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In the analysis of the star character Rachel in the 1968 movie ‘Rachel Rachel’ by Paul Newman, I have used the Theory of Personality Development by Freud Sigmund (1856-1939). Sigmund developed this theory about psychoanalysis from his works on patients with mental problems several years back. In this theory, Freud Sigmund believed that allthe spheres ofsomeone’spersonality were in one way or another determined by the sex of the person and aggression.Sigmund believed that other factors that shapedsomeone’s character also developed during this period of personality development which in totality determined the adults’ personality and how well they relate with the world. According to Freud Sigmund the three elements that make the personality are the Id, the ego and the superego.

The ID is the part we are born with and is the part of us that wants us to be comfortable. For instance children will cry when they are hungry until they are fed in complete disregard of whether there is food or not or even whether the person attending to them is busy or not. As we have observed around us, a child will always cry until what they want is done for them or given to them.

The Ego is believed to develop in children from three years of age onwards. This part enables one to realize the realities of life. At this stage of development a child can very clearly understand the consequences of their actions. For instance they can understand that some unpleasing actions can make them to be punished or rewarded.

Main Body: Analysis

The Superego is the part that develops by the time a child reaches five years. Once the superego develops the cycle of personal development is completed and one attains a balanced personality. The superego is also known as the conscience because it helps us distinguish between wrong and right actions and it also defines for us the ethics and morals by which we live.

The movie ‘Rachel Rachel’ based on the novel ‘Jest of God’ by Margaret Laurence is about a 35-year-old schoolteacher Rachel Cameron who is unmarried and is portrayed in the movie as feeling terrible that she has wasted her life. The Interprofessional education would also enable me to involve all the necessary stakeholders in cases of emergency so as to limit conflicts and ensure the delivery of quality health and social care. For instance, in case I will be faced with a similar situation as the drunken patient case, I would be able to reassure the patient and ensure that they have plenty of drip water added to their body, while ensuring that before I take any steps, I consult with other adult nurses and doctors.

In addition, I would advocate for joint multi-disciplinary training so as to ensure increased harmony among the IP group members at the work place. Moreover, I would also ensure that there is a clearly distinct role defined for each IP team member so that each member contributes to the situation at hand. The role of effective communication would be key to the success of my career as an adult nurse. This is because; the service user and the nurses as well as the doctors would require knowing the progress of the patient as he is being treated. In the above case, after treating the patient, he will be moved to the recovery ward where he will be attended to by other nurses and health care givers. These health care givers will require knowing the progress report of the patient, which I would ensure that they have in good time. As an adult nurse, the value of communication is immeasurable

The star character Rachel lives with her mother in an apartment that was once owned by her late father in New England. It is time for the summer holidays and Rachel is not excited like the other teachers about the vacation as she figures it will just be another holiday when she will be bored and she will have to put up with her demanding mother in the house.

In the movie, another character Calla Mackie who happens to be Rachel’s best friend,a lesbian and a fellow teacherpersuades and invites Rachel to attend a religious meeting with her. Rachel is convinced into attending the meeting and while there she is touched by the sermon delivered by the guest preacher who is a young man.

This incidence marks the beginning of a series of several other events which will convince Rachel to get out of the cocoon she was hiding in and live in the real world where she can freely express her emotions and desires. Calla also feeling touched by the sermon confesses her feelings for her best friend but she is turned down by Rachel who does not have lesbian tendencies.

After the religious meeting and Rachel feeling that she can express her emotions and love to those she cares about she gets involved in a short lived sexual relationship with their old family friend Nick Kazlik who was back in town to visit his folks. Rachel then has her first sexual relationship with Nick;she falls in lovewith him and starts thinking of a future with Nickmistaking the lust they have for one another for love. Nick on the other hand on noticing that Rachel is treating their relationship more seriously than it ought to be treated ends the fling because to him it was just a casual affair.

Shortly after Rachel suspects that she might have fallen pregnant and this really makes her happy as she imagines having a baby of her own.Rachel therefore plans to relocate elsewhere to a place where she can raise her child now that her relationship with Nick is short-lived. Her best friend Calla helps her get another teaching job in Oregon but Rachel soon finds out that she is not pregnant but has a benign cyst. A surgery is organized and after having the cyst removed Rachel still decides to move away with her mother to Oregon and even though she is feeling alone and empty because of the loss of the man she loved and her supposed baby, she has a strong will to continue with her life.

Rachel’s Experience

‘Rachel Rachel’ is a very moving romance, classic and drama themed movie that shows the loneliness and existence of some ladies in real life where someone does not get what they have always wanted or where life seems so unfair to someone. The problem could be in our personalities where we have internal battles within us over what we want and what society or everyone else will say about us.

There were several ideologies that the students discussed in low tones relating to the behavior of these students. However, this was only qualified by the fact that the medical profession students liked discussing their peers’ conduct and professional ethics. In this book, I learnt that Rachel had issues with other student’s conduct which frequently extended to the rest of the other peers both at school and at home. I concurred with critics that she often exhibited this trend. The rest of the team members agreed that the time limit of working in groups could not be construed to mean that medical students were often too pervasive. The setting of the group work was more controlled, thus limiting the results of the findings. It was agreed within my group that the real picture could be depicted in the work place though with limited variations. This was the case with the attitude of the medical students towards other medical students as well as the other students in general. The multi-disciplinary team meeting gave me insights and adequate experience in relation to the kind of communication among different professional team members. They were constantly evaluating her work which sounded kind of uneasy for Rachel.

Striking a balance

In emotionally sound persons, the ego normally comes out as the strongest element of personality taking care of both the Id and the superego. When these three elements are balanced someone is able to survive and exist well without taking undue advantage of others.

Unfortunately not all of us can have the ego coming out stronger than our Ids and superegos. For some the Id is stronger and such a person will be self-centered and concerned only with their wellbeing and if the superego also happens to be stronger such a person can be too hard on themselves, have judgmental tendencies and relating with others would be extremely difficult for them.

Like mentioned earlier the three elements are driven by sex and aggression. Sex which Freud calls the Eros stands for our desire to reproduce and live. Aggression on the other hand represents our need to acquire more wealth and protect our lives.

According to Freud’stheory, our ego therefore has so many tasks. It is charged with the duty of checking that everything is balanced, it deals with life’s challenges and ensures that our actions do not hurt those we care about and all this is done by employing ego defense mechanisms like:

Denial- where we pretend that a problem does not exist.

Suppression- where we consciously block out some thoughts from our minds especially thoughts that can hurt our feelings.

Regression- where we can go back to decisions we had made earlier on.

Rationalization- where we come up with logical explanations to problems or difficult situations instead of admitting the truth.

Projection- where we put behaviors that are unpleasing on other people.

