Three months has passed since starting my ASYE programme. I have spent some periods of my employment doing online training courses and practical joint visits to service users’ homes and also attended various hospitals.
Doing these stages during my employment has helped me work towards a good standard of care and support for my service users that I work with. Payne (2014) claims that successful introductions helps to protect staff accomplish a sufficient levels of skills to practice and to value diversity and empowerment (KSS 2 and 8).
Professionalism: I have demonstrated professionalism within my work and supervision with my deputy manager has help me adapt further by supporting me to advance my practice abilities (KSS 8).
Some cases I have worked have been rather challenging and often left me feeling quite worried after working hours.
TZ is a 54 year old women of Iranian background who is living at her sister’s house. TZ does not speak English and has never left the house on her own due to her depression, lack of motivation and not knowing the Stockport area.
TZ left the house after an argument with her sister which resulted in the police being called, as TZ was placing herself in a vulnerable position due to negative thoughts of ending her life.
At this time, TZ was deemed to have capacity to make this unwise choice (KSS 5).
Due to the breakdown in the family home, I went to the vulnerable housing panel to discuss TZ as I believed that if TZ was to go into a hostel due to the family dynamics, this would significantly impact her mental health.
The panel meeting also concluded that TZ would be best suited going into supported accommodation due to her care act (KSS, 8).
I discussed the option of supported accommodation and what it entails. TZ was reluctant to accept, as it was outlined that mental health is a taboo subject within her culture and within their community, family members have to support each other in which TZ sister M is doing.
During and after my intervention, I did learn that communication skills is a core value of social work practice (KSS 2, 3, 6, and 10). Although it took weighing the pros and cons up of supported accommodation, TZ agreed that she would look around the support accommodation and make her decision.
I understood how difficult this was and I informed TZ that it is her choice and can turn it down if not suited to her needs. By communicating to meet TZ needs enabled me to build a rapport, be solution focused and to discuss future plans.
Although this case has been challenging and frequently left me nervous with regards to TZ vulnerability of leaving the house without no support, feedback from supervision and peer support helped to compose my anxieties and to give me self-assurance in my work (KSS 7 and 8).
Ever since, I have improved my values in supervision as it gives me that respected hour to review, discuss my decision making and professional judgment and then to get clinical feedback from my supervisor. When starting my employment, I did not think supervision was a necessary but now I hold it as a crucial part of my social work duty of care (KSS 8).
My supervisor has given me direction during my supervision sessions which has inspired me to continue with my development in social work professionalism by reflecting on my social work KSS and PCF skills (KSS, 8).
Agreeing with research founded by Carpenter and Webb, (2013) supervision within social work turns out to be the most significant when supervision is focused to the attention of task, social and emotional support and having a confident, open, constructive relationship with your supervisor.
I have continued to develop my career and professionalism by continuing to provide evidence under my professional development plan which is attached to the bottom of this document. By doing this enables me to see what I have achieved and what valuable skills I need to work on (KSS 2).
Value and Ethics: According to O’Grady and Malloch (2010) ‘traditional’ values in social care stems from the social norm about person centered services to high expectations of one’s personal values and applying in deference to the patient’s society and the unique values by treating them with respect and, when possible respect confidentiality and independence (KSS 3).
To evidence my practice, I have always made sure that I have had my service users at the centre of their care. I have demonstrated this by involving them throughout assessment, care planning and future care planning. An example of this is when working with LM who is detained on a section 3 under the Mental Health Act 1983.
When conducting a S117 planning meeting prior to discharge, it was suggested for LM to go to a support accommodation so her needs can be met in the community. LM did not want to go to support accommodation and wanted to go home. I took LM wishes and feeling into account and looked at other alternatives. I suggested LM to have daily support from support workers so her needs can be met at home.
Overall, LM was happy with the plan (KSS 2, 3, 6, 9 and 10). Agreeing to Beresford & Branfield (2006) there is always an understanding of factors that can help to make the service user involvements work; as the essential factor is for the view of the service user to be taken seriously by professionals, even if the need cannot be fully met (KSS 3 and 6).
