowledge and skills to understand children and their family circumstances. Also the laming report noted that despite the progress in inter-agency working there are still problems of day to day reality of working across organisational boundaries and culture, sharing information and lack of feedback when professionals raise concerns about a child.

In this literature review I will be focusing on black African children and their families analysing their experiences of the child protection system that have come to live in united kingdom and how the children are protected in the child protection arena. I will be paying attention to key themes and debates in research, validity and generalisability of data, gaps in research and future implications to practice. I will be using the term ‘black African’ throughout the review of literature; however I recognise that there are different races in Africa who share the same culture and beliefs.

Literature search

Material used for the literature reviewed varies; I included journals searched online, books from the library and articles from the internet and material published by the government. As I searched the online journals and books I discovered there was little material about my chosen topic and scarce research on the topic of the needs of black African children and child protection children. Most studies and literature focused on black and minority ethnics and mixed parentage children hence the proportion of black African children can be over-represented in these studies and the data cannot be generalised easily to the wider population. There is need for professionals to have knowledge about the identity and diversity of black African children and their families because Britain has seen an enormous growth of African people due globalisation and other environmental factors such as war, famine and work opportunities. However not all children from African families get involved in the child protection system.

Review of the literature

Research data and statistics on African black children are not constant and highlight mis-representations. According to the 2001 census the population of black African people was 0.8%. However, these statistics are from 2001 and the populations could have increased due to migration and the 2011 census will offer more up to date statistics. Also not everyone registers for the census especially black and minority people who are isolated and who do not have any immigration status might shy away from the census in fear of deportation. The department for education and skills (2006) estimated the number of African children in need to be 8000 in 2005. ‘this accounted for 3% of the overall total- an over-representation compared with the 2001 census in which African children made up 1.4% of the population’. Research highlights the over-representation of the African children and their families involved in the child protection system for example, data of African children is combined with afro-Caribbean children and ethnic minority children- statistical data from British children represented 5% of the children on the child protection register in 2005, but census data 2001, ‘black or black’ children made up 3% of the total population (national statistics, 2003). Research data continues to indicate that black communities are disproportionately represented across social welfare statistics (graham, 2006; barn et al 1997).

Britain has experienced a massive increase in population due to people coming into Britain for better lifestyles, escaping war, famine, torture and looking for better job opportunities. Britain has experience a rise in the number of people claiming asylum and some of them are unaccompanied asylum seeking children. When looking at experiences of black African children and their families and how to offer them appropriate intervention it is important to acknowledge diversity in terms of religion, culture, language and beliefs (Bernard and gupta 2008; gibbs and huang 2003; robinson 2007).

Research has shown that black families black African communities and ethnic communities are likely to live in poverty. There is well documented literature on social exclusion and poverty experienced by black African children which also is inclined to impact on the parenting abilities of parents. Also looking at histories and backgrounds of black African families is which add to poverty is also highlighted in research, (Bernard and gupta 2008; gibbs and huang 2003; robinson 2007). Research has shown some of the factors that affect African children and their families such as private fostering and asylum seeking, HIV/AIDS, poverty- highlighting grief, loss and separation, (Bernard and gupta 2008).

Review of the research suggest that black African children are almost twice as likely to be looked after, however some of these children will be accommodated under section 20 of the children act 1989 due to being unaccompanied asylum seeking children (Bernard and gupta 2008; robinson 2007; barn 1993). Jones 2001, highlights the conflict between the children act 1989 and immigration legislation and policy and Jones argues that ‘social work profession singularly failed to provide critical scrutiny on the status and relationship of immigration and child care law and the erosion of children’s rights’. The number of refugee children arriving in uk is arising annually and the vulnerability of refugee children has legal, emotional and practical aspects (woodcock, 2003; chase, 2009). There is substantial evidence to indicate that many refugee children and young people from different cultures manifest symptoms of post-traumatic stress disorder (PTSD) and other mental health problems (Hodes, 2000, 2002; Ehntholt and Yule, 2006; Dyregrov and Yule, 2006).Research on social work with unaccompanied children is limited (kohli and mather 2003). Research also states that there is risk of alienating black children in care by not meeting their emotional and psychological needs due to no contact with community with same culture, family and lack of black workers (bran et al 1997 pg 9). However, available research data paint a complex and contradictory picture and data is combined with other minority ethnic children

Analysis of literature draws attention to that the way black African families parent their children and their daily lives had been neglected in many studies in child welfare literature and there is little empirical evidence especially about African parenting in Britain (Bernard, 2002 graham 2006). Research has looked at cultural values and how they influence parenting in African families involved with the child protection system (brophy et al 2003). Literature highlights that there is need to look at kin-ship and extended families. Family structures have been changed due to globalisation, war and other social factors. There is few research data on impact of culture, gender ideology, socio-economic status and religious belief influencing parenting and also notions of what constitutes harmful behaviour. The few data that exist states that; cultural practices appear to play some part in African children being involved in the child protection system, (mama 2004). Barn et al 2006 challenge popular myth and stereotype that some cultural groups have more punitive punishment practices. They found no significant differences between ethnic groups with regard to physical punishment of children-thoburn et al 2005 pg 83 agree. Nobes and smith 1997’s study of physical punishment by parents found physical punishment was universal in the 99 two parent families and Thompson et al 2002 found that 67 mothers in new forest are of England reported diverse behaviour management tactics and mothers who used physical punishment reported less behavioural problems in their children than mothers used reasoning. This supports the challenge the stereotypes that cultural groups have more punitive punishment practices because the majority of the above studies involved parenting by white culture in the United Kingdom. Studies on parenting by other black and ethnic cultures are scarce and there is need for research. A growing body of literature emphasises the importance of appreciating the social contexts of parenting and lived experiences of African children for making sense of child maltreatment (Holland 2004, Robinson 2007).

Black perspective is based on the notion of common experiences that black people in Britain share and it is critical of oppressive research paradigm and theoretical formulations that have a potential oppressive effect on black people, (Robinson 2007). An understanding of black frame of reference will enable social work professionals to come up with more accurate and comprehensive assessments of African black children involved with the child protection system, (Robinson 2007).

Ecological perspective is important in analysis of impacts of poverty, discrimination, immigration and social isolation on black and minority children (gibbons and huang 2003 pg 3). However there is the danger of over-generalisation and stereotyping because individual members of a culture may vary greatly from the pattern that is typical within that culture (Robinson 1998)

Research argues that postmodern theories have gained a strong foothold in the profession of social work (pease and fook 1999; learnard 1997). However Their tenets have been strongly contested by those demanding a more complex understanding of identity, i.e., one that links the personal with the structural or collective elements of human existence alongside the individual ones (Dominelli 2002; graham 2002) and those drawing on the idea that what holds people together are what they share in common or their sameness (Badiou 2001). The lack of appropriate preventative suppoirt servives and lack of understanding of cultural of black families often result in social work operating against the interests of black children (barn 1993, graham 2002)

Anti-discriminatory perspectives and incorporation of knowledge from service users

Social workers contribute to the perpetuation of oppression through their practice by directly or indirectly engaging in structural oppression – its institutional and cultural forms that are integral elements in the ways in which social relations in a globalising world have been organised, (dominelli 2007). Key to eliminating structural forms of racism is that of addressing the issue of binary dyads that reaffirm racist dynamics rather than challenging them. Nonetheless, resistance to its perpetuation is evident in many of the responses by service users and practitioners. Social work educators and practitioners have much more to contribute to the elimination of oppression. (dominelli 2007). Social work has operated within a problem oriented framework which is characterised by deficit and dysfunctional theories of black families (Robinson 2008). Dominelli (1992) argues that black children and families are over-represented in the controlling aspects of social work and under-represented in the welfare aspects of social work.

