Modern social work is based on the values of multiculturalism and social justice, which is directly tied with the ideas of acknowledging one’s own privilege or lack thereof, when facing social barriers customers may experience (Adams et al., 2018). Social workers engage clients from a position of power inherent not only to their workplace, but also their racial and cultural identities (Plummer et al., 2014). Perceiving clients from the lens of a dominant culture may have a pathologizing effect on the relationship as well as on the measures taken to improve their lives (Plummer et al., 2014). The purpose of this paper is to discuss anti-oppressive strategies in social work practice.
The Potential Impact of White Privilege on Clients from Dominant and Minority Groups
The presence or absence of privilege colors the nature of the relationship between a social worker and a client. If a therapist is white, they inherently possess white privilege, no matter their economic or social background (Adams et al., 2018). It may create positive or negative interactive connotations with the client, depending on what race they are. If the client is also white, it may create feelings of buy-in and rapport, due to the fact that they perceive each other as equals (Adams et al., 2018). In a white-dominated cultural paradigm, Conversely, if the social worker is from a minority group, it may create a perception of incompetence and an erosion of trust. In turn, social workers themselves may perceive their clients differently based on the presence (or a lack of) white privilege (Plummer et al., 2014). A white therapist, applying his or her own cultural paradigm to a minority client, may ignore the existing issues of racism, which are not evident to them, or appear culturally insensitive. A black specialist, on the other hand, may perceive the client through the prism of their position of racial victimhood, resulting in an erosion of empathy towards the client, especially if they (willfully or otherwise), commit racially-sensitive microaggressions. White people perceive blacks, Latinos, Asian, native-Americans, and other cultures differently, resulting in a multitude of positive and negative stereotypes, which may affect the application of social work practice.
The Impact of Intersecting Identities on Individual Experience
An individual is not defined solely on their race alone, as there are multiple other variables that come into play, including gender, class, ability, and sexual orientation (Mattsson, 2014). Based on these intersecting identities, a client or a specialist may have more or less inherent privilege that shapes their experience, and in turn shapes the experiences of other parties. From a perspective of societal power balance, men have more power than women, straight individuals are in a dominant position to gay and other minorities, and the rich have more opportunities open to them than the poor (Mattsson, 2014). Nevertheless, privilege is not a uniform quantity that could be measured with units. Likewise, it is wrong to assume that, for example, a white woman of poor economic standing would have the same amount of privilege as a middle-class black man. They would have a different set of privileges, each corresponding to their belonging to a specific group. A social worker must be aware of these differences in regards to themselves as well as their clients, and not assume that their affiliation with a particularly socially-disadvantaged or oppressed subclass gives them insights on all of these intersecting identities (Mattsson, 2014). In other words, a therapist must know their limits of knowledge, and not assume that their experience necessarily equates that of their clients.
Utilizing Cultural Strengths When Working with Clients
Being part of the same cultural framework, whether growing up in the same country, having the same skin of color, gender, or having come from a similar socio-economic status would allow social workers to gain rapport and buy-in with their clients (Plummer et al., 2014). For example, a black client may feel more trusting towards a black social worker, while suspecting a white person to be a part of the oppressive societal mechanism that does not have their best interest in mind (Mattsson, 2014). Likewise, a woman would, in most cases, be more willing to open up about her problems to a female therapist than a male, due to the assumption that she may have experienced the same issues in her life (Mattsson, 2014). Likewise, some experiences may have a limited use in gaining rapport. While being discriminated against for being black does not equate being discriminated against due to gender, the common theme here is discrimination, meaning that both the client and the social worker would be able to empathize with one another to some degree.
Social Work Skills and Anti-Oppressive Work
The two most important skills needed to engage in anti-oppressive work are self-awareness and empathy. Self-awareness is necessary to recognize one’s own set of privileges given to us either through skin color, gender, sexuality, hierarchy, or economic position in the society (Adams et al., 2018). This skill is necessary to recognize which socio-cultural experiences a therapist has would be applicable to the client, and which ones would not. Empathy, on the other hand, is necessary to understand and recognize how one’s own cultural identity affects the patient. It is natural for a person of color to be wary of a white social worker, and it is not a fault of their own. A therapist must be empathetic and work to overcome such obstacles, while recognizing the client’s experiences, rather than adopting a color-blind approach or perceiving the aversion towards oneself as a personal, rather than a racial issue (Adams et al., 2018).