Diversity: Whenever I am allocated a referral I always make it my duty to find out about the individuals concerns and to include and promote diversity by recognising every individual’s differences. These can be along the dimensions of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs, or other ideologies.
As part of my social work professions, I always make sure that I provide necessary adaptations as ‘recognising and respecting diversity and individuality is the cornerstone of social work practice’ (Gast and Patmore, 2012:14) (KSS, 2, 6, 7).
An example of this is when I have been working with TZ, I always make sure that I book an interpreter. TZ has found it easier to open up to one of the interpreters which I booked. TZ stated that she would not like any other as too many people will know all her ‘problems’. I am aware that mental health is a taboo subject in Iran therefore, I always book another appointment on the day making sure the interpreter is also available (KSS 7).
Critical reflection: Some of my service users that I work with have a dual diagnosis, for example, schizophrenia with autism. These service users predominantly challenged me as schizophrenia and autism seem to overlap at multiple levels (Meyer et al, 2011).
Patients with schizophrenia and autism also display a similar pattern of deficient neuronal activation during a social cognition task (Pinkham et al, 2008) and find it difficult to process information. I developed this capability when working with AN who is a 27 year old male. His cognitive functioning towards processing information was poor (KSS 2).
I was apprehensive working with a service user with autism as I have never worked with someone with autism let alone a dual diagnosis and was unware of what method or approach would be best to use within my practice. I read AN notes on the system prior to meeting him. During my intervention, AN asked me to not speak to him ‘like a baby’, I was unaware I was doing this until AN notified me.
The diagnosis of schizophrenia and autism does invite stigma, prejudice and the loss of a service user feeling ‘normal’ within society (KSS 8). Stephen Shore quoted “if you’ve met one person with autism, you’ve met one person with autism” (Autism Speaks, 2019).
For social workers to convey that they understand their service users difficulties as they experience them, will enable to put them in a better position to emphasise and help empower to change their lives (Hepworth et al, 2013). This made me reflect on my practice that I should be treating people in the way I would want others to treat me, if I was in there shoes (KSS 8).
Theory: Reflection in social work practice is to enable social workers to be analytical and to apply theory to practice (Trevithick, 2012). Social workers have an ethical responsibility to understand theories, as they are a crucial part of social work practice (Teater, 2014).
Within my reflective log I am going to make recognition to crisis intervention as I have worked particularly with one service user PL who is seeking for a hospital admission via phone contact, coming into office unexpectedly and home visits. It is essential for me to take necessary action where someone poses a risk to themselves, their children or other people in which I felt a hospital admission was not necessary (KSS 4).
It is important to recognise the definition of ‘crisis’ which Bard and Ellison, 1974 (cited in Stepney and Ford, 2000) identified it as “a subjective reaction to a stressful life experience, one’s affecting the stability of the individual that the ability to cope or function may be seriously compromised”.
PL did become unwell after having a TIA two years ago and was diagnosis with anxiety and depression. When using crisis intervention approach, it is essential to promote anti-oppressive practice and person centred practice by enabling the service user as an independent person and seeing the person as an individual within their own rights (Trevithick, 2012) (KSS 2,3 and 6).
As the prevention of my work is to work in the least restrictive option under the Mental Health Act 1983: code of practice, and maximising independence I support PL in a person centred way to promote dignity and resilience (KSS 3, and 8).
When working with PL, we discuss coping strategies provided by psychologist (5-4-3-2-1 and breathing techniques) to help overcome anxiety when feeling in crisis. During my visits the aim is for PL to regain control over his life by learning and re-establishing coping skills so that he can move forward after the presenting issues has been resolved (KSS 2, 3 and 7).
At times, I have found PL a challenge, as I would receive phone calls daily. When PL informs me that he has not been utilising the techniques, I find myself stuck, as I can only do so much without his input.
I do accept and understand the trauma PL is experiencing on a daily basis therefore, I have started to become more resilient and plan my visits around person centred practice by asking what he wants from me, the support he needs and how he can get it (KSS 3). By putting the responsibility back on him, demonstrates that he is leading an independent and inclusive life and things can only change if he puts the hard work in (Trevithick, 2012) (KSS 9 and 10).
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