Problems with communication and working in partnership have been highlighted in literature. Fifty-four young people participated in the research. Chase, 2009 study-The majority (80 per cent) of participants were identified through a single London local Authority, Young people often described complex relationships with social workers and other social care professionals and were also more mistrustful of the interplay between social care and immigration services: Hellen, from Ethiopia, said:

Sometimes they don’t understand you when you are sad. They keep asking you questions. It makes me angry, it makes me want to shout. It makes me remember all the bad things and they don’t understand that. If they ask me (questions) I will suffer for months. The positioning of social workers within the asylum system is a difficult one to negotiate. They are expected to apply social care principles such as ‘the best interests of the child’, yet work within very clear organisational boundaries and regulatory codes-frequently dictated by resource and funding limitations.

The Climbie inquiry (laming 2003) highlights the challenges faced by local authorities when developing information-sharing indexes for keeping insight of the children who are on the margins of society and whose lives are characterised by transitions. Literature highlights some of the challenges for social work assessing and making decisions about African children and families whose cultures differ from the majority white population (brophy et al 2003, laming 2003)

The fear of being seen as a racist combined with cultural stereotypes can lead to a failure to make judgements and intervene appropriately regarding practices that are harmful (burman et al 2004 study)

Whilst their views should form part of policy related discussions on current topics, respect for children’s rights may still be lacking. Meanwhile, such notions challenge us to take children seriously and to appreciate their contribution to social reproduction and change (Aubrey and Dahl 2006). Lots of research appear to focus on empowerment through cultural knowledge inviting new thinking about the challenges faced by black communities

Relevance to policy and practice

The complex social circumstance experiences by many African families pose challenges for parents, children and social work professionals working to safeguard and promote children’s welfare

The framework for assessment of children in need and their families (DoH, 2000) based on the ecological approach places a requirement on workers to consider families histories and social circumstances and literature of anti-oppressive practice stresses the importance if consideration being paid to power relationships (dlrybple and burke 1995). There must be some understanding of the links between people’s personal experience of pressing and structural reality if inequality pg 123

In order to safeguard and promote welfare of African children acknowledgement of sources of discrimination and oppression, a commitment to human rights and social justice must be met. Through developing effective relationships with African children and families can professionals begin to understand their individual, emotional as well as practical needs. Global mobility and consequent changing nature of communities require local authorities to be proactive in gathering information and developing services including interpretation services that are responsive to the needs of African and minority ethnic families. Several authors have critically analysed the evidence on service provision for black families in general. A pathologising approach to black families may lead to unnecessary coercive intervention and on the other hand a cultural relativist approach may lead to a non-intervention when services are required (dominelli 1997, chand 2000). Either way appropriate intervention is not provided for black and ethnic minority children. The quality of services in black communities is a focus for debate and raises important issues about the lack of policy initiatives based upon needs and aspirations of local communities (graham 2002)

Subjecting cultural practices to scrutiny is a necessary party of the assessment process of professionals are to achieve better outcomes for children. A balance must be struck between sensitively challenging claims that certain types of behaviour are the norm in African families whilst at the same time not losing sight of children’s welfare needs. By drawing on strengths perspective professionals can illuminate how parents draw on cultures a s a resource to parents in circumstance of adversity whilst not excusing behaviour that is harmful to children. The issue of punishment is one of the most controversial areas relating to black families, child abuse and social work (chand 2000 pg 72)

Conclusion

This review has highlighted that multiple social, environmental and parental factors interact in complex ways to bring black African children into the child protection arena. Thus, making professional judgments regarding thresholds of concern for African children poses a major set of challenges and, ultimately, practitioners need the skills, knowledge and conceptual tools to distinguish between the styles of parenting that differ from those of the majority culture, but which are not necessarily harmful, and parents who seek to justify abusive and neglectful behaviour by drawing on cultural explanations to justify their actions.

This project is based on a foster care assessment of a prospective carer undertaken as a student social worker. It gives an overview of my assessment from allocation to closure due to concerns. Although immediately allocated another more fruitful assessment, I have chosen to look at this unsuccessful assessment as I believe it taught me more as a student about my practice.

An agency description is firstly provided to give the reader a picture of the team which should put my role into context. This is followed by the background and objectives of my work. The main text follows the natural progression of my work from planning to evaluation. I will analyse my work identifying the social work themes, issues and theories that guided my practice. Reflection acknowledges that we are part of what we are experiencing (Schon, 1983); looking at our relationships with service users beneath the surface (Payne, 2002). I will therefore reflect throughout this project, rather than purely at the end, as this is what I naturally did in my practice. This will lead to a reflective evaluation of my practice and the implications it had for both me and the service user.

The agency I was placed with was a statutory foster care team within the local authority’s children’s services. Although the team works more directly with foster carers it serves children in need between the ages of 0 and 16 and is therefore classified as a Tier 4 service as shown below.

Fostering services in this local authority were originally integrated amongst other service user groups, regulated by the Boarding-Out Regulations (1955). These regulations caused ambiguity by encouraging foster carers to treat foster children as their own (Triseliotis et al., 1995). In the 1970’s, with the changing emphasis to the professionalisation of fostering, the team gradually became a separate division. The 1955 regulations were eventually updated with the Boarding-out of Children (Foster Placement) Regulations (1988) which were subsequently absorbed into the Children Act (1989) regulations. Only a few years later the Foster Placement (Children) Regulations (1991) were introduced which changed the focus of assessment from households to individual foster parents. However, what both regulations were lacking was met in the establishment of the Fostering Services Regulations (FCR) (2002) and National Minimum Standards (NMS) (Department of Health (DoH), 2002). These come under sections 22 and 48 and 23 and 49 of the Care Standards Act (2000) respectively. This changed the regulation of the agency from the local authority itself to the National Care Standards Commission (NCSC). The NCSC inspects how the agency recruits, assesses, supervises and trains foster carers. These four areas describe my role as a supervising social worker within the team.

Background to the Case

Monica is a 55 year old female who had contacted the fostering agency with an interest in becoming a foster carer. The process from public interest to approved foster carer is complex and thorough. Each local foster care service will have a similar but slightly different procedure and the team I was placed with used the process shown in figure 1.

Initial Interest
Initial Home Visit
Application form sent and completed by Applicant
Full Assessment by Social Worker leading to Fostering Panel
Approved Foster Carer is allocated a Social Worker and begins fostering

Figure 1: The Fostering Assessment Process

When trying to visualise the assessment process for the reader, I felt a pyramid was the most appropriate. This is firstly because the wideness represents the greater personal investment a prospective carer must put into the fostering process and secondly the deeper into their life a social worker will and must go. At each stage a prospective candidate may have a different social worker. The initial home visit with Monica was conducted by another social worker. The purpose of this visit was to get a snap shot of Monica’s suitability and motivation to foster. The social workers report is then presented to senior staff with recommendations and a decision is made as to whether an application form should be sent. Once returned, the next step is to go through a process that combines elements of assessment and preparation (McColgan, 1991). This is where my involvement with Monica began.

Objectives of the Work

‘As well as strong attachments to family members, foster carers or residential care workers are really important for children in care, as these are the people who have the most impact on their day-to-day experiences’ (DCSF, 2008, p.11)

‘Foster carers are central to many children and young people’s experience of care. It is essential that we value and support them and ensure that they are properly equipped with the necessary range of skills’ (DfES, 2007, p.8-9)

When assessing Monica I held the two statements above firmly in my mind to use in times of uncertainty but also lucidity. It is well known that the recruitment and retention of foster carers has been consistently problematic for local authorities (Association of Directors of Social Services, 1997; Bebbington and Miles, 1990; Colton et al. 2008; Hill, 2000; NFCA, 1997). Despite this, Quality Protects (DoH, 1998) and the government’s launch of Choice Protects in 2002 (see everychildmatters.gov.uk) continually attempt to raise the quality of fostering provision to improve placement choice and stability. The green paper ‘Every Child Matters’ (DfES, 2003) and more recently ‘Care Matters’ (DfES, 2007) argue that foster care services need carers with the skills to look after vulnerable children.

In some countries, such as Australia, the selection of foster carers still has no empirical base beyond criminal record checks and suitable accommodation (Kennedy and Thorpe, 2006). This was the past picture in the UK, however the National Foster Care Association (NFCA), now called The Fostering Network (TFN) introduced the ‘Codes of Practice’ (NFCA, 1999a) and ‘National Minimum Standards’ (NFCA, 1999b) for assessing foster carers. My assessment of Monica would consider her skills, experience, values, knowledge and overall suitability to foster children for the local authority. This was based on assessing her on four competencies (caring for children; providing a safe and caring environment; working as part of a team and own development) broken into 18 units (Appendix A).