Consequently, after looking at the storyline of the movie briefly and having explained the theory of Personality Development of the psyche by Freud Sigmund, we can say that Rachel the lead character in the movie had a personality problem. This is evident in several ways:

First at 35 years of age, Rachel was still a single woman never married before and still a virgin. This shows that Rachel’s ego could probably be weaker than the other two elements of her personality because in Freud’s explanation there reaches a point in life when every human being of reproductive age would like to procreate and have offspring of their own. And that is why when Rachel suspects that she is pregnant and her belly starts swelling she is so excited. Even though she could have ended up being a single mother she does not seem bothered at all. All that seemed to pre occupy her mind was the fact that she would have her own baby finally.

This shows that Rachel’s super ego couldbe much stronger than her ego and her Id and that is why she was a virgin till late into her life.

Secondly, Rachel looks like she has a personality development problem because she had not known who she was or what she wanted in her life before she and her friend Calla attended the crusade. It is while at the crusade that Rachel decides to have a free spirit.

Rachel looks like she was hiding in some shell and it was the young preacher who helped her get out of it after which she had a sexual relationship with Nick.

In this case we conclude that it is Rachel’s superego which was dominant once again because her morals were probably too uptight that she could not have sex before marriage. I also learnt that adult nurses should learn to downplay their differences for the common good of their patients. I also learnt that the power and authority held by students in their past affected the IP collaboration. Critics subsequently felt beaten at it. However, this has changed owing to the modern reorganization of the healthcare delivery. I learnt that other team members have now been given a chance to take lead roles in the delivery of quality health and social care. This kind of delegation was necessary due to the busy schedule of the doctors. This had to be communicated effectively within the Interprofessional teams. Nurses have been empowered and can now play a vital role which was traditionally reserved for lead doctors in the health care centers. IP working has therefore made nurses more powerful and authoritative thus providing them with ardent experience to further their careers.

Rachel also does not seem to enjoy her life. Schools have closed and people are happy to be going on vacation but Rachel on the other hand is just there not excited about the holidays like everyone else. Rachel was more of an outgoing kind of person than any other character in the movie. In fact, the movie depicts Rachel as aggressive lass who not only care about her own affairs and her state of being but also the state of others. It is indeed appalling to learn that she attempts to repair the bad relationship that others have been nurturing all this while. It should be remembered that Rachel’s earlier background is one to reckon. I acknowledge the fact that working together as a team is integral to the success of my career. There are many times when I will have to consult various health and social care practitioners to effectively treat or deal with complications that may arise during treatment. Likewise, such professional team members may require my help in dealing with social, physical and mental health problems. I also appreciate the fact that effective communication within the IP teams is key since no professional staff within the health and social care can work in isolation. Professional health and social team members should attend the same training session so as to improve their IP team collaboration. Her character is mostly confused to be that of a person who is very strict and stern with all aspects of her life. This indeed helps to illuminate on the kind of character that we expect her to have.

The issue again could be that her superego dominates over the other elements of her personality so much that Rachel is uptight and her conscience cannot allow her to indulge in activities that are fun even during vacation.

Rachel does not seem to make decisions or to be in total control of her life. When she gets invited by Calla to attend a revival meeting Rachel goes just to please her best friend not that she really cared what was going to happen at the meeting. Fortunately for Rachel, it is a time she gets to discover herself and start doing things that other normal adults do without feeling guilty about anything. She even gets to fall in love for someone something she had never done all her entire life.

The best thing is that the movie ends when Rachel seems like she is beginning to have a grip of her life and that her own life is beginning to bring meaning to her and excite her as well. Hopefully she found the love of her life where they relocated to.

In the movie ‘Rachel Rachel’, several people are struggling with personality issues. The theory by Freud has helped us to study an individual’s character and to be able to draw a conclusion concerning the level of development of the Id,ego and superego.

My Experience

During my internship at the general ward as a practicing nurse to be, I was able to experience teamwork conflicts. This experience played well during the conference, thus enabling me to learn more from a practical approach. I was also able to share my experience with the other IP team members. I also learnt important aspects of IP communication and working that are integral to the success of IP collaboration. These include, not using jargons, listening whenever other team members are talking, questioning assumptions sensibly, promoting the rights and dignity of IP team members. There are certain terms that adult nurses will use which cause confusion and ambiguity, thus making others who assume the meaning of jargons to error.

On the other hand, I would also learn to resolve ethical issues within my IP team. Certain ethical issues are bound to affect the IP collaboration within my working teams. I would therefore respect other IP team member’s ethical standing and approach any indifference with a voice of reason in a bid to drive sense into the team member’s understanding. Indeed, most of the team members agreed to the fact that discrimination was indeed a shared concern.

During my internship, I watched a patient walk in with his girlfriend. It was evident that from the start, the doctor on call could not give effective direction and as if this was not enough, the doctor could not take a leadership role and advice the girlfriend to calm down. I believe as a future adult nurse, I would have tackled this situation with more wit. My first step would have been to take control of the situation and give the patient options with the benefits of each. This would have given more insight to the girlfriend and reduce the conflict.

I would also initiate active communication with the rest of the adult nurses for consultation in privacy. Interprofessional education would have enabled me to effectively initiate communication with my team members, thus taking control of the situation in good time. As an adult nurse, every patient’s condition is important since my core value is to preserve life.

I have also learnt the effectiveness of working in partnership with the patients through listening and responding to their concerns. I have also learnt that it would be important to consult with the patients regarding their treatment and care before commencing such. While reflecting this experience, I shall work closely with my team members as an adult nurse and constantly communicate with the relevant authorities and IP team members for quality health and social care delivery.

I truly acknowledge that I would need a succinct understanding of teamwork and modern approaches towards health and social solutions. As a future adult nurse, I will always ensure that I initiate effective communication with the rest of my IP team members so as to work together for the common good of the patients. The experience that I learnt was indeed useful as it would enable me to effectively become a successful adult nurse who would stand out from the rest. The person-centred approach was particularly imperative in ensuring that I am able to understand the genesis of multi-disciplinary teamwork.

I indeed acknowledge that issues relating to patient care should be approached with interprofessional teamwork so that each medical practitioner offers advice in his or her area of professional knowledge while ensuring that they work as a team.

My experience at the multi-disciplinary conference would enable me to become a successful adult nurse who values teamwork and professional collaboration. This conference has also enabled me to have a clear picture of what medical professionals go through and what can be done to avert such challenges. I now feel adequately capable of tacking these challenges that my career as an adult nurse will provide. I have also learnt to take into account the views of other people when making important decisions. Indeed issues of race, gender, class and sexuality among others should not affect multi-disciplinary teamwork. Cultural and social differences should not be construed as effective barriers to IP teamwork. As a future adult nurse, the conference was a brainstorming session which expanded my experience.

I was also able to learn that certain general terms used by patients to refer to their illness may indeed cause great confusion among professional health and social care practitioners. These are referred to as stereotypes. In such a situation, the health and social professional practitioner should consult the other members of his or her IP group or team so as to come up with the proper interpretation thus limit errors in the treatment of the patient’s condition. Synergy model of nursing supports this argument and calls for more consultation in the treatment of the patient.

