Social Work Knowledge And Skills Analysis Social Work Essay

Social Work Knowledge And Skills Analysis Social Work Essay This essay provides a critical analysis of a 10-minute AV recording transcript (appendix 1) of an interview with a service user in a simulated role play. This is not a real interview, but part of a student assignment. All names used in this recording transcript are fictitious and thus there are no issues concerning confidentiality. The essay comprises two parts. In Part 1, Kolbs Learning Cycle (Kolb, 1984) will be utilised to reflect upon the interview. In Part 2, the ASPIRE Model (Parker and Bradley, 2003) will be utilised to outline how further work with this service user would be approached. Kolbs Learning Cycle and the ASPIRE Model will both be briefly outlined within the appropriate section. Part 1: Reflection and Critical Analysis Kolbs Learning Cycle, which will be used to reflect upon and critically analyse the interview, comprises four stages of learning from experience: Concrete Experience (i.e. active involvement in an experience); Reflective Observation (i.e. reviewing and reflecting on the experience); Abstract Conceptualisation (i.e. concluding and learning from the experience); and, Active Experimentation (i.e. planning and trying what has been learned). Each of these stages will be used in this reflection and critique. Concrete Experience A simulated role play interview was conducted with Paul Jones, a 60-year old who contacted the adult social work team to discuss the possibility of some assistance. Paul is the sole carer of his 92-year old father, James. Paul has been finding it increasingly difficult to care for James, who spends all day on the sofa and does not even go upstairs to his bed at night. James became this way soon after the death of his daughter 1-month previously. She died of cancer not long after Paul and James lost Pauls mother and James wife to a heart attack, 6-months previously. Their only relative is Pauls son, who lives up North and is unable to visit regularly. The full case study can be found in appendix 2. Reflective Observation The purpose of the interview was to work collaboratively with Paul in establishing his current needs. With the exception of the beginning of the interview when I was nervous and finding background noise distracting, I communicated in a clear and courteous manner. These skills are important when establishing rapport with a service user, laying the foundations to develop mutual respect and trust (Koprowska, 2005). After some introductions and the setting of boundaries regarding confidentiality, I placed the interview agenda into Pauls control with the appropriate use of the open-ended question, What has bought you here today? By recognising the power imbalance present between social workers and service users, I was mindful to reduce the oppressive impact of hierarchy (Dalrymple and Burke, 2000). The question did, however, seem to unnerve Paul and he passed the question back by asking Well, Im not sure how much you know? I informed him that I do know a little bit. . . and then gently en couraged him to provide me with some more information. On reflection, I should have clarified with Paul why needed the information again (i.e. to confirm accuracy of details). He was clearly uncomfortable with repeating the information, possibly due to a previous resistance to seeking outside help. I was focused on eliciting information from Paul first-hand to prevent any assumptions being made, but should have adapted my approach based on Pauls needs. A key strength within the interview was the effective use of empathic understanding, which appeared to put Paul at ease. Statements such as, This must have been a very difficult time for you and appropriate use of eye contact and body language conveyed empathy, congruence (genuineness), and unconditional positive regard. These are three core conditions required in person-centred counselling (Rogers, 1980). I feel that by utilising these skills within the interview, Paul was able to speak openly about his concerns. Indeed, evidence suggests that congruence supports anti-oppressive practice by facilitating the development of a partnership (Miller, 2006). Paul sought help under the premise that it was for James, but with the appropriate use of open-ended and closed questions it was established that he needed help too. The needs of the carer are far too often overlooked within social care (Herring, 2006), but I ensured I gained a balanced accumulation of information on both Paul and James in order to establish both of their needs. Systems Theory (Bronfenbrenner, 1977) purports that in order to understand an individual, they need to be assessed in terms of their interactions with their environment and within their relationships. By the end of the interview, a shared understanding had been reached, as well as a plan of action in terms of arranging a home visit and contacting Citizens Advice to discuss financial concerns. Thus, the initial aim of the interview was met. Abstract Conceptualisation When discussing his problems, Paul was very open and forthcoming, as was facilitated by the use of non-verbal encouragers such as nodding and leaning slightly forward to show interest (Seden, 1999). He was, however, resistant to further outside help such as from his GP or a counsellor. I was careful not to judge Paul on this and to remind myself that there are a number of reasons why he might be resistant (e.g. previous negative experiences with health professionals; family belief systems, etc.). Interestingly Paul did share that James would also be resistant to outside help, indicating the possibility that seeking