More recently the Children’s Workforce Development Council (CWDC) has developed 7 standards for foster carers (2007) (Appendix B). The team had only begun using these alongside the competencies (NFCA, 1999a, 1999b) when I started Monica’s assessment. The standards support a three stage training framework for foster care (pre-approval; induction and foster carer development). Pre-approval was my objective with Monica linked to section 27(1) of the FCR (2002) (Appendix C), and other relevant legislation (Appendix D). Although the FCR (2002) are the legislative force, it was the NMS (DoH, 2002) under section 17 which gave me a more detailed understanding of the areas (caring ability, sexual boundaries, religion etc) needing assessing with Monica (Appendix E).

Brown (1992) observes that a fostering assessment has two interrelated aspects: (a) Evaluation of prospective carer’s strengths and weaknesses and (b) the assessment of their capacity to learn, adapt and change. These objectives are still relevant to assessing foster carers today. Whilst I was assessing Monica on the competencies and CWDC standards, there is no standardised way of obtaining the evidence for these. I therefore felt I had a lot of discretion in my assessment. I decided multiple knowledge sources (research, intuition and experience etc) would guide my assessment. Webb (2001) argues that Evidence Based Practice (EBP) cannot work in social work as the parting of facts and values inherent in EBP undermines professional judgement and discretion. I disagreed and felt the use of both evidence and my own intuition was needed to obtain an accurate assessment of Monica. For example, research states a need for carers committed to training after approval (Hutchinson et al., 2003). However, I knew that just because a carer agreed to training after approval that my intuition or practice wisdom (Stepney, 2000) may tell me otherwise. Further, Sinclair’s (2005) research emphasising the need for improvements in foster carer selection, I felt, justified my use of multiple knowledge sources to reach my objectives with Monica.

Planning for the Work

When first allocated the assessment of Monica, I was in the first week of my placement and admittedly had little understanding of what actually made a good foster carer beyond my own common sense. This lack of knowledge and understanding left me feeling out of my depth and anxious. I therefore decided that before making any contact with Monica I would gather all available information and use my existing knowledge base to see how it fitted with the fostering assessment. Brown (1992) suggests that when approaching a fostering assessment we should ask ourselves a range of questions. The three I found myself asking were: what knowledge do I need; is the assessment discriminatory or oppressive and what skills and values do I need.

Knowledge Gathering

Assessment is at the centre of all good social work practice (Bartlett, 1970; Milner and O’Byrne, 2002) and therefore my planning was crucial as ‘failing to plan is planning to fail’ (Trevithick, 2005, pg.140). I wanted to use Monica’s initial home visit report as my starting point, as assessments are rarely, if ever, value free (Rees, 1991). Therefore before I understood any more about the fostering process I wanted to identify and check any bias I may have that could affect the assessment undertaken (Clifford, 1998). However I was surprised by the reports lack of detail and therefore spoke to the social worker who completed it. He couldn’t give me any additional information which frustrated me as the report, in my opinion, failed to give the intended snapshot of Monica.

This didn’t help relieve my anxiety, however reading the guidance ‘Assessing foster carers: A social workers guide to competency assessments’ (NFCA, 2000) increased my confidence of what I was expected to achieve in my assessment with Monica. Using this guidance coupled with the NMS (DoH, 2002) and colleague information placed the assessment of Monica in my mind as task centred practice (Doel, 1994, 2002; Reid and Epstein, 1972). This was because the tasks involved were not just activities but held meaning because of what they represented overall (Coulshead and Orme, 2006); the fostering of vulnerable children. As fostering assessments vary in length, typically between 4 months and a year, I saw the assessment as a continuous process (Hepworth et al., 1997). Therefore although my assessment visits would be based around specific tasks and information gathering, my assessment of Monica would follow the ASPIRE model (Sutton, 1999). This was because during my assessment I would continually plan, intervene, review and evaluate the assessment with Monica.

Oppression and Control

From all available information sources, one issue rose within me. This was how intrusive the fostering assessment appeared, and how for me, it epitomised the care vs. control dichotomy. Triseliotis et al., (1995) believe that nowhere else are such questions asked with greater persistency than in the assessment of prospective foster carers. They acknowledge that ways are being sought to make the process less intrusive and fairer to applicants. Although I saw the competencies and standards as one way of achieving this with Monica, I still felt that I had a lot of power in her assessment. Davis et al., (1984) believe that the unequal power relationship between social workers and applicants may promote the development of ‘a relationship of dependence’ rather than the type of open partnership required in fostering today.

I viewed this open partnership as being based on Monica’s self determination which to be met began with Monica voluntarily accepting my intervention (Spicker, 1990). My original thinking was that oppression only applied to vulnerable groups. However, I knew I should avoid complacency as oppression could happen to anybody, including Monica. In fact Monica had begun a ‘Skills to Foster’ preparation group and I had asked the facilitator of the group for some feedback. She described Monica as ‘an interesting one’ commenting that she looked like she was about to drop dead. I discovered this judgment was based purely on her use of a walking aid. Understating the impact of labelling (Becker, 1963; Lemert, 1972), I didn’t want this judgment to impact on me as I wanted to go into Monica’s assessment with an anti-oppressive, non judgmental and accepting attitude (Biestek, 1961).

Reflecting on my skills and values

Central to our knowledge base is the need to know ourselves (Dominelli, 2002; Crisp et al., 2003). Effective assessment depends on the deployment of key skills such as Engagement (Egan, 2002), communication, negotiation, decision making (Watson and West, 2006) and administrative skills (Coulshead and Orme, 2006). I felt I already possessed the skills needed and found it was my values in relation to this assessment that were more difficult to pinpoint.

As already stated, I didn’t want to label Monica but I did see her as an ‘expert by experience’ rather than a ‘service user’, which is descriptive not of her as a person but of our relationship (McLaughlin, 2009). Although participation in social work is determined by context (Kirby et al., 2003; Warren, 2007) I saw our relationship as reciprocal. I found the exchange model (Smale et al., 2000; Fook, 2002) of assessment was particularly relevant in assessing Monica’s ability to foster children, as she would obviously be more of an expert on her abilities. This actually made me feel quite anxious and powerless. This was, on reflection, because as a man with no children, I questioned my ability to assess an experienced ex-childminding mother. I took this to supervision and through discussion I understood that my virtue ethics (McBeath and Webb, 2002) based on judgment, experience, understanding, reflection and disposition; coupled with staying client centred and respecting Monica as an individual (Dominelli, 2002; Middleton, 1997) would guide my assessment. I saw myself as a hermeneutic worker acting in a reflective interpretative process between myself and Monica (Gadamer, 1981).

Direct Work

I had telephoned Monica and arranged to meet at her home. As the majority of my visits would be two way conversations between me and Monica I saw them as interviews with a ‘specific and predetermined purpose’ (Barker, 2003, p. 227).

Eyes of a child

When undertaking Monica’s assessment, I tried to see everything not only from the eyes of a professional but also that of a child. I understood that children in the care system would have diverse needs and backgrounds (Schofield et al., 2000) with possibly a complex history of moves (Ward et al., 2006). However I also knew that care can be a ‘turning point’ and opportunity to lift children, enabling them to fulfil their potential (Rutter, 1999; Schofield, 2001; Schofield and Beek, 2005). Young people have commented that it is a foster carer’s personality that makes the difference (DfES, 2007b). Therefore by thinking like a child, I wanted to feel confident that by recommending Monica to the fostering panel I could see she would be of great comfort and benefit to vulnerable young people.

Upon arrival at Monica’s I was greeted by two aggressive dogs jumping and barking at the door. A tall stocky man, who I later learnt was her son, appeared from the garage and asked what I wanted. When asking for Monica he replied ‘who wants to know’. This hostility was soon alleviated when I explained who I was, upon which he opened the door, called for Monica, and left me with both dogs jumping up at me. I felt that a child entering Monica’s home was likely to be experiencing a range of emotions, including anxiety and from the eyes of a child this would be scary. Despite not the best of starts, I was determined not to make a judgment at a superficial level (Lloyd and Taylor, 1995) and to keep an open mind about Monica’s assessment.