The group discussion on IP education enabled me to visualize the reality between theory and practice. The patient-centred perspective was clearly illuminated by the patient’s voice presentation. The exclusion of IP working has been seen in collaborative treatment. Decisions made by individual inexperienced doctors have been tragic. The case of Victoria Climbie and Baby Peter can best illuminate this when Baby Tiffany passed on due to negligence. Findings from this tragic situation enabled doctors and nurses to establish a framework that saw the prevention of such situations. It was agreed that IP teams would not be able to prevent the occurrence of every tragic incidence. Some would indeed be inevitable. Hence, I was able to learn the value of communication and collaboration in the build up to my career as an adult nurse.

Calla also seems to be struggling with her sexuality. She is a lesbian but before the Christian revival she cannot confess her feelings to Rachel because of the society’s views on the subject but after the meeting everyone is feeling like they can open up and that is when she openly tells Rachel of her feelings even though she is turned down.

Conclusion

In conclusion, we can say that the three elements that make up someone’s personality are very crucial in molding the character of someone and greatly influence what someone turns into when they are adults. We should therefore strive to help the Id, ego and superego to grow well and the ego especially should be nurtured to surpass the other two in dominance, because as research has shown for a sound thinking adult, the ego should dominate. As much as this may not be achieved in all people, those who hang around children should motivate them so that they do not have problems in adulthood in identity or of self-esteem like was the case of Rachel and Calla. Rachel’s super-ego is something to reckon with though at times she seems to be not confident enough to tackle the situation at hand. She stands out as a she-wolf, always seizing any opportunity that comes her way.

There are past literature reviews related to work and family conflict, but hardly any review which gives a quick overview of work and family research in global context. This paper outlines both the positive and negative outcomes associated with work and family interface, theoretical models related to work and family research, antecedents and consequences of work and family interface, importance of topics in work and family study and future implications of work and family interface.

Introduction

In the 21st century it is a challenge for many working families to maintain a balance between work and family. The increased participation of married women in the labour force has led to a growing realization that work and family domains are highly interdependent. Duxbury and Higgins (1991) reported that due to the increasing prevalence of dual bread-winner families and single working parents, workers are facing more challenges in meeting the demands of work and family. Issues of work and family have always been a part of our life. Lopata and Norr (1980) suggest that work and family issues have gained greater importance because the stereotypic life-course pattern is changing and more flexible options are available. Killien, Habermann, and Jarrett (2001) reported that in more than 50% of all married couples in United States of America, both partners work outside the home. In the western and dual earner couples are the norm today, representing 54% of married couples in the U.S. in 2001 (U.S. Census Bureau, 2000).

The interference of the home and work domain has been identified as one of the ten major stressors in the work place (Kelloway, Gottlieb, & Barham, 1999). The spillover from work and family can be negative or positive and is bi-directional; it involves the transfer of mood and behaviour from one domain (home or workplace) to the other (Almeida, Wethington, & Chandler, 1999; Bromet, Dew, & Parkinson, 1990). Work can be very important and can have positive effects for people (e.g. Rothbard, 2001). A balanced life can give multiple sources of satisfaction (Baruch & Barnett, 1893), and can provide many people with social support, opportunities for increased self-efficacy and an expanded frame of reference (Barnett & Hyde, 2001). If the workers are unable to make the balance between work and family roles, the potential for conflict between the roles increases (Frone, Russell, & Cooper, 1992a; Greenhaus & Powell, 2003). Work and family conflict is emerging as a research topic because there have been significant changes in the social conceptions of gender, parenthood and work identity (Beach, 1989).

Work and Family from the Conflict and Balance Perspective

Voydanoff (2004b) reported that work and family conflict and work family balance are independent constructs rather than opposite ends of a single continuum. Work and family conflict is based on the principle of scarcity theory. The scarcity theory of human energy assumes that personal resources of time, energy, and attention are fixed. The scarcity hypothesis also suggests that the multiple roles inevitably reduce the time and energy available to meet all role demands, thus creating strain (Goode, 1960) and work-family conflict (Marks, 1977). Work and family conflict has been defined as ‘a form of interrole conflict in which role pressures from the work and family domains are mutually incompatible in some respect’ (Greenhaus & Beutell, 1985, p.77; Greenhaus & Powell, 2003). Work and family conflict occurs when the demands of work are in disharmony with the demands of family (Bruck, Allen & Spector, 2002). Boundaries of work and family are asymmetrically permeable, such that work interferes with family life and family life interferes with work (Eagel, Miles & Icenogle, 1997; Frone, Russell & Cooper, 1992b). The incompatibilities between the two roles are based on the three different forms of work and home conflict: time based, strain based and behaviour based (Greenhaus & Beutell, 1985). Time based conflict occurs when the time demanded by the family puts pressure on work and the time demanded at work take away from spending quality time with the family. Parasuraman, Purohit, Godshalk, and Beutell (1996) hypothesized that commitments of time represent an important cause of work and family conflict (WFC). This hypothesis is based on the view that time is a limited resource. If a person devotes his time to a given role e.g. work, the less time that person has to meet the family role. Strain based conflict occur when stress from one domain shifts to another domain. Bartolome and Evans (1979) explained strain based conflict as the extent to which an individual preoccupied with one role (e.g. family) stressed someone attempting to meet the demands of another role (e.g. work). Behaviour based conflict occurs when behaviour makes it difficult to fulfil the requirements in another role. Behaviour based conflict refers to the display of specific behaviors in one domain that are incongruous with desired behaviors within the second domain, where norms and role expectations in one area of life are in- compatible with those required in the other domain (O’ Driscoll, Brough, & Kalliath, 2006, p. 118). Several researchers acknowledge that the direction of conflict is an essential element and that both work-to- family and family-to-work conflict need to be identified (e.g., Frone, Russell, & Cooper, 1997; Higgins & Duxbury, 1992). WFC was originally operationalized as an uni-dimensional construct (Kopelman, Greenhaus, & Connolly, 1983). The recent studies by Carlson, Kacmar, and Williams (2000) and Frone et al. (1992, 1997) have explained that work family conflict is a multidimentional concept work can interfere family; (WIF) as well as family can interfere work; (FIW). Frone (2003) reported a four dimensional model of work-family balance, that is direction of influence between work and family roles (i.e. work-to-family and family to work) and type of effect (conflict versus facilitation). The studies by Aryee, Luk, Leung and Lo (1999); Frone, (2003); Netemeyer, Boles and McMurrian (1996) and Williams and Alliger, (1994) reported that the prevalence of WIF conflict is greater than FIW conflict. A study by Roehling, Moen, and Batt (2003) reported that family life enhances work life to a greater degree than work life enhances family life.