help is not part of the family belief system. It was important that I did not oppress Paul or James by undermining their responsibilities for the choices they make (Dominelli, 2002, p.47). On reflection, I should have been more understanding of Pauls difficulties accepting help and adjusted my approach accordingly. In particular, if I was to conduct this interview again, I would change the way I responded to Pauls concerns that, I am just worried that I am going to lose it with my dad and I often find things closing in on me. . . I should have probed these concerns further, as has been highlighted in my feedback, in order to establish whether Paul was a danger to himself or James. One of the key roles within the National Occupational Standards for Social Work is to Manage risk to individuals, families, carers, groups, communities, self and colleagues (GSCC, 2002, p.12). Pauls feelings of despair were mentioned on more than one occasion and, on reflection, I should have detected this as a potential risk factor. I feel I was effective in my use of paraphrasing, as used to clarify issues and demonstrate active listening. However, greater use of summarising might have facilitated communication and ensured that information provided by Paul was being interpreted according to his own subjective experiences (Seden, 1999). I will endeavour to develop these skills throughout my training. References Bronfenbrenner, U., 1977. Toward an experimental ecology of human development. American Psychologist, 32, pp.513-530. Dalrymple, J. and Burke, B., 1995. Anti-oppressive Practice: Social Care and the Law. Buckingham: Open University Press. Dominelli, L., 2002. Anti-Oppressive Social Work Theory and Practice. Palgrave Macmillan. General Social Care Council, 2002. The National Occupational Standards for Social Work. Topss England, April 2004. Herring, J., 2006. Where are the carers in healthcare law and ethics? Legal Studies, 27(1), pp. 51-73. Kolb, D.A., 1984. Experiential Learning experience as a source of learning and development. New Jersey: Prentice Hall Koprowska, J., 2005. Communication and interpersonal skills in social work. Exeter: Learning Matters Miller, L., 2006. Counselling Skills for Social Work. London: Sage Publications. Parker, J. and Bradley, G., 2003. Social Work Practice: Assessment, Planning, Intervention, and Review. Exeter: Learning Matters. Rogers, C.R., 1980. A way of being. Boston: Houghton Mifflin. Seden, J., 1999. Counseling skills in social work practice. Buckingham: Open University Press. Part 2 Further Work with the Jones Family The acronym ASPIRE represents the social work process of Assess, Plan, Intervene, Review, and Evaluate, which enables the exploration of successfully operationalising a plan made with a service user (Parker and Bradley, 2003). Adopting this framework also encapsulates the fourth stage of Kolbs Learning Cycle: Active Experimentation. Importantly, supervision would be required in any interviews since I am a newly qualified Social Worker. Furthermore, the contribution of regular and high quality supervision in the social work profession has been emphasised (Laming, 2009). If the case of the Jones family was allocated to me after this initial assessment, I would take an eclectic approach, using the ASPIRE framework to guide intervention delivery. An eclectic approach would be adopted in order to ensure that Paul and James individual needs were taken into consideration. I would be unable to identify the most appropriate approach to use without first meeting with James, thus an eclectic approach would facilitate flexibility between service user needs. Assessment would take place within the home, thus adopting a person-in-environment perspective (Kemp et al., 1997). Importantly, supervision would be required in any interviews since I am a newly qualified Social Worker. Systems Theory posits that in order to understand a service user, their ecological system needs to be taken into consideration (Bronfenbrenner, 1977). This includes their microsystem (i.e. immediate relationships), mesosystem (i.e. different parts of the microsystem working together), exosystem (i.e. systems that the individual is not directly part of but that affects them), macrosystem (i.e. the larger social world, such as government and culture), and their chronosystem (i.e. a system of change). The rationale for utilising this theory is that the current problems experienced by Paul and James appear to be related to recent changes within his microsystem. This includes the loss of two family members, changing health status (i.e. James has gained weight, has emphyse ma, and is becoming less mobile), changing roles (i.e. Paul is now sole carer to James), and a change in their relationship. Bell (2003) asserts that it is easier to understand an individuals behaviour in the setting in which it occurs, which is the approach I feel most appropriate within this scenario. Family relationships are complex and aptly described by Dallos (1991) as, The essence of family life is that it is complex and changing and that unique situations and combinations of needs continually arise (p.7). Therefore, effective support for individual members requires the utilisation of theory and knowledge that assesses their needs within the family context. An understanding of demands and resources is important when working from the systems perspective, an understanding which the theory itself lacks to emphasise (Coady and Lehman, 2008). For the Jones family, demands within their life include bereavement, deteriorating health, and financial concerns. In terms of resources, they are fairly isolated and, despite initiating this interview, they are