Building a rapport

Aware of the care and control dichotomy I wanted Monica to feel relaxed with me. I therefore invested time in getting to know about her as a person before explaining the assessment process. Although genuine rapport can be questionable (Feltham and Dryden, 1993) I felt my interest in Monica was non-tokenistic, as I admired and respected her for wanting the challenging role of fostering (Kant, 1964). I believe this was transmitted to her an enabled her to trust me.

Monica talked about her family including the separation from her husband. She also spoke about caring for her sick mother that caused her serious back problems. Monica explained that she had a spare room and couldn’t think of any better use then for children in need of a loving home. Interestingly she went on to add ‘well they might not want to come here, I’m a mad lady and they might ask: how would I fit into her world’. I found this expression strange but following a gut feeling decided not to explore at this point. I did this firstly because I didn’t want to appear authoritarian but secondly I felt my assessment would later provide sources of information that my intuition would be tested against (Munro, 1996).

I explained the fostering assessment process to Monica including the competencies (NFCA, 1999a) and standards (CWDC, 2007). I used a mixture of interpretative, descriptive and reason giving explanations (Brown and Atkins, 1997) to ensure Monica was clear of our future work together. I commented ‘you might be thinking how a young man without children of his own can can assess me in looking after children’. This elicited laugher from both Monica and me. As Kadushin and Kadushin (1997) explain ‘laughter is an equalizer. It deflates pomposity. Workers’ capacity to laugh at themselves without embarrassment or shame communicates genuineness in the relationship’ (pg. 225). I also believe it served a social purpose (Foot, 1997) to shift power to Monica and make my next statement easier to deliver. I explained that in the fostering assessment it was expected that prospective candidates were as open and honest about their past experiences. I explained about confidentiality and that whilst not everything would be included in the fostering panel report, I couldn’t guarantee absolute confidentiality (Evans and Harris, 2004; Millstein, 2000; Swain, 2006). I explained I would always inform her if I needed to disclose information and that personal information with no relevance to her fostering ability would remain confidential. I believe this explanation built the required trust (Collingridge et al., 2001) essential for our relationship to progress (Leever et al., 2002).

General Task

Due to being my first visit, no specific tasks had been set to discuss. Therefore reflexively I thought about the group facilitators earlier comments about Monica ‘dropping dead’ as I had noticed her walking aid. I wanted to reflexivity challenge how I made sense of Monica’s fitness (White, 2001) by creating more knowledge about this (D’Cruz et al., 2007) and keeping the power balanced towards her. We therefore completed a required medical questionnaire. Monica stated, ‘this is the bit I was worried about’. Homing in on this anxiety and understanding that she may feel criticised (Lishman, 1994), I used reassurance to display respect (Clark, 2000). I explained that I was not trying to categorise her as either eligible or ineligible (Fook, 2002) but a medical was expected of all carers. Monica explained that she was diabetic and was controlling this without her medication and GP’s knowledge. I explored this with Monica and the potential impact for a vulnerable child, stating I would need to discuss with my supervisor. Whilst going through the medical questionnaire Monica didn’t mention her mobility problem and therefore I probed about this. This achieved its desired effect (Egan, 2002) as I learnt that Monica was registered disabled and hadn’t been able to work for two years. Monica exclaimed ‘that’s it now isn’t it’. I really valued Monica and thanked her for being honest with me. I stated that I was actually more concerned about the diabetes then her disability. My own values were that as long as a child was safe, then any person regardless of disability should be able to foster. I set Monica the task of constructing her chronology to discuss in our next visit and left her home.

Supervision

Supervision is not only to aid practitioner’s development (Hawkins and Shohet, 2000) but also the needs of service users (Pritchard, 1995). I raised my concerns surrounding Monica’s diabetes. I also raised concerns surrounding the general state of Monica’s home which was extremely run down, covered in dog hairs and had particularly poor air quality. Using the hierarchy of heeds (Maslow, 1954) I saw how important the house would be in meeting the child’s basic needs and therefore its potential impact on a child reaching self actualisation. Risk has assumed increasing importance in social workers daily activities (Webb, 2006) and I found my supervisor and senior practitioner recommending we close the assessment based on risk. However I viewed the situation from a preventative risk perspective (Corby, 1996) and felt that with work and support Monica could still foster.

I put my case to the team manager from a Disability Discrimination Act (1995) and Equality Act (2006) perspective, stating that there is a dominant ideology of disability where services tended to focus on incapacity (Prime Minister’s Strategy Unit, 2005; Thompson, 2001). However I saw potential in Monica due to raising her son independently and her childminding experience. I was granted to continue with my assessment if Monica could address her health and household issues. Dalrymple and Burke (2006) believe that critical debate about personal, professional and organizational values is essential in dealing with ethical dilemmas. Although colleagues will have different viewpoints (Watson, 2006), I felt my colleagues were acting habitually seeing Monica’s assessment as unworkable. However I saw my role as also ‘moral worker’ (Hyden, 1996) and felt, with the care vs. control and anti-oppressive practice in my mind, that Monica deserved the opportunity to make the necessary reasonable adjustments.

Discussion around issues

On the second visit I discussed the issues surrounding Monica’s diabetes and she agreed to visit the GP and begin to control this again. Her acknowledgement that she was ‘just being stubborn and thought she knew best’ I believe showed that my actions were with her best interests in mind. I also raised the subject of the cleanliness of her home. Monica didn’t feel there was an issue as she and her son had lived there with no concerns. At first I questioned my values and whether I was imposing them upon her. I reflexively began thinking about the Human Rights Act (1998) Article 8 ‘Right to Respect for Family and Private Life’. However I also thought about how I felt when I had left after the first visit and again took my viewpoint from a child who would potentially be less healthy than me. Under Article 27 of the UN Convention on the Rights of the Child (1990) ‘children have the right to a standard of living adequate to their physical, mental, spiritual, moral and social development’.

I explained to Monica that I was not trying to impose my values and believes upon how she lived and using motivational interviewing (Miller and Rollnick, 2002) asked her to compare her house with her friends homes. I had used this method in my first placement and believed its use in identifying discrepancies was transferrable. My use of this method obtained its acquired affect as Monica stated that she knew her house could be a lot cleaner but because of her disability she couldn’t maintain it. Exploring this with problem solving (Howe, 2007) identified the need of her son to help maintain the home, but Monica stated she didn’t want to inconvenience him. I was having difficulty understanding how Monica’s son fitted with her fostering. From a systems theory perspective (Goldstein, 1973; Specht and Vickery, 1977) I saw this as important to Monica’s assessment as he was her main support and therefore his behaviour would impact upon both her and children placed with her. When thinking about the assessment of foster carers we should be addressing whether or not the family system is ‘closed’ or ‘open’ (Shaw, 1989). An open family system is one that is accepting of change and more likely to offer successful placements. Monica explained her son was indifferent but supportive of her fostering. I explained that I would need to interview him separately to address this issue at a later point in the assessment.

Chronology

I had asked Monica to complete her chronology which provides a history of significant events in her life (Parker and Bradely, 2007). This was to assess one of the competencies looking at how our own experiences can affect us (NFCA, 1999a). Monica discussed her life events but nothing from her childhood. I asked her about her childhood and she said it wasn’t important. I used challenging to aid further self reflection and understanding (Millar et al., 1992). Monica asked me about my comments in our first meeting about being open and honest and whether I needed to know everything. I stated I only needed to know things that would impact on her ability to foster.