Marks (1977) (also see Sieber, 1974) proposed a theoretical alternative to the scarcity theory, which he called the role expansion theory. The role expansion theory Marks proposed assumed that human energy is abundant and participation in one role could also have a positive effect on the other role. The potential benefits of engaging in both work and family roles have largely been overlooked (Brockwood, Hammer, & Neal, 2003; Hanson, Colton, & Hammer, 2003). The terms ‘work and family enrichment’, ‘positive spillover’, ‘work and family enhancement’ and ‘work and family facilitation’ are used for the positive relationship between work and family. Work and family facilitation is a form of synergy in which resources associated with one role enhance or make participation in the other role easier (Voydanoff, 2004a). Better functioning of both work and family adds a more positive look at the interaction between work and home, allowing for the possibility of synergy between work and home (Zedeck, 1992). O’Driscoll (1996) examined the processes of role enhancement where multiple roles energize the individuals and give them more satisfaction in work and family roles. In addition, employees today are more likely to express a strong desire to have a harmonious balance between work and family (Offermann & Gowing, 1990; Zedeck & Mosier, 1990).

Barnett and Hyde (2001) also proposed an expansionist theory of work and family and they explained several benefits of combining multiple roles. They stated that multiple roles give benefits such as added income, more sources of social support, greater self complexity and more shared experiences between men and women. The success in one role can buffer failure in another role. The idea of an interaction between work and family comes from statistical models where two effects combine to provide something that is greater than would have been predicted from either one alone ( Halpern & Murphy, 2005, p. 4). Research has also found a modest positive correlation between work and family commitment (Marks & MacDermid, 1996).

The exchange theory of Pittman (1994) defines work-family fit as “an assessment of the balance between the spheres and may be considered the acceptability to the multidimensional exchange between a family and work organization” (p. 135). Pittman referred to work-family fit as an assessment of balance between work and family. There are many empirical studies that have abundantly examined work-home conflict, whereas there have been fewer studies on positive work-home interaction (Geurts & Demerouti, 2003). At the same time, there are few instruments available to measure work and family balance than work and family conflict (Carlson, Kacmar, Wayne, & Grzywacz, 2006). Later in this paper I discuss work and family from the scarcity theory perspective in more detail.

Theoretical Models related to Work and Family Research

Researchers have proposed a several ways in which the work and family domains may be linked (Edwards & Rothbard, 2000; Lambert, 1990). Earlier work and family research were based on three popular hypotheses (Cohen, 1997): segregation (segmentation), compensation, and spillover. Segregation refers to the separation of work and family in which there is no systematic connection between work and family roles (Edwards & Rothbard, 2000). Segregation also refers to the separation of work and family from the psychological, physical, temporal and functional point of view, and suggests that this is the best way to keep a boundary between work and family (Lambert, 1990). Compensation refers to the negative relationship between the work and family role. If a person is dissatisfied in one role of life, it offsets satisfaction in another (Burke & Greenglass, 1987). Spillover can be seen in terms of work and family mood, value, skills, and behavior spillover. The spillover model of work and family refers to the “positive and negative feelings, attitudes and behaviors that might emerge in one domain and are carried over into the other” (Googins, 1991, p. 9). Kabanoff and O’ Brien (1980) have expanded the spillover and compensation hypothesis by analyzing the work and family activities in five dimensions (autonomy, variety, skill utilization, pressure and social interaction).

A comprehensive model of the work-family interface was developed and tested by Frone et al. (1992a). This model introduced a major change in the theories of work and family conflict. The model extended prior research by explicitly distinguishing between work interfering with family and family interfering with work. This distinction allowed testing of hypothesis concerning the unique antecedents and outcomes of both forms of work-family conflict and the reciprocal relationship between them.

Frone et al. (1997) developed an integrative model of the work-family interface. This model extends prior work by Frone et al. (1992a). Although this present model adopts the distinction between WIF and FIW, several important changes have been incorporated. First, a more explicit attempt is made to model the reciprocal (i.e., feedback) relations between work and family life. Second, a distinction is drawn between proximal and distal predictors of work-family conflict. Third, the relations between work-family conflict and role related affect have been differentiated into predictive and outcome relations. Finally, role related behavior and behavioral intentions have been explicitly incorporated into the model.

Bronfenbrenner (1989) developed an ecological systems theory which stands in contrast to the individual, deterministic perspective of the structural-functionalist role theory. The ecological systems theory suggests that the work-family experience is a joint function of process, person, context and time characteristics. Ecological theory suggests that each type of characteristic exerts an additive, and potentially interactive, effect on the work-family experience. Researchers have used this framework to guide the study of work-family conflict (e.g., Grzywacz, 2000; Hammer, Bauer, & Grandey, 2003; Voydanoff, 2002). From the perspective of ecological systems theory, work, community and family are microsystems consisting of networks of face-to-face relationships (Bronfenbrenner, 1989). When two or more microsystems are interrelated, such as work, family and community, the processes connecting them form two types of mesosystems. In one way, we can find direct relationships within one or more microsystems. The relationship within the work, family and community may be positive or negative, unidirectional or reciprocal. From another perspective, we can see the combined effect of these microsystems on individual, community and work outcomes. Grzywacz and Marks (2000) examined the work and family interface using the ecological systems theory. They found four dimensions in the experience of the work and family interface: negative work-to-family spillover, negative family to work spillover, positive work to family spillover and positive family to work spillover. Also, they reported that the ecological resources at work (i.e. decision latitude, co-worker and supervisor support) and family (i.e. spouse and family support) were associated with lower levels of negative spillover and higher level of positive work-family spillover. They also found that ecological barriers at work (i.e. work pressure) and family (i.e. spouse disagreement and family criticism burden) was associated with higher levels of negative work-family spillover.

Senecal, Vallerand and Guay (2001) proposed and tested a model of work-family conflict based on the Self-Determination Theory and the Hierarchical Model of Intrinsic and Extrinsic Motivation. Individuals who perform an activity out of choice and pleasure regulate their behaviour in a self-determined manner. Individuals also do activities out of internal and external pressures, which regulate their behavior in a non-self-determined way (Deci & Ryan, 1985; 1991). The model posits that positive interpersonal factors both at work (i.e. one’s employer) and at home (e.g. one’s spouse) influence work and family motivation. But low levels of self-determined motivation towards the two life contexts (work and family) facilitate the experience of family alienation, which leads to work-family conflict. Finally, work-family conflict leads to feelings of emotional exhaustion. Results from structural equation modeling supported this model. Although the model was supported by data from both men and women, some sex differences were uncovered at the mean level.

Voydanoff (2002) proposed a conceptual model that links the work-family interface to work, family and individual outcomes through several mediating mechanisms. First, the work-family interface is related to a cognitive assessment of work and family conflict, role balance or role enhancement. This relationship may be moderated by social categories and coping resources. The assessment of conflict, balance or enhancement can result in either work-family role strain or work-family role ease. Then, depending on the extent of strain or ease, individuals and families pursue various work-family adaptive strategies designed to improve or facilitate adjustment to various aspects of work and family interface. The success of these strategies is indicated by the extent of perceived work-family fit. Work-family fit is related directly to work, family and individual outcomes. Lastly, work-family adaptive strategies are proposed as having feedback effects on the work family interface.