References
Adams, M., Blumenfeld, W. J., Castaneda, C., Catalano, D. C. J., DeJong, K., Hackman, H. W,… Zuniga, X. (Eds.). (2018). Readings for diversity and social justice (4th ed.). New York, NY: Routledge Press.
Mattsson, T. (2014). Intersectionality as a useful tool: Anti-oppressive social work and critical reflection. Affilia, 29(1), 8-17.
Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing.
The range of responsibilities of human services workers is vast: consulting, defending the rights and dignity of people, overcoming disagreements, and changing psychological attitudes. Generally speaking, each role helps solve all types of human problems, from psychological to material.
As for me, I developed a particular interest in the job of a school social worker, whose professional role seems to be the most relevant and significant. It is a specialist who works with children with mental challenges. This profession combines pedagogical activity with the provision of psychological assistance to children violating generally accepted norms of behavior. According to Sosa et al. (2017), this specialist’s main task is to identify and prevent psychological problems in children and possible negative consequences of a child’s psychological trauma. It is crucial to raise children correctly and help them overcome any psychological issues because the future depends on the younger generation. Thus, I think this role is absolutely suitable for me.
As a result of studying human services professional practitioner roles, I would completely change my professional identity. Before, I could not decide what career I would like to associate my life with. Now I clearly understand that providing psychological assistance to children is my role and my vocation. Due to the knowledge gained during the course, I understand that it is essential to recognize inclination to a particular profession and, accordingly, to master the set of abilities characteristic of this job. Only by forming a holistic professional identity, you can become a helpful employee. Additionally, I diligently work on my feelings of pity, because during the course I made the conclusion that I cannot help children to socialize by feeling compassion for them.
Reference
Sosa, L. V., Alvarez, M., & Cox, T. (2017) School social work: national perspectives on practice in schools. Oxford University Press.
Negotiation is an important skill to have in nearly every aspect of one’s life. Interacting with other people inevitably brings a conflict of interest, where people have to work together towards their own goals. Negotiation is a very broad domain that revolves around finding a compromise that satisfies all parties involved in the process. The application of negotiating skills is numerous, ranging from bargaining for a raise or a salary and ending up reconciling two friends having a heated argument. There are many personal qualities contributing to one’s effectiveness at bargainings, such as charisma, reputation, knowledge, empathy, and positioning. Thus, the ability to find common ground with other people is incredibly important in social work. The purpose of this paper is to describe my personal negotiating experience.
Situation Description
During high school, I used to work part-time in a small restaurant at the edge of the city. Although I was almost of legal age, it was very hard for me to find a part-time job, because all of the low-skilled labor positions were occupied by students or graduates. This restaurant was one of the last places I applied to, as many other companies flat out denied me a chance upon seeing that I was only 17 years old. When I arrived at the interview, the owner of the restaurant was at the table, glancing through my resume. Looking at me, he asked a question many HR officers often ask during their interviews: “Why should I hire you?”
I answered the question by stating that I will be able to perform the same work as other candidates but charge less for it. The owner of the establishment seemed interested in my response, enough to continue the interview. Later, we negotiated the terms of my potential employment, with him trying to lower my payment bar as far as he possibly could, and me preventing him from reducing my salary to the point it would become economically unreasonable for me to work for him. As a result of the negotiations, we achieved an agreement that I would work for him for a rate 25% lower than that he pays his other employees, with guaranteed raise to a normal salary the moment I turn 18. Two days later, I received another call and was told I am hired and that my working week starts from Monday. I succeeded in scoring a job.
Negotiation Analysis and Explanation
Before the negotiation, I correctly identified the strengths and weaknesses of my position. I was an underage employee with no working experience, putting me at a disadvantage against virtually any other candidate. I did not have any particular skills to offer to my employer, in comparison to everyone else. The only bargaining point I had was my salary. I discovered the employer’s wants and needs in this negotiation, which revolved around hiring a reasonably capable and competent individual and training them to work in the restaurant. Since the training was going to be provided on-site, the only difference between me and any other candidate, besides personal qualities, was age, which brought upon unnecessary legal aspects of employment. I won the employer over by offering to work for less money in order to compensate for the disadvantage.