Monica began crying and started to explain to me that she had been sexually abused in childhood by her uncle. The information elicited took me by complete surprise and made me anxious. I sat and listened to understand, empathize and evaluate what Monica had disclosed (Smith, 1997). Counselling techniques can be used across many social work situations (Seden, 2005) and I felt I demonstrated the core/basic counselling skills (Rogers, 1951; 1961) required of social workers (Thompson, 2002). However with something so entrenched and deep I felt I wasn’t in the position to explore this. Monica stated she wanted to continue and I therefore asked Monica her it’s impact on her current life. She stated she still had the occasional ‘black’ day where she couldn’t get out of bed. Care Matters (DfES, 2007) states that we need carers who can ‘stand in the child’s shoes’ (p.46) to help them regulate their feelings. Monica positively identified that she could empathise with a sexually abused child but then worryingly said that by talking to a child about their issues would help block out her own depressing feelings. Anxiety can enrich the identity of social work practice (Miehls and Moffatt, 2000). On quick reflection this anxiety I felt enhanced the understanding between me and Monica (Ruch, 2002) and empowered her to tell me that she still had her own issues to address. Monica acknowledged that she hadn’t thought about the abuse for forty years believing her disability caused her depression. I talked with Monica whilst waiting for her friend to arrive to ensure she was safe before I left and stated I would soon be in touch.

Endings

After the visit I compiled my notes using a funnel approach to refine my information (Parker and Penhale, 1998) into a report for senior staff. I used theory to offer accountability to all involved, including Monica, in my decision to close her assessment (Payne, 2005). This was based on standard 6.1 of the NMS (DoH, 2002) in making available ‘carers who provide a safe, healthy and nurturing environment’ (p.11). My colleagues supported my decision and said to send Monica a closing letter which I found insensitive and unacceptable. I wanted a more moral face to face closure with Monica rather than a procedural closure (Lloyd, 2006) as Monica had disclosed something extremely personal to me and I respected her for this. Endings are planned from the beginning (Kadushin and Kadushin, 1997). The natural ending would have been presenting Monica’s assessment to the fostering panel. Instead our ending was on different terms in which I provided Monica with a range of local agencies that could offer help or counselling to address her own issues.

Reflective Evaluation

As stated at the beginning of this report, I decided to choose this unsuccessful assessment to analyse rather than my later successful assessment. This may seem strange to the reader as the latter carers are now approved and fostering. However although I could write in equal length about the more successful assessment, it was Monica’s that taught me more about social work and about myself.

I felt Monica’s assessment demonstrated the acquisition and deployment of my knowledge, skills and values over the past two years. The broad range of literature presented in this report pulls on old and new resources, demonstrating the need to consistently update my knowledge in an ever changing profession. Without this knowledge I would never have been able to work with Monica. I believe my assessment, communication and interpersonal skills demonstrated my competence (O’Hagan, 1996). This ensured a natural, almost unconscious, use of the ASPIRE model (Sutton, 1999) throughout and meant I could adapt to the situation and respond eclectically to Monica’s situation due to its complexity (Cheetham et al., 1992). Integrity (BASW, 2002) has been the most significant value throughout my training. I believe it incorporates all values such as Biestek’s (1961) principles. My integrity ensured that I fought for the continuation of Monica’s assessment at one point; working anti-oppressively, non-discriminately and fighting against social injustices (BASW, 2002).

However despite my strengths, I appreciate that self knowledge is central to becoming a reflective practitioner (Dominelli, 2002); requiring an openness and ability to be self critical (Trevithick, 2005). With Monica’s assessment I was reminded of how practice isn’t straightforward and can constantly change (Parker and Bradley, 2007). I went into this assessment feeling that everything would be clear-cut because Monica had been seen by another social worker and therefore she must have been a certainty for fostering. However my complacency and reliance on other workers judgements didn’t prepare me for the information I was later to receive. Uncertainty is an inevitable part of human interaction and decision making (Roy at al., 2002) and is something I need to appreciate more and continually address within myself. I feel another area that I could have improved upon was focusing more on Monica’s strengths as she demonstrated an inner resource in responding to the daily challenges in her life (Kisthardt, 1992). I feel that although my decision would not have changed, in future practice I need to keep a firm grip on service user strengths to appreciate that there is room in assessment to focus on the cognitive skills, coping mechanisms, interpersonal skills and social supports that can be built on as strengths (Pierson (2002).

Although the assessment hadn’t gone as planned for Monica, I still believe it had some positive impact upon her. Monica’s childhood had been traumatic and I viewed this afterwards using the Johari window (Luft and Ingram, 1955) in figure 2 below. At first I had wondered whether Monica’s abuse was just an aspect of her hidden self. However what struck me afterwards was that Monica stated ‘I haven’t thought about that in over forty years’. I hadn’t attached any significance upon this statement, probably due to the emotiveness of the situation. However upon reflection I feel that Monica’s childhood abuse was part of her unconscious self that

The aim of this assignment is to show how a Social Worker would apply a Behavioural Method as an understanding and intervention on the case study supplied. I will do this by explaining what Behavioural Social Work is, how it is used in practice, how it meets the needs of the service user and identify personal challenges along the way. I will try to challenge my own views and ideals on the service user, and how these can be challenged for Anti-Oppressive Practice.

Most of what makes us truly human, most of what makes us individuals rather than ‘clones’, most of what gives us a discernible personality – made up of characteristic patterns of behaviour, emotion and cognition – is the result of learning (Sheldon and McDonald, 2008). The Behavioural Perspective focuses on the individual and the relationship between stimuli in an environment and how it determines behaviour through learning (Westen, 2001). This is also how Behavioural Social Work is executed, by focusing on behaviour that is observable and changeable. Like other forms of social work methods it has been adopted from other disciplines, and in particular Psychology, but has been adapted to achieve measured outcomes and effective practice for Social Work (Watson and West, 2006).

There are four main Theories that are relevant and used in Behavioural Social Work;

The first behavioural theory is Respondent Conditioning, first introduced by Ivan Pavlov, who used experiments on dogs to discover how to condition a response after the presence of a certain stimuli has been removed.

The second major behavioural theorist is B.F Skinner and his Operant Conditioning, he observed that the behaviour of organisms can be controlled by environmental consequences that either increase (reinforce) or decrease (punish) the likelihood of the behaviour occurring (Westen, 2001). He claimed that the outcome of behaviour was voluntary and goal directed, and always controlled by the consequences the behaviour would lead to.

The next behavioural theory identified is Social Learning Theory, which extends behavioural ideas and claims that most learning is gained by copying others around them, rather than them being reinforced as skinner claimed. That behaviour is shaped by observing others and interpreting it (Payne, 1997).

The fourth behavioural theory is Cognitive Learning Theory and was introduced by Albert Ellis and Aaron Beck in the 1960’s, this is a theory that focuses on the way people perceive, process and retrieve information (Westen, 2001). A perception of the environment from previous experience.

It was during the 1980’s that Social Work adopted behavioural theory as a method of working with service users, part of the reason for this was the ability of the theory to achieve realistic outcomes (Watson and West, 2006). The learning theory used in social work is a combination between all four theories listed above; Respondent Conditioning, Operant Conditioning, The Social Learning Theory and Cognitive Learning. These are used to enable the social worker to observe behaviour and therefore intervene appropriately (Watson and West, 2006). The importance of behavioural social work is that the behaviour is learned and can therefore be unlearned. Cognitive learning theory focuses on this specifically and its engagement with cognitive processes which produce thoughts and feelings (Sheldon, 1995). Behavioural social work allows the service user to modify and change their behaviour through a process of reinforcement, both positive and negative, to produce a likeliness of a wanted behaviour occurring (Watson and West, 2006).

There have been criticisms of this form of social work as it involves deciding what ‘normal’ behaviour is. This may lead to discriminatory and oppressive practice, as a perception of ‘normal’ behaviour can come from a range of sources, such as, personal and professional values (Trevithick, 2000). Another criticism is that the social worker may be seen as having significant power in deciding a future for the service user, which may in turn lead to further problems. To overcome these criticisms for an affective and constructive service for users, social workers have to be aware of empowering skills to help the service user help themselves. Informed consent and active participation is also a significant part of behavioural social work (Watson and West, 2006).

How is Behavioural Social Work Used in Practice?

Some of the reasons a behavioural method was chosen for intervention is because it mainly targets problem solving, and anger management, which are some of the problems faced by the family in the case study.