Boundary theory (Ashforth, Kreiner, & Fugate, 2000; Nippert-Eng, 1996) and Border theory (Clark, 2000; Michelson & Johnson, 1997) state that each one of a person’s roles takes place within a specific domain of life, and these that domains are separated by borders that may be physical, temporal, or psychological (Ashforth et al. 2000; Clark, 2000). Boundary/border theory specifically addresses the issue of “crossing borders” between domains. Although this theory is relevant to all domains of life, its most common application is to the domains of home and work. According to the boundary/border theory, the flexibility and permeability of the boundaries between people’s work and family lives will affect the level of integration, the ease of transitions, and the level of conflict between these domains (Ashforth et al. 2000; Clark, 2000; Nippert-Eng, 1996).

Loy and Frenkel (2005) present societal cultural models of work and family. They explained that societal cultures vary by race, ethnicity, social class, and region. They explained that although the number of dual-earner families has risen in all industrialized nations countries, the families vary in the ways they address work-family conflict, in part, due to differences in societal cultures. Recognizing the importance of cultural models of gender, work and family has consequences for the construction of states and organizational policies.

Hobfoll (1989) developed the conservation of resources (“COR”) model. According to this model individuals seek to acquire and maintain resources including objects, personal characteristics, conditions and energies. Stress occurs when there is a loss of resources or a threat of loss. The COR model proposes that work and family conflict leads to stress because resources (e.g., time and energy) “are lost in the process of juggling both work and family roles” p. 352). Grandey and Cropanzano (1999) argue that the conservation of resources model is an improvement over role theory. Until recently, work and family researchers have relied mainly upon role theory (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964). According to the COR model role theory has some limitations because it has paid less attention to family roles. On the other hand, the COR model encompasses several stress theories, and explains stress outcomes for both intra and interrole stress. The individual difference variables in stress patterns are also included in the COR model and treated as resources. Finally, the COR model also provides an additional insight that has not been widely considered in WFC literature. The model has emphasis on threatened resources and suggests that certain critical events are the source of stress as well. The Grandey and Cropanzano (1999) study is the only study which has tested the application of the COR model to work and family research.

An extensive body of research is based on theories of role strain and role enhancement and addresses the effects of performing multiple roles (in the family and the work place). According to role theorists, a role is a set of activities or behaviors that others expect an individual to perform (Kahn et al. 1964). Thus, an increase in roles gives rise to an increase in role conflict. Role stress theory proposes that the greater the role accumulation, the greater the demands and role incompatibility and the greater the role conflict and strain (Burr, Leigh, Day, & Constantine, 1979; Goode, 1960). Role conflict is defined as the “simultaneous occurrence of two (or more) sets of role pressures such that compliance with one would make more difficult the compliance with the other” (Kahn et al. 1964, p. 19). At the same time a number of empirical studies support role enhancement theory (e.g., Barnet and Hyde, 2001; Waldron, Weiss, & Sieber, 1974).

After the development of all the above-mentioned models in work and family, Carlson et al. (2000) proposed a six-dimensional model of work and family conflict. Their model include three forms of conflict (time based, strain based and behavior based conflict) and two directions of conflict (WIF and FIW) which results in a six-dimensional model of work and family conflict (see figure 1).

Figure1. (Source: Carlson, Kacmar, & Williams, 2000, p. 251). Explain the model describe

Antecedents and Consequences of Work and Family

Jacobs and Gerson (2001) reported that the vast increase in working mothers, single parents and dual earner couples means that more workers than ever are attempting to balance work and family life. As a result, the majority of working parents feel that they have a shortage of time to fulfill their multiple life roles (Hochschild, 1997). Researchers have considered a number of different variables as possible antecedents of WIF and FIW. Consistent with the classification scheme of Eby, Casper, Lockwood, Bordeaux, and Brinley (2005) regarding antecedents of work-family conflict, antecedents can be classified into three categories: work domain variables, non-work domain variables, and individual and demographic variables.

Work domain variables and work and family conflict

There are more studies examining the work domain as predictors of WFC than the family domain as predictors of FWC. WIF interaction has been given more research attention than that given to FIW interaction (Eagle, Miles, & Icenogle, 1997; Higgins & Duxbury, 1992). Job demands, job control and social support were the most discussed antecedents of work. The Job Demand- Control (JDC) model reported two crucial job aspects in the work situation: job demands and job control (Karasek, 1979). In the 1980s, a social dimension was added to this model and called job demand-control and support (JDCS) model. Job demands refer to the work load, and have been operationalized mainly in terms of time pressure and role conflict (Karasek, 1985). The central component of job demand is the task’s mental workload and the mental alertness or arousal needed to carry out the task. Three types of job demands are included in this theory: time demands, monitoring demands and problem solving demands (Karasek & Theorell, 1990, p. 63). The job characteristics mentioned by the demands, control and support models have been reported in a number of work and family studies (e.g., Grzywacz & Butler, 2005; Grzywacz & Marks, 2000; O’Driscoll, Ilgen, & Hildreth, 1992; Pal & Saksvik, 2006; 2008). Employees who had higher job demand, lower job control and less social support were more likely to experience high levels of work-family conflict (Grzywacz & Marks, 2000; Pleck, Staines, & Lang, 1980). At the same time, there are many studies focused on working hours, long hours of work, long days and the relation to WFC (Carlson & Perrewe, 1999; Grzywacz & Marks, 2000; Keith & Schafer, 1980; Pleck, et al. 1980; Reich, 2000). A natural conclusion is that those who work long hours and days are not able to give time to the family. The average number of hours a couple worked in America in 1997 was ten hours a week more than the average couple in 1970 (Jacobs & Gerson, 1998). Toterdell, Spelten, Smith, Barton, and Folkard (1995) reported that employees who work in different shifts reported work and family conflict because shift work leads to sleep disturbance and interferes with social life. Demerouti, Geurts, Bakker and Euwema (2004), in a study on military police, reported that fixed non day shifts including weekends (i.e., during highly valuable times) should be avoided in order to minimize the conflict between work and family. Length and difficulties of the commute to and from work has also been shown to be related to WIF conflict (Bohen & Viveros-Long, 1981; Pleck et al. 1980). The relocation of work also gives rise to negative work and family consequences (Munton, 1990). Management support and recognition (Burke, 1988; Love, Galinsky, & Hughes, 1987), the levels of work role assigned to work roles (Greenhaus and Kopelman, 1981; Greenhaus and Parasuraman, 1987), role overload at work (Bacharach et al., 1991), and individuals highly involved in work (Frone et al. 1992a; Greenhaus, Parasuraman, Granrose, Rabinowitz & Beutell, 1989; Hammer, Allen, & Grigsby, 1997) are also important factors related to WIF conflict. Job insecurity or concern over losing one’s job is a strain based demand that threatens the economic well-being necessary for the stability and quality of family life. The stress associated with job insecurity reduces interpersonal availability and limits effective participation in family life. One study reported that job insecurity is positively related to WFC for men and women (Batt & Valcour, 2003), whereas another study found this relationship for women but not for men (Kinnunen & Mauno, 1998). Several studies also reported a significant relationship between WFC and job satisfaction (Coverman, 1989; Rice, Frone, & Mcfarlin, 1992).