both resistant to outside help, which also limits their resources. This provides the rationale for utilising a Task-Centered, problem solving approach in the intervening stage of the ASPIRE framework. The evidence suggests that such an approach is appropriate for dealing with family problems, new roles, and illness or bereavement (Reid, 1978). Paul mentioned a number of problems, both personally and in relation to James, and thus facilitating him to identify the cause of these problems would be a useful endeavour in helping him tackle them. By using a problem solving approach within a collaborat ive partnership with the family, I would anticipate that it would enhance their capacity to deal with future problems if they were to arise (Germain and Gitterman, 1996, p.139). In turn, educating Paul on the use of problem solving strategies would act to prevent further oppression by providing him with tools he can utilise in other areas of his life (Coulshed and Orne, 1998). A problem I identified during the role play, but which would need to be confirmed via a shared interpretation with Paul and James, is that Paul could unintentionally be colluding with James disengagement. For example, by leaving his lunch next to the sofa so that he does not have to move, Paul is creating dependency. Thompson (2001) suggests that when working with carers, it is important not to encourage them in a role that could result in dependency and thus further oppress the person being cared for. This would need to be attended to sensitively and without causing offence to Paul. One such way of achieving this is via the problem solving approach to help Paul recognise this for himself. Indeed, change is easier if the directions that professionals and users wish to follow coincide (Dominelli, 2002, p.25). In working with Paul and James, great consideration would be needed in terms of bereavement. It sounds like James might be experiencing depression associated with one of the purported stages of bereavement (Kubler-Ross, 1989). In addition, Paul might be in the anger stage or possibly unable to process his feelings due to the stress of taking care of his father and worrying about finances. Their current problems are likely to hinder them both reaching a period of restoration orientation, where they can focus on building their future after their loss (Worden, 2003). In order to facilitate a move towards restoration orientation, I would work with the strengths possessed by Paul and James to ensure anti-oppressive focus is maintained (Parker and Bradley, 2003). There has been some critique to Systems Theory, including that it lacks theoretical and empirical support in practice situations (Healy, 2005). Overall, however, the purpose of the theory is to work with service users in a way that enhances and strengthens their abilities to adapt and solve problems, which ultimately provides long-term outcomes rather than short-term solutions. The key role of social work, as agreed internationally, is the promotion of social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being (GSCC, 2002, p.12), and I anticipate that the theories and approaches outlined above would facilitate the empowerment and liberation of the Jones family. In order to effectively meet the needs of the Jones family, it will be essential to conduct the review and evaluation stage of the ASPIRE model in order to provide closure, implement any additional interventions, and develop my own skills and abilities through reflection and critical analysis.

Nursing Care Plan of a Patient with Embolic CVA Essay

Summary of Admission History and Progress Notes: 67-year-old male has a history of non-ischemic cardiomyopathy with ejection factor of 24%, chronic left ventricle thrombus on anticoagulant, hypertension, metastasis of prostate cancer, chronic kidney disease stage 3. Patient was admitted to UCSD emergency department on 08/20 after falling down stairs. Patient presented confused but conscious. Upon presentation in the ED he had left face, left arm, and left leg weakness. After MRI and cerebral angiogram, findings were conclusive to a right-sided embolic CVA. Echocardiogram revealed apical ventricular thrombus. Patient presented to ED on Coumadin therapy with INR at 3.1. Patient was not a candidate for thrombolytic therapy. He continued on Coumadin and aspirin 81 milligrams was added. Left-sided weakness resolved within one to two days. Cardiologist at UCSD recommends Cardiac Thrombectomy to prevent further strokes. Neurologist recommends endovascular intervention to prevent future embolic strokes though not during an acute episode. Patient was held at UCSD ED for permissive hypertension during acute stroke. Patient complained of cough with green phlegm over the past few days; chest x-ray findings of no local infiltrate. Pathophysiology: Embolic cerebral vascular accident (CVA); stroke   Etiology/Risk factors: Risk factors include a history of transient ischemic attack, hypertension, elevated serum cholesterol, diabetes mellitus, smoking, cardiac valve diseases, anticoagulant therapy, oral contraceptive use, methamphetamine use, aneurysm, or previous stroke (Swearinger, 2012). Pathophysiology: A stroke is caused by disruption of oxygen supply to the brain by either thrombotic occlusion, embolic occlusion or cerebral hemorrhage. Most thrombotic strokes are the result of atherosclerosis. Plaque formation builds to the point of blockage in the large blood vessels that deliver blood to the brain. Most embolic strokes are caused by a cardiac emboli resulting from cardiac valve disease or atrial fibrillation. The carotid artery feeds the main blood vessels of the brain, therefore cardiogenic