The first stage of Behavioural Social Work is the process of Assessment. This will begin by identifying the service user’s problem(s) (Howe, 1998). It not only identifies the problem behaviour, but how it manifested to begin with, and what can be done to change it.

The first stage of assessment and intervention is to establish the behaviour to work with (Watson and West, 2006). Within the case study, the problem is the behaviour of Jake who is increasingly violent and aggressive towards his parents and siblings. To establish the intensity and occurrence of his aggression it should be recorded and written down. This will provide clarity and understanding of the nature of the violence, which person(s) are present when he does it and what are the consequences of his behaviour (Watson and West, 2006) The problem behaviour has to be described in terms that are observable and measureable (Howe, 1998). To ensure an accurate documentation of behaviour, partnership should be used with the parents and social worker for empowerment (Watson and West, 2006). A contact either written or verbal can be useful in establishing aims and goals for sessions, and an overall aim for behaviour (Howe, 1998).

Operant conditioning is one of the main theories used in Behavioural Social Work; this is put into practice by the ABC Assessment, which uses the identification of Antecedents, Behaviour and Consequences to help shape wanted behaviour (Hudson and Macdonald, 1998 cited in Watson and West, 2006). The Antecedent – what precedes the behaviour, The Behaviour – in this case aggression and violence, and the Consequence – What happens immediately after the violence i.e Is the behaviour being reinforced? Once all the assessment has been carried out and all the information gathered, the social worker and the service user (parents) must work together to plan a method of intervention which promotes a wanted behaviour, this will be a baseline for intervention (Watson and West, 2006)

The next stage in the process of behavioural intervention is the implementation of the plan to change the unwanted behaviour. For this method to be effective it needs partnership of both parents and the social worker to establish roles, tasks and responsibilities (Howe, 1998). The main task for all involved is to develop appropriate strategies to implement within a certain time frame (Watson and West, 2006), which will enable the social worker to evaluate the process and respond by either changing the strategies or the method implemented. In the case study Jake’s behaviour deteriorated after the new baby was born, so the strategies that could be implemented would involve activities and more contact with his mother, and the rest of the family. Consequences of his bad behaviour should be consistent and happen immediately after an event (Watson and West, 2006). The main aim of Behavioural Intervention and Operant Conditioning is to focus on positive reinforcement rather than punishment, this is to positively change behaviour and motivate Jake to complete goals (Watson and West, 2006).

How Does Behavioural Intervention Meet the Needs of the Service User?

Behavioural Social Work is effective in meeting the needs of the service user as it is specific, simple and structured. It works in partnership with the parents and gives them an understanding into why their son behaves the way he does, and that Jake’s behaviour is the problem and not Jake. Behavioural intervention is also cost effective and doesn’t rely on financial help, therefore can be used immediately to help and support Jake’s parents, as well as Jake’s behaviour. One of the reasons why this method is widely used is because it is time limited; this allows the social worker to assess if the method is effective and if it is not it can be easily altered or changed.

This method is specifically relevant to the case study as Jake’s behaviour is the problem, which has been learned through time. A positive to this is that it can be unlearned with the help of his parents. To avoid oppressive practice this has to be a method that includes Jake, both his parents and the Social Worker. This will ensure empowerment to Jake’s parents; a less likelihood of powerlessness over Jakes behaviour and a more effective outcome.

Some of the negatives of this method if intervention is that it does not tackle the underlying problems to Jake’s violence, but by using skills, values and knowledge the social worker can talk and support Jake to discover other underlying issues.

Challenges working with this service user

Some of the challenges I would face being a social worker for this case is helping Linda and Michael become more involved in changing Jake’s behaviour. There is a new baby in the home and one other sibling besides Jake, and getting time to respond to Jake’s behaviour may be difficult. There is also no other social support outside the home and Linda is very stressed and “at the end of her tether” with Jake, so getting time to spend with Jake alone may also be complicated. Another problem is that Michael is already threatening about having Jake removed from the home as his behaviour is so bad, so Michael’s patience to assess and implement a behavioural intervention may be limited. To resolve these challenges I would have to use skills such as empathy and active listening, as well as appropriate questioning to gain a full awareness of the situation. The next step would be to involve both parents in trying to understand that Jake’s behaviour is a result of learning and can therefore be unlearned in time, to show both parents that I am there to help and support both them and Jake for the sake of the family.

Some personal challenges I would face as the social worker is trying to understand what it must be like to have three children under the age of ten, and being at a crisis point with one of them. To be so stressed that your husband is threatening to put one of your children into care because of his behaviour towards the rest of the family. I can’t help but feel “how could anyone, through choice, want to put their child into care”. Can things get that terrible that some parent’s cannot see any way out rather than this? I couldn’t help but think that Michael is saying this because he is Jake’s step father and not biological father, but then, I do not have children and therefore have never had a child with behavioural difficulties. But I do understand what stress can do to a person, and how it can seem like there is no way out. I must challenge these stereotypical views on Michael and realise he has raised Jake from six years old, and probably knows a lot more about Jake’s behaviour and the family dynamic than I do, as a Social Worker.

Conclusion

A behavioural method for Social Work was chosen for this case study. It enables the social worker and the service user to work in partnership which is fundamental for a behavioural method to succeed. It includes a step by step process with defined roles and responsibilities to alter behaviour. Operant Conditioning is mainly used as its emphasis is reinforcing positive behaviour, but with punishment which should be consistent and applied immediately. Behavioural Intervention provides the Social Worker with a method which can be implemented swiftly, but can also be evaluated after time for its effectiveness. This provides the social worker with the knowledge to alter a method or implement and new one. Values such as anti-oppressive practice and empowerment are vital to implement this method as they provide the service user with choice, roles and responsibilities. By challenging stereotypical views, a social worker can make informed decisions and support the service user effectively. Over all a behavioural intervention is used to alter behaviour, as it is the behaviour that is the problem, not the person.

The purpose of this essay is to offer the reader examples of my understanding in personal and professional development. The discussions of two ethical dilemmas, offered by comments on ways of dealing with them are included. It will further conclude with an evaluation of my support and supervision during the practice placement setting.

My self-awareness resulted through childhood difficulties. In the gradual process of maturing I have become more conscious of my inner feelings, attitudes and thoughts, and through relating more to myself I have become a well-informed person. Individuals entering Social Work choose this career because similarities exist with other people, service users. However, to practice I should not dwell on personal experiences (Lishman, Adams, Dominelli & Payne, 2009), and should move into brushing up my skills. Having natural ability is good, but in an ever changing world and reform of Social Services growing new awareness’s and understandings is good.

The process of professionally developing derived from learning my own internalisation, absorption and the way in which I accepted a certain situation. For example, I observed another worker meet a mother and during the gathering of information she delivered her questions and explanations clearly. This was acceptable to the mum; she appeared relaxed and had no need to ask for further confirmation. My approaches seemed complicated and unsatisfactory at that point. I wanted change and felt motivated to try this workers method. In a different meeting conducted only by me I adopted the approach and incorporated it within my interaction. This was a better way to conduct an interview. I relayed my experience to the manager and through speaking to him I finally realised the connection between personal and professional development.

In realising that I gained professional development through observing another I found myself wondering where else I could develop. Without trying I went into another colleague’s office to pass a message onto her and by chance I noticed an aspect of her office organisation to be a better than mine. In an unconscious and instant comparison I realised my office organisation was not as well set out. My rearrangement of office resulted out of an unplanned observation. I was not only able find inspiration in others, but to find it when not expecting too surprised me. In adopting this better way I was able prioritise my workload by viewing what was in front of me, plus by pinning my notes on a desktop board I could write my notes without wading through paperwork.

Enhancing my professionality through conscious and unconscious internalisation processes it has allowed me to replace the once known displaced professional work related knowledge and skills to a newer and even more superior professional work related knowledge and skills. By growing I have learnt to reducate myself and by updating my beliefs and values I can be proactive, overcome faults, weaknesses and insecurities.