Organizational commitment is another work-related variable that has been studied in association with WFC. Netemeyer et al. (1996); Good et al., (1998) and O’Driscoll et al. (1992) found that as WFC increases, the organizational commitment decreases. Greater levels of WFC are associated with increased intentions to leave the organization (Grandey & Cropanzano, 1999; Good et al. 1988). Wayne, Musica and Fleeson (2004) and Grandey, Cordeiro, and Crouter (2005) proposed that attributing the source of the work and family conflict to the work domain is associated with reduced satisfaction with the work role, whereas attributing it to the family domain contributes to lower marital quality.

Research suggests that a supportive organizational culture, supervisor, or mentor is generally beneficial in reducing WFC. Several studies have found that work support (Carlson & Perrewe, 1999; Greenhaus et al. 1987; Thompson, Beauvais, & Lyness, 1999), the availability of work-family benefits (Thompson et al., 1999), having a mentor (Nielson et al. 2001), receiving more role modeling and overall mentor support (Nielson et al. 2001), and having a mentor who was perceived as having similar work-family values (Nielson et al., 2001) are related to less WFC. At the same time, job satisfaction buffers the relationship between hours spent helping parents and psychological distress for mothers (Voydanoff & Donnelly, 1999). Having a flexible work schedules is ranked as the most valuable benefit option for employees (Allen, 2001).

Family domain variables and family and work conflict

Numerous studies have examined characteristics of the family domain as predictors of WFC and family involvement as adversely influenced by work-related concerns (Burke & Greenglass, 1987). Research into WIF conflict and FIW conflict antecedents in the family domain has found positive linkages between WIF conflict and FIW conflict and marital status (Herman & Gyllstrom, 1977), size and developmental stage of the family (Herman & Gyllstrom, 1977; Keith & Schafer, 1980), level of importance assigned to family roles (Greenhaus & Parasuraman, 1987), family stressors (parental workload, extent of children’s misbehavior, lack of spouse support, and the degree of tension in the marital relationship) and family involvement (Frone et al. 1992a). Negative relationships were found between WIF conflict and spouse and family support (Bruke, 1988; Greenhaus & Kopelman, 1981). Indeed, Suchet and Barling (1986) found evidence for spouse support as a moderator of WIF. A study by Higgins and Duxbury (1992) which revealed that males in dual career couples (that is, male breadwinner and fulltime housewife) found WFC related to life satisfaction. Studies by Bedeian, Burke and Moffett (1988); Greenhaus, Bedeian and Mossholder (1987), and Parasuraman et al. (1989) found that WFC was strongly related to quality of life. Some studies that take into account the bi-directional nature of work-home interferences suggest that home characteristics are more likely to foster home-work interference. For example, Frone et al. (1992a) have shown that whereas job stressors were positively related to work ‘work interferes with family’, family stressors (e.g. parental workload and lack of spouse support) were positively related to ‘family interfering with work’. They even argue that the positive relationships between family stressors and WHI suggested and documented in previous research (e.g. Burke, 1988; Kopelman et al. 1983; Voydanoff, 1988) are, in fact, indirect relationships through ‘family interferes with work’.

Individual and demographic variables

Gender, marital status and age are frequently described as the most important demographic characteristics influencing work and family. Byron (2005) found that demographic variables tend were weak predictors of WIF and FIW; although they did tended to have indirect effects on WIF and FIW. This coincides with recent theory that supports the use of social categories as moderators in the work-family literature (Voydanoff, 2002). In general, being male appears to exacerbate any negative effects of family domain antecedents, such as family stress, family conflict, number of children, and marital status, related to work-family conflict. Paradoxically, females tend to enjoy greater protective benefits from those antecedents, such as flexible work schedules, and, to some extent supportive families, which lessen the experience of interferences.

One’s life stages also influence work and family conflict (Barnett, Gareis, James, & Steele, 2003). A study by Burke and Greenglass (1999) found that age is positively related to work-family conflict. Grazywacs and Marks (2000) examined the effects of age on the experience of positive and negative work and family interaction. They found that young men reported more negative spillover between work and family and less positive spillover between family to work than older men, while younger women reported more positive spillover from work to family, and more negative spillover from family to work than did older women.

Personality should also be given greater consideration in understanding how an individual views and experience multiple life roles (Carlson, 1999; Wayne et al. 2004). Friede and Ryan (2005) discuss the role of personality in interpreting work and family. Behavior based conflict is also linked to the personality of an individual and is one of the main predictors of WFC. Carlson (1999) reported that it occurs when there is incompatibility between the behaviors at either the work place or the home. Personality can influence the actual type and amount of work and family role requirements that an individual experiences his or her, perception of work and family role requirements and the approach to work and family interface.

There is the need for a greater recognition of individual differences in work and family theorizing. Some may ignore this because of a concern that focusing on individual differences, such as personality, is not a key influence of work and family conflict and work and family enhancement. But this may lead to viewing problems in work and life balancing as individual responsibility, with little or no accountability on the part of the firm or of societal institutions (Friede & Ryan, 2005, p. 204). Emotional stability (Kinnunen, Vermulst, Gerris, & Makikangas, 2003) and self esteem (Greenhaus & Powell, 2003) are also linked to the work-family conflict. Finally, researchers discovered that interpersonal attachment styles (Sumer & Knight, 2001), and psychological involvement in work and family roles (Adams, King, & King, 1996; Frone et al. 1992a) are linked to work and family conflict.

Importance research Topics in Work and Family Study

Gender and work-family interface- Gender refers to the set of culturally expected personality, behavior, and attitude attributes associated with being male or female in any given society. Much gendering takes place in the context of family, where the feminine social ideals are what makes a “good mother” or a “good daughter” or a “good wife,” and the masculine social ideals are reflected in notions of the “ideal father” or the “ideal husband” (Simon, 1995). The literature on gender, work and family reveals that a gender difference is found when interpreting work and family. Women exper

‘Doing more of the same wont work’ (Changing Lives: 21st Century Review of Social Work, Scottish Executive 2006) Why is this? Discuss with reference to some of the challenges that face social work in Scotland today. The role of a social worker has become a ‘grey area’ and subsequently undergone necessary scrutiny to establish what needs to be done to improve the use of a social workers time, the relationships built between the service users and providers, and how to adapt to and cater to the service users complex and challenging needs. It became particularly relevant in 2004, when Scottish Ministers registered the need for change, and put together a ‘challenging brief’ asking William Roe to chair the 21st Century Social Work Review. This review asked those involved to question all aspects of social work, and to examine what could be done to fundamentally change, and improve the work of the social worker, and the successive result that had on the service users. It became apparent that as we are living in an ever changing society, ‘social work itself needs to change so that it can match our country’s expectations for high quality, accessible, responsive and personalised services.’