At the same time, I managed to negotiate a safeguard against being exploited by the employer, by stating that once I turn 18, he would need to pay me in full. This part of the negotiation made the employer recognize that after I reach legal age, the disadvantage I held would disappear. In addition, by that time, I would acquire some working experience, thus enabling me to find better work, if need be. So, the power balance shifted from the employer to me, as it was in his interest to pay me fairly in order to keep me from leaving and having to endure the recruitment and training process with another candidate all over again. Identifying the strengths and weaknesses of everyone’s positions as well as the overarching goals behind the negotiation managed to secure me a paying job for a year successfully.
Conclusions
Although personal affability and charisma are important in negotiating a working contract, an understanding of various factors and parameters behind the process make up the core of any successful endeavor. If I were unaware of my own disadvantages, I would have failed to get a part-time job. At the same time, had I been unaware of my employer’s underlying motivations, I would have negotiated a poor deal.
The object relations theory has two definitions used in different senses. In the first definition, it’s in a synonymous relationship with the relationships between and among persons. For instance, in the early stages of human development, the developmental stages of intimate relationships with others have a link with the development of instincts in the individual. For example, in the early oral stage of infants, the associated object relations is known as autoerotic meaning a stage with no object. While in the latter stage of the oral phase, the object relations associated was known as narcissistic meaning incorporation of an object (Goldstein 1995).
Propelled by internal instincts, the object incorporation was viewed as important but not fully understood by the researchers. The other defined usage of the object relations theory is used in the sense of intrapersonal structures and external relations with others which is a concept of the ego organization. In this context, the theory a baby is born with the desire for object relation. It’s of great usefulness to understand that after the baby is born the object relations is between the baby and the mother (Ogden 1990). This results in a social attachment between the mother and the baby.
From the fourth or sixth month to the thirteenth or thirty-sixth months, the child starts to have a separation where he/she is separated from the fused state to a stage of development with unique characteristics for the interaction with the real environment. The separation process is known as the individuation stage. The stage is further subdivided into autistic and symbiotic sub-phases. At the autistic stage, the inborn is too sensitive to environmental stimuli and he/she sleeps all the time and wakes up only when need states of the body arouse him/her. At this stage, the infant exists in her own world but slowly gets responsive to environmental stimuli (Goldstein 1995). In the symbiotic stage, the child starts to have a wider perspective or view than before. At this stage, the mother acts as a mediator between the environment and the child.
In any social setting, the presence of an acceptable environment is only determined by the relations among the society members. A society with poor social relations is more likely to experience more disagreements which compel the leaders to divert part of their efforts in conflict resolution instead of initiating development activities. This re-experiencing of some necessary vital object-relational issues as intimacy in feelings, control, loss, transparency, dependency and autonomy, and trust forms the primary curative influence on any relation problem. Whereas some ideas may be interpreted and then some confrontations arise, the resolution of personal and components of relationships in the world of objects for any needy individual requires the first action be aimed at primary therapy.
Segal (1990) claims that it is necessary because the initial source or roots of the problem need to be addressed first. Object relations theory has its ideas useful in personality pathologies and poor mental capabilities. Many researchers have continued to increase and elaborate the theory and applications to other fields. J. Masterson developed what is known as the Mastersonian application which is helpful in working with problems of the personality structure. Many of his findings have had variations of personality structure vary from the mainstream. While the more technical aspects of personality development and psychotherapy differ significantly, many end up sharing the core tenets of the provision of a safer, caring environment in the relationship between human beings.
Ogden (1990) further explains that in contrast to looking at object relations as a single ego function, object relations provide a base for attachment and development of all ego functions. The capability to test reality depends not only on the maturation of the innate cognitive apparatus but also on the experience of developing ego boundaries in the close relationship between the self and the primary caretaker. It is also necessary to be mentioned that social attachment is only best explained by the object relation theory. The infant at his or an early age maintains his or her closeness with her mother or the primary caretaker. He or she manifests her closeness through sucking, rooting, grasping, smiling and gazing. This is usually referred to as the first stage which stages from birth till the first three months. At the second stage, the child responds to the presence of the mother or the primary caretaker by smiling and their absence sends