Part 2

Social Workers work relentlessly toward enhancing all people’s wellbeing, offering a large focus on meeting needs and empowering the vulnerable, oppressed and those suffering from poverty. Modern day professionals must observe environmental forces as they can make, and add to pressures already endured by clients. To end discrimination, oppression, poverty and social injustices Social Workers implement a Code of Ethics throughout all working practices. The embracing of core values, ethical principles and ethical standards assists Social Workers to make decisions and behave accordingly when faced with ethical dilemmas.

During the practice placement a child required support. He was experiencing behavioural problems resulting from sexual abuse. To provide support for this child I was required to meet with the mother and do a screening report. During contact I presented an information sharing form, an explanation of the service, its purpose and usefulness. This was to inform the mother of her rights and allow for an insight into the charity, and its services. The child was asked to be absent as I wanted to get the mum’s perspective on things. In gathering background information Mum disclosed that her son was partially blind and required specialist Braille books.

On return to the service and disclosure of my findings to the Children Service Manager I was told we had no reading materials suitable for this type of disability, therefore the provision of services could not be offered. It was felt that we could not meet his needs and a more specialised service should be found. This did not sit well with me. The child was being discriminated against because we did not have specialised materials.

To reduce any possible conflict I let the conversation die down before approaching the subject again. Meanwhile, I thought of ways in which the child could be included within the service. In another meeting with the CSM I recommended that we ask to borrow a selection of materials from the mother. The CSM agreed. In a phonecall the mother agreed. She was elated. The child went on to have non-directive play and I was later informed that through use of the books brought from his home he had felt comfortable enough to disclose some of his bad memories. The service believed this to be a worthwhile cause and later purchased materials, staffs have signed up for new training.

Another instance, Social Workers may often be oppressed within an organisation. I found myself within such a scenario. My placement began with an allocated Practice Teacher/Link Supervisor and our relationship begun to develop positively. Sadly a staff member died and shock hit the team. I briefly knew the woman, but for others they worked closely with her for years. I distanced myself and waited on the grieving process beginning, but it never appeared. “Healing from a loss involves coming to terms with the loss and the meaning of the loss in your life” (Family Doctor.org, 2009). The effects of losing the valuable team member and friend caused my Practice Teacher/Link Supervisor to withdraw from the group, she became quiet and non-engaging!

I had to learn, but with no experience in working with children I too found myself lost in the process and did not know which way to turn. The Practice Teacher/Link Supervisor was my first port of call and whilst empathising with her situation I had approach her. She acted coldly, therefore any further approaches made me feel awkward and stressed. This continued for a fortnight and something had to give.

In understanding the relationship between and among people change is sometimes required. I met with the CSM and aired my concerns. I believed I was not being treated fairly, nor respected. The CSM emailed all staff with the Five Step Programme Personal Life Changes. I put my head down and got on with my work, but still the atmosphere did not change. If anything the once friendly attitudes from everyone changed. Being in this situation I fully understand how one person can influence others and how group dynamics can change. The conflict was not resolved and for workers to forget their roots in practice says a lot. This example has taught me to remember the Code of Ethics when working with clients, but also to incorporate them into my work when working with colleagues.

Part 3

Planned informal and formal supervision did not occur during the infancy stages of my learning. It can be argued that poor management was to blame. Once structures were in place it was time to explore my practice, my time to learn, a time to facilitate my growth. During preparation for supervision a requirement to select experiences for discussion scared the hell out of me, and in not having supervision previously what would I take? Armed with a planned agenda I entered what seemed to be the war zone (1st formal supervision).

Encouraged to discuss my experiences I slowly began, during explanations there appeared to be an unsettling period. My own experiences were surfacing which resulted in an awkward fidgetiness. When quizzed I denied the reason. I did not want to appear incapable of my job. I breathed deeply and moved on. Confidence returned and I finalised my explanations. Achieving what could have been disastrously resulted in my first attempt to separate personal from professional experiences.

Standing as a professional in other supervisions I reflected on experiences. It was like looking in a mirror, strengths and weakness became visible. Strengths were praised, but weakness required work, one weakness meant the return to literature. Applying knowledge to practice is one thing, but to understand what that knowledge is can be another thing. To apply my understanding I put my evidence into written pieces of work.

During the review of my work it led to judgement. I was told ‘work situations can be complex at times, but only if you allow them to be. Keep things clear and simple’. My recognition of this phrase meant that I was being coached to identify thought processes and move from being ignorant to understanding. Feedback like this was good because not only was I learning to reflect, but I was also motivated to alter my future thinking.

The contribution of support and supervision proved to be valuable, despite it being offered half through the placement. I recognise that self-awareness is part of the reflective process. To have my values and beliefs heard allowed me to become a happier worker; it also allowed change in the way I practised. With the willingness to accept positive and negative feedback I was able to adapt the way in which I thought. Nearer the end of placement it benefitted my practice and reduced the amount of support that I once required.

To progress in a professional manner I will take forward all feedback and my skills developed during supervision. The important thing to capture is the experience and to learn from it. I will look at the bigger picture and through evaluation I can break down my strengths and weakness, and in recognising my weakness I can self as a better Practioner. This process has helped me to achieve a rewarding experience, and one I am keen to continue with into practice. It can benefit not only to me, but clients and colleagues also.

Social Work is a helping profession which promotes the well being of people while human rights and social justice are highly stressed (IFSW, 2000). The primary mission of social work on the NASW webpage is stated that it is to enhance human well-being and help meet the basic human needs with special attention to vulnerable and oppressed people (NASW, 2007). When the topic “Vulnerable group” is discussed, women, children, handicapped and aged people are mainly under discussion and the issues of Lesbians, Gays, Bisexual and Transgender population (LGBT) are less discussed.

The LGBT population is one of the vulnerable minority groups since the population takes only a small proportion of the whole population. It takes approximately 10 percent of the population (Hilda, H et al. 1988). Also because of the facts that being lesbians or gay in the society was regarded as mental disorder and homosexuality was labeled as a sexual deviation over the early past decades (Hilda, H et al. 1988). The LGBT populations had suffered discrimination based on sexual orientation depending on different geographical area. Exclusion is what the population was brought up with and equity is what they had been struggling for.

Although people became more and more aware of LGBT issue nowadays, the population is still discriminated and marginalized by the majority. The perceptions, attitudes, values and stereotypes of people are the major barriers for LGBT to be socially included. As social work professional who is supposed to promote human rights, social justice and to help the oppressed and vulnerable groups, these influence factors limiting the social work practice are needed to be emphasized. At the same time, persons who are going to help this population need to be competent in this specific field of helping. There are many challenges and difficulties to help this population because of personal and environmental factors.

In this paper, I will try to bring this issue to my own local context: elaborate the situation in Myanmar regarding LGBT, brainstorm how they can be helped applying social work practice and most important of all, I will try to examine and explore how my own perceptions, attitudes, values, experiences, emotions and stereotypes may interfere my ability of social work practice with this specific issue. Moreover I will try to find out how social work practice can be done to help the sexual minority in my local context.

In chapter 2, I would explore how the issue of LGBT came into existence and what is the significant literature about this issue for the better understanding of this population. In chapter 3, I would try to relate the issue to my own local context: explaining the values, cultural norms, perceptions and stereotypes in Myanmar and why gay persons are significant to study. In chapter 4, would make a personal reflection. I would also try to examine myself regarding my own personal values, perceptions and attitude towards this issue. I would also discuss environmental factors in this chapter. In chapter 5, I would conclude with the description of my personal plan while I am in MSW. Potential intervention plan in three levels of social work intervention would also be discussed.

Chapter 2

Literature Review

2.1 History of Homosexuality

Homosexuality had long existed in human history and it can be seen in different culture in different settings. It had made a long way and still making its way ahead.

Wormer et al. (2000) stated that people were morally against homosexuality since ages ago although the term became to be popular in the 1980s. People accepted that homosexuality is morally unacceptable and the attitude of people towards homosexuality is mainly based on strong religious beliefs. Homosexuality was regarded as a sin, a crime, a sickness in the Roman Empire times and it was also legally forbidden (Wormer et al. 2000).

Even in the modern times, homosexuality or same sex relationship and marriage take a controversial topic in debates. It is controversial when discussion comes for rights talk and legal issues. There are some parts of the world where homosexuality or same sex relationship is legalized while in some parts it is illegal and strongly forbidden.