There were many factors that instigated the need for change, and reasons why this review came to fruition. The demands for change are now so important partly due to the media coverage that has show major gaps and careless work from social workers. In some cases, social workers have stood by, acting only when an incident occurs, instead of preventing it from happening. This becomes clear in the case of Miss X, as it highlights that ‘Caseloads for social workers in community care in the two offices concerned with the Ms X case were all over 70, while one had a caseload of over 100, and another had more than 120 cases.’ It also states that ‘A study by the Scottish Executive last year had revealed that Scottish Borders Council social workers had the highest caseloads of any authority in Scotland.’ The case of Baby P, know known to be Peter Connelly, is another example of what some might call neglect by the social services. Interestingly Peter had lived in an area of London that was under the same child care authorities as Victoria Climbie, another child of a failed case. The services involved with these cases have been widely criticised, and enquiries have been made. It has been said in an article in the guardian ‘Social workers believed Baby P’s mother was a “caring but inadequate” parent who just needed support.’ This quote highlights the lack of attention given to the case from the social worker, due to rigour and lack of time given. Although excellent work was being carried out in other areas of social work, just these few examples are enough to show that there was much need for change in the social services, and the 21st Century Social Work Review discusses what these changes are.

It became clear when putting together Changing Lives: 21st Century Review of Social Work, that ‘doing more of the same’ wouldn’t work. The problems within the social care sector were deeper and in need of more attention than simply ‘doing more of the same work’. It has been stated by the Users and Carers panel that ‘this is an unsustainable direction for social work services and that simply pouring ever more public resources into a service based on welfare models rather than the promotion of individual wellbeing will not, in itself, achieve a sustainable future’ Needless to say, there have been numerous examples of success with service users, where the social worker has provided an excellent service and transformed the lives of people in need, but the evidence for the need for improvement has outweighed the evidence for the somewhat limited outstanding work. Therefore the Review looks at the challenges to tackle, as well as the strengths that can be built upon and improved further.

Looking at the major issues and challenges that faced social workers, we can see a trend emerging that suggests a huge lack of confidence, and this is due to the lack of clarity within their field of work. Unreasonable expectations of what, and how much a social worker can do also provides problems, as these expectations clearly cannot be met, and then a sense of failure kicks in, that subsequently has an effect on other work that is being carried out, creating a negative cycle. Risk is another factor that social workers need to carefully consider. This again has a negative cycle effect; the social worker takes fewer risks, as they feel the need to protect themselves from media and political criticism, but this then leads to a less focused and in depth relationship with the service user. It must also be noted, that previously social workers that are fully qualified and skilled had been doing work that didn’t in fact require that level of knowledge and expertise. This is partly due to lack of staff in the service care sector, but also with bad organisation, and not using these skilled workers to the best of their abilities. These social workers are not being put to the best of their ability. Finance is an issue within social work, as without the funds, the service cannot be provided. A social worker has posted their concerns on a discussion group on the internet, and this reads as follows; ‘Lack of funding is by far the biggest challenge in social work today. Many social service agencies are currently experiencing hiring freezes. This leads to larger case loads and less time being given to each client. This is true regardless of the population that is being served. Unfortunately, due to our poor economy, more and more people need the assistance of social workers. Financial hardship causes homelessness, child abuse, and a multitude of other issues, but there is no funding available to assist existing clients, much less new clients that are being affected by the recession.’ This really highlights the urgency for funding, and is further emphasised within the Review by the User and Carer Panel, ‘there are fewer taxpayers and more people needing services, so there is not enough money to fund these services.’ Another problem that has faced social work is the discrepancy between care and control. This leads to an ambiguous relationship between the provider and the user, which needs to be addressed in order for the user to feel comfortable enough to make the most of the service. The Users and Carers Panel have stated, “Services should meet the needs of people. People shouldn’t have to fit services. Social workers should be allowed the time to get to know their clients really well, so that they really understand the different needs of each individual.’

Changes in context and society are other reasons that the role of a social worker needed to be examined, ‘demographic, socio-economic and political trends have driven significant change in social work services since landmark legislation that underpins social work today.’ There are a number of major trends that are expected to affect how the social care services are delivered in the future. Some of these include; an ageing population, this is particularly important as the number of people over 75 years of age has risen an enormous amount and it is thought to have increased by 60% by 2028, therefore 25% of the U.K population will be over 60. The increase being due to advances in science and medicine actually puts forward a huge challenge for social services, as these 25% of people, 60% of which are predicted to have long term conditions, will be handed over to the care of the social services. Children in need remain a significant proportion of those requiring the care of the social services, especially as they become older and leave care. It is stated in the review that ‘60% leave school with no qualification and a similar proportion don’t enter employment, education or training and as many as 20% become homeless within a year.’ As this is know a known and accepted problem, it can be addressed and concentrated on by social workers in the child sector. As well as Children, those suffering from disabilities, stress, anxiety and depression are in need of care and support from social workers, and the demand is only increasing as medical advances allow for disabled individuals to live longer than they may have been able to in the past. Other society related problems that demand a change in the social sector are fractured relationships, social polarisation and shrinking workforce. All the issues touched upon here are inextricably linked to the latter, shrinking workforce, and if this is to continue, the ideas and hopes for the future will be unable to take affect.

The most important factors when considering the new direction for the future of social work are capacity and effective use of resources. In all areas capacity needs to be built upon to achieve the required results. If the capacity is increased, the social worker can deliver personalised services and sustainable change. Both of the latter are extremely important for the future of social work, as said in chapter 5 of the review, ‘personalising the delivery of public services is an explicit goal of Scottish policy’, and this is even more relevant today as ‘we live in a time of great choice and opportunity. Increasingly this means that we want and expect personalised services.’ It is so important to encourage the strengths of the individual and to ‘work with them through the use of a therapeutic approach to make changes and regain their independence’. This then links to the very important factor, giving service users a sense of independence and self assurance. This is made clear in Kieron Hatton’s book ‘New Directions in Social work Practice’, as he refers to the discussion of the ‘common third’. This is essentially a practice ‘in which neither (the service user or provider) is the expert and in which each makes an equal contribution the purpose is to develop the self-esteem and self-confidence of the person using the service so that they can take that new self belief forward into other areas of their lives and become fully empowered citizens.’ This shows a vibrant new idea that will help social workers deal with their service users in hand, rather than maintaining them. This idea is further highlighted by the Users and Carers panel from the Changing Lives, 21st Century Social Work Review stating ‘there needs to be a power shift away from the people who commission and provide services to service users and carers’

When considering all of the factors mentioned, it becomes clear that Social Work demanded a change or a new outlook. However, it could be argued that if there was an increase in workforce, who then released the extraordinary work loads of under pressure social workers more service users would be helped, and more successful outcomes would come about. Yet, it cannot be denied that even if this was a possibility, which unfortunately it is not due to a lack of new workers, the 21st Century demands more interaction, hence forming better relationships, more funding, and a bigger workforce, all of which contribute to the fact that ‘doing more of the same wont work,’ and the challenges and changes put forward by the Changing Lives review are positive suggestions for new directions that will change peoples life and make a difference.