emboli have a direct path to the brain (Swearinger, 2012). S&S: Signs and symptoms vary depending on severity and side of brain affected. Symptoms may improve within 2 to 3 days as cerebral edema decreases. Patient may appear apathetic, irritable, disoriented, drowsy or comatose; incontinence may occur; unilateral weakness or paralysis may occur; headache, neck stiffness or rigidity may be present. The patient may have difficulty chewing or swallowing and may present with unequal or fixated pupils (Swearinger, 2012). Diagnostics: Time is critical in diagnosing the type of stroke a patient has experienced. A patient is no longer eligible for rTPA if the critical window of 3 hours from last seen normal has expired. CBC, electrolytes, blood glucose and clotting factors should be drawn immediately in order to determine eligibility for rTPA. An MRI will reveal the site of infarction and other brain structure abnormalities related to cause and effect of the CVA. An MRI may take as long as an hour to complete. While a CT scan is generally a diagnostic tool of choice in many emergency situations due to the rapid process, ischemic areas will not show in the CT imaging until they start to necrose 24 – 48 hours after the CVA (Swearinger, 2012). Complications: Complications include recurrence of CVA, paralysis, aspiration, depression, falls, and coma. Chronic left ventricle thrombus on anticoagulant: Anticoagulant therapy is prescribed to prevent increased formation of existing thrombi. Outside of the hospital environment, the anticoagulant of choice is usually warfarin because it may be taken PO. When the therapeutic range of warfarin is achieved patient’s INR will be 2.5-3.5. Cardiogenic trombi are the result of the heart’s inability to effectively ejecting blood after managed daily living, therefore the blood becomes stagnant and begins to clot (Deglin , Sanoski , & Vallerand, 2013). Chronic kidney disease (CKD) stage 3 is marked by a GFR 30-59 mL per minute (Bladh, et. al., 2013). CKD is a progressive and irreversible disorder. Aggressive management of Hypertension and Diabetes Mellitus, both of which are common contributing risk factors, may slow progression. Eventually CKD can progress to end-stage renal failure (ESRD). Before development of ESRD, a person with CKD can still manage normal daily living through diet and medication (Swearinger, 2012). Diagnostic Tests, Results and Rationales: Diagnostic Tests Results Rationales MRI Several areas of restricted diffusion within right MCA region; consistent with acute embolic infarcts MRI images differentiate between acute and chronic lesions. Ischemic strokes can be identified early. Site of infection, hematoma, and cerebral edema can be viewed through MRI (Swearinger, 2012) Cerebral angiogram Right MCA stroke, right internal artery non-flow limiting dissection with associated pseudo-aneurysm; right superior trunk M3 occlusion Identify presence of hematoma in stasis of blood vessels after a rupture (Swearinger, 2012) Chest x-ray Negative for infiltrate A presence of infiltrate could indicate pneumonia or heart failure (Swearinger, 2012) Echocardiogram Severely depressed left ventricular ejection factor; apical ventricular thrombus Assess ventricular and valvular function of the heart, ejection fraction, and hemodynamic measurements (Swearinger, 2012) Cerebrovascular carotid duplex Low flow right ICA; bilateral proximal ICA right 9.5 mm, left 5.5 mm; no significant stenosis; vertebral arteries patent with antegrade flow Evaluation of carotid arteries to detect occlusions three-dimensional visualization providing information on circumference, length, and thickness of plaque volume (Swearinger, 2012)

Research Technique Essay

Suppose your sociology instructor has asked you to do a study of homelessness. Which research technique (survey, observation, experiment, existing sources) would you find the most useful? How would you use that technique to complete your assignment? If my sociology instructor has asked me to do a study of homelessness, I will choose the observation research technique because I think this method is the most useful to me. In definition, observation means collecting information through direct participation and/or by watching a group or community engaged, which means, this is a technique which researchers observe carefully the behaviors of people involved in their hypothesis. Although there are various types of observational research techniques (naturalistic observation, participant observation†¦), each of them has both strengths and weaknesses. Personally, I believe participant observation is the most suitable method for the study of homelessness. Firstly, this technique allows me to gain information in my own point of view as I’m the observer and participant as well. Secondly, by using this method, the subject behaviors (homeless people) remain natural, therefore, giving the results high validity and reliability. Thirdly, it’s flexible as I can myself test the hypotheses and be able to redefine possible personal conceptions. Fourthly, by directing involving the research, my results will contain highly-detailed, high-quality information about the homelessness’s behaviors. However, this technique also has some disadvantage. First, it’s likely for me to have a close relationship with others which may influence the results. Second, it’s quite difficult for me to be accepted in the group (maybe I’m too different from them). Third, this technique requires a great deal of skill and commitment from the researchers. I must have the ability to fit-in with the people being observed and the ability to communicate naturally to them without letting them know my purposes. Finally, I