2.2 Homosexuality

Wormer et al. (2000) explained that “Homosexuality refers to sexual attraction between members of the same gender, often but not always accompanied by sexual behavior.” It implies that both male and female who are sexually attracted are covered in the term Homosexuality although males are referred as gays and females as lesbians.

2.3 Lesbian, Gay, Bisexual and Transgender people

This term, also abbreviated as LGBT usually refers to homosexuality while bisexual talks about sexual attraction to members of both sexes. However, in review of the literature, bisexual and transgender are not as commonly seen as lesbian and gay are. Mallon (2009) mentioned that there had not been many researches on the two important populations besides gays and lesbians and the terms and bisexual and transgender were added into research literature only after 1998.

2.5 LGBT and Social Work

The National Association of Social Workers (NASW) had been working on the LGBT issues since 1970s. The National Committee on Lesbian, Gay, Bisexual and Transgender issues was formed in 1982 with 8 specific objectives in which promoting social justice and defending the rights of persons who are suffering oppressions and discrimination based on their sexual orientation NASW (2010).

Chapter 3
Situation in Myanmar
3.1 Situation of LGBT persons in Myanmar

There is no specific study and literature about LGBT persons in Myanmar. The issue is not published nor does not take media coverage despite of its existence. Yuuki (2009) complained that there have not equal rights or opportunities for LGBT in Myanmar even though there is no apparent discrimination towards the population (para. 1). There is very little knowledge about LGBT in Myanmar and they are only regarded as the carriers and distributors of HIV/AIDS.

As cited in The International Lesbian, Gay, Bisexual and Trans and Intersex Association of Asia (2009), the Penal Code, Act 45/1860, Revised Edition, Section 377 states

“Whoever voluntarily has carnal intercourse against the order of nature with any man, woman or animals shall be punished with transportation for life, or with imprisonment of either description for a term which may extend to 10 years, and shall be liable to fine.” (Ottosson, 2007). The law is in fact not very clear whether or not all LGBT persons who have sexual relationship to same sex. The International Lesbian, Gay, Bisexual and Trans and Intersex Association of Asia (2009), only states that male to male sexual relationship is illegal (p. 1).

There have not much concern on LGBT persons in Myanmar. Only gays; male to male sexual relationship has been concentrated regarding the distribution of HIV/AIDS. It has been only a decade or so that the LGBT issues involved in public chat and gossips with the celebrities who had come out of the closet and with the popularity of sex change operations in neighboring country, Thailand. People in Myanmar hardly know about Lesbian, Bisexual and Transgender but gays. When LGBT is discussed, gays would be the major discussion.

3.2 Values, Culture norms and stereotypes in Myanmar

Myanmar, being one of the Asian countries holds and practices Asian values. Buddhism is the national religion and the culture is not different from other Asian countries. Masculinity is accepted as superior, being male is believed as natural gift which is related to the good deeds one had done in the previous life according to Buddhism belief. Only males can be monks and become God.

As seen all over the world, gender stereotypes can also be seen in Myanmar. Men are supposed to be the bread winners while women are responsible for the household chores. Men are socially looked down if they can not be able to support the family. Similarly, women are looked down if they can not be able to perform the child care and house works. Min (2010) explained that males have to behave like males and if a boy or girl behaves like a different gender, they would be scolded and punished by the elders. He also told the media that it is a shame to express one’s gender identity whether gay or lesbian and people dare not come out to their real gender identity since they are afraid of discrimination.

3.3 Discrimination against LGBT in Myanmar

Although obvious discrimination against gays was not made public in Myanmar, there are similar situations in the society. The head of the Human Rights Education Institute of Burma reported to a media that there is discrimination against gays. Min (2010), reported that “Although several Asian countries have discriminatory laws against homosexuality, it is illegal in Myanmar. Discrimination against gays and lesbians is traditionally rooted in our societies and the society does not tolerate homosexuality.” (p. 1).

In a few years ago in Myanmar, a gay person who expressed himself as gay and engaged a same sex marriage was expelled from his society after he identified as being gay. He was a strong member of that artist society before he expresses himself as gay but soon after, he suffered sexual prejudice. Irrawaddy (2010) reported that some commented on the case that the Myanmar society should understand gays and allow them to enjoy their rights, including marriage, but some believe that gays should be shunned because it is thought they spread the HIV virus (p. 1).

There are similar cases of discrimination against gays in Myanmar, in a wide society, in the community and even in families. People have little knowledge and misconception about gays by the value, norms and stereotypes.

Chapter 4
Social Work Practice with LGBT in Myanmar
4.1 Personal reflection

In reviewing myself, I do not seem to accept gays as normal. I did not have good experience with gays and I found it difficult to deal with them. The first time I recognized gay persons was in my adolescence. They appeared to be different from other boys that I disliked the way they behave since they do not behave like boys but girls. I see them as cowards and when I encounter those who have sexual relationship with same sex, I used to regard them as persons who are against the religious teachings and law. Although I came to know more about the gay persons, I observed myself that it is still hard for me to deal with them.

4.2 Personal factor contributing the difficulty for social work practice

Since social workers value dignity and worth of a person, my own perception and attitudes towards gay persons would be a barrier in social work practice with them. The factor that I had bad experience with gay persons where I began to dislike them might also contribute the difficulty. It would be difficult for me to bring about equity and change to them because transference and counter transference issues may interrupt my ability to perform social work practice.

More importantly, I do not feel comfortable talking with gay persons and when I examine myself regarding my hesitation dealing with them, the reason behind is that I had the experience in which I was approached by some gay persons. Thus it is very much likely for me and I easily tend to stereotype other gay persons that they would approach me as well. It can also be said as pre judgment which contradicts to social work practice. Again, my perception and attitude towards gay persons is that they are shameless and immoral because they approach and sexually harass the same sex. These personal factors are the barriers that may influence my ability to perform social work practice.

4.3 Environmental factor contributing the difficulty for social work practice

In Myanmar, the cultural and social norms are strong and conservative that there are misconceptions and social exclusions for gay persons. A person who works with the gay persons is likely to be seen as someone strange since the society tends to dislike gay persons. People have very little knowledge about LGBT and tend to label and stigmatize them. One of the comments post on the case of a gay person who was expelled from his society goes as mentioned in Irrawaddy magazine (2010):

Anyone who is neither woman nor man is alien or guest. So, real man and woman have to defend their homeland from invasion of aliens. By common sense, alien or guest should follow the requirements of host. If they do not agree with the terms and conditions of the host, they must go somewhere else. (p. 1).

It shows that despite of the educational level, many people do not accept nor tolerant the LGBT population in Myanmar. The factors that the issue is illegal and no right of expression may also result the isolation of the LGBT and they would not come out of the closet.

Chapter 5
Conclusion
5.1 Personal plan for social work practice with LGBT

During in the MSW program, for better social work intervention practice with the LGBT, especially with the gay persons in Myanmar, I would try to study more on social work practice with diversity. I will try to explore more about the oppressed and vulnerable population: what are the needs and how best intervention can be brought. To change something, I believe that it is important to change one self first. Thus, I would reflect my own personal perceptions, values and attitudes to try to be aware of myself in every situation of social work practice.

5.2 Possible social work intervention for sexual minority in Myanmar

In terms of micro level intervention, with the proper knowledge on the specific subject and by applying social work values, the LGBT population can be helped to adapt with the environment. Empower them as good contributors to the society to receive good image.

In mezzo level, awareness raising for the family members can be done so as all the family members are acknowledged the LGBT subject and the ways they can help their LGBT family members. LGBT group work can also be implemented so that there will be sharing among them for mutual support and coping with the difficulties they face.

In macro level intervention, public awareness can be raised regarding the subject by means of using palm flats, banners and through media so that many people will be acknowledged the know how on LGBT issues.

Now that I am aware of my personal weaknesses that interferes my ability to work with the sexual minority, I am sure that after intensive study while I am in MSW program, I can work with the population efficiently under limitations of my personal values, perceptions and attitudes.