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Service users with mental health problems can present social workers with their own unique challenges; by exploring these challenges it is possible to gain a greater understanding of the role of the social worker. It is intended to look at the desired outcomes from Social Work intervention and the processes that a Social Worker can use to facilitate these outcomes.

Prevention-Work with groups at risk of mental health problems to promote positive mental health -work with individuals and families – reduce the negative effects of institutionalisation and to promote social integration. (DAVIES, 2008)pp260

Multidisciplinary Teams-medicine- Psychiatrist-nurses-psychologist-occupational therapists-social worker

All Social Workers, not just Mental Health Social Workers, need to be aware of the multitude of mental health conditions that exist. Whilst it is not the role of a Social worker to diagnose a mental illness; it is important for Social Workers to recognize that a client may have a mental health problem and be able to refer the client to a medical professional. Mental Health issues are present across all areas of social work including, child protection, older people, criminal justice and physical illness. (Manktelow, 2008) It is also important that Social Workers understand the various causes and contributing factors that can lead to the onset of mental health problems.

It is widely agreed among health professionals that the causes of mental illness can be physical, psychological, social and environmental or more usually a combination of these factors.

Physical- Genetic, brain injury, illness, pre birth factors such as maternal substance abuse or maternal illness during pregnancy

Psychological- Abuse or trauma, bereavement or divorce

Social and environmental factors- Lack of support network, stressful job, unemployment, living in a deprived or high crime area, poor accommodation, and lack of privacy. (www.rethink.org)

http://www.rethink.org/about_mental_illness/what_causes_mental_illness/index.html [accessed 23/11/2010]

Whilst physical causes can generally be put purely in the realm of the medical professionals; some issues such as substance abuse during pregnancy are a social work issue and whilst it is intended to concentrate on the work of the social worker within the bounds of mental health it is important to remember that many of the agreed causes of mental health problems are also social work issues and that early intervention in these areas can prevent future problems.

The Social Worker’s role is especially important for service users with a dual diagnosis i.e. schizophrenia and substance dependence as the two conditions tend to be managed by different agencies; add to that issues with housing and benefits and it can be seen that effective communication as facilitated by the Social Worker is paramount (Parrish, 2010)

The ultimate role of intervention is to improve the quality of life for the service user, their families, carers and all concerned. Cite Perhaps now would be a good time to look at what a person requires to feel that they have a good quality of life and the negative effect that a mental health problem could have on these requirements. Maslow with his “Hierarchy of Needs” tells us that to achieve a good quality of life we need firstly, the basic requirements of life without which a person will die then next in the hierarchy is the need for safety followed by Love and belonging, esteem and finally self actualization. Whilst the theory has its’ critics; most of the criticisms are aimed at the hierarchal nature of the theory. When the theory is applied to a specific population as in Majercsik’s study of the needs of geriatric patients it can be seen that the hierarchy can be skewed.(Majercsik, 2005) It is generally agreed that if these needs are not met then this will have a negative effect on quality of life.

E. Majercsik. (2005). Hierarchy of Needs of Geriatric Patients. Gerontology, 51(3), 170-3. Retrieved November 26, 2010, from ProQuest Nursing & Allied Health Source. (Document ID: 823764721).

The initial concerns during assessment and intervention are to ensure that the basic needs of the individual are being met and that they can continue to be met either by the individual or if necessary by a care plan. As well protecting the client from harm Service users with mental health problems my present a safety risk to themselves or others and it is important that these risks be assessed and if necessary steps taken to reduce these risks. If a client is deemed to be a risk to themselves or others they may be detained for treatment under the Mental Health Act (1983). This process requires an Approved Mental Health Professional (AMHP) to make an application for admission to hospital for assessment or treatment. Deprivation of liberty is a serious matter and as such it is covered by strict laws and guidelines. It is important for a Social worker working in the field of mental health to know the laws and procedures involved with compulsory detention. (Golightley, 2008)

Mental illness can be caused by abuse but also having a mental illness can leave a person vulnerable to abuse. Individuals with mental health problems are vulnerable to abuse in many forms, physical, sexual, psychological, financial, discrimanatary and neglectful. This abuse can come from many sources, friends, family, neighbours, strangers and even care proffessionals. This abuse can be intentional or unintentional. Working with vulnerable people puts a Social Worker in a position of power both real and percieved and it is important that this position of power is not abused. The GSCC Codes of Practice state that as a Social Worker you should recognise and use resposibly the power that comes from your work with service users and carers (GSCC 2002). The use of anti oppressive, anti discriminatory and reflective practices is therefore essential to good practice. Working in partnership with clients, setting the client realistic goals and the use of a person centered approach all serve to redress this balance of power. Recognizing how one’s own emotions, circumstances and values effect the way in which a person or situation is percieved is an important factor in being non-judgemental. A Holistic approach, taking into account, race, culture, social standing can help prevent discrimination.

It is important to appreciate that any care plan should meet the needs of the individual and to ensure that the family/carers are also supported. Caring for a family member with a mental health problem can have many negative effects on the carer. The family may suffer financial hardship, social stigma and isolation. Children may feel or even be neglected due to the demands of caring placed on a family; this can lead to attention seeking behaviour, missing school, poor hygene, poor health or criminal activity. They may feel fear or intimidated by the unusual behaviour exhibited in some forms of mental illness. Carers may feel helpless, overwhelmed, tired, socialy deprived and may neglect their own care in favour of that of the ill family member; this can lead to physical or mental illness for the carer. If the carer can no longer cope with the caring role then the individual can be neglected. It is essential then that the family/carers receive support in their role. The Social Worker must develop a care plan that helps the family cope with their role as carers; this may include carer support groups, coping strategies for dealing with aggressive behaviour or hallucinations, advice on benefits, bringing in outside carers and explainations of treatments and illnesses. An effective care plan can improve the quality of life for the service user and their family and this in turn reduces the need for hospitalization and can prevent a host of future problems.

Service users who require hospitalization for long periods of time can present different problems. They can become institutionalized and require a lot of work when the time comes that they are ready to re enter society.