have to make sure that I have enough money, time, resources, skills and support to go through this research. More details about my study. After having finished 3 important steps (defining the problem, reviewing the literature, formulating the hypothesis), I’ll continue the fourth step: collecting and analyzing data by using the observation technique (participant observation). I’ll join the homeless communities, which usually gather to sleep in the parks, under the bridges or in the verandas of the private or public houses†¦It’d be easier for me to participate if I can show them for sure that I’m a real homeless person (little money, no mobile phone, have acceptable reason to become homeless, dirty clothes†¦). The length of my stays are going to be about 6 months to 1 year as this time is long enough for me to have a generally view about this problem (however, it mainly depend on the time which the instructor allows me to so that I can limit/expand the areas researched). During the time I’m homeless, I’ll try to gain the acceptance in the group studied in order to collect the information needed without raising close relations or letting them know who I am, which will affect the conclusion of my study. Then, I’ll listen to their stories about the reason why they become homeless (of course I must have a reason for myself), observe their feeling, their behaving in life as well as their attitudes about their present conditions. Besides, I also have to try fulfill my study by finding the answers for these following questions: 1. How did they become homeless? (different people will have different answers) 2. Do they feel like the government is helping them to reduce homelessness? 3. How has being homeless affected them? (difficulties in all aspects) 4. What are the main causes of people becoming homeless? 5. What should the government do to help the homeless people? 6. The link between being homeless and having social diseases (HIV, syphilis†¦) 7. Where do the homelessness rates have the highest/lowest percentage? What are the differences in these areas? These 5 questions are the basic information that I have to find the answers by asking directly through normal conversations, by observing, by listening†¦ Besides, I think I can conclude some other useful results so as to have a general overview to support for my study thank to the time I’m being homeless. My conclusion will include these data: 1. Trends in homelessness recently. 2. Characteristics of persons experiencing homelessness 3. Causes of homelessness 4. Effect of homelessness. 5. Homeless policy initiatives 6. How different places have different rate of homelessness. Reasons? Solutions (If I can) 7. Outlook for the future (solutions) Finally, I’ll finish the final step: developing the conclusion base on the data I have to support or redefine the hypothesis.

Depression Among the Elderly - 1991 Words

Depression Among the Elderly Though depression and anxiety are common throughout the life cycle; depression and older age have commonly been associated with one another (Mulsant, 1998). Unfortunately, many elderly people are not satisfied and look at this stage as depressing. After years of planning, dreaming, and expecting the golden years to be the highlight of one s life, the increased number of stressors related to aging causes feelings of depression. Depression can happen at any age from birth to death. Depression is a heterogeneous disorder that can begin early in life and have recurrent episodes later in life, or the first onset may occur late in life (Doris, 1999, p.1369). It is already said that depression affects about†¦show more content†¦When thinking back about their lives, they should feel good, but thinking about the failure in their lives they have feelings of depression knowing it is too late to change anything. Old age deepens our understanding, not only of ourselves, but of aspects of life which may have been avoided (Matousek, 1999). In some ways loss is a normal part of aging, from personal losses and the loss of others, maybe friends, status, and/or possessions. The National Mental Health Association s report (2001) on coping with loss suggests that one of the big causes of late adulthood depression is related to the loss of a loved one or spouse. The loss of a loved one is life s most stressful event and can cause a major emotional crisis. After the death of a loved one, one will experience bereavement, which literally means to be deprived by death. When a death takes place, one may experience a wide range of emotions, even when the death is expected. Many people report feeling an initial stage of numbness after first learning of a death, but there is no real order to the grieving process. The recent loss of a spouse is a significant risk factor for depression in elderly patients, according to a study published in the October issue of the American Journal of Psychiatry. Some people can continue to have symptoms of depression up to two years after the loss of their spouse (Turvey, 1999). Loss through death is a common and extremelyShow MoreRelatedEvaluation Of An Article II Development And Validation Of A Geriatric Depression Screening Scale1633 Words   |  7 Pages Review of an Article II â€Å"Development and Validation of a Geriatric Depression Screening Scale: A Preliminary Report† PSYC 1300 Section # 17659 Rishma Bhat 18 June 2015 Introduction: Whereas symptoms of dementia in the elderly are due to cognitive impairment, ‘pseudodementia’ is a classification of depression that leads to psychomotor retardation and passive refusal to cognitive abilities, mistaken for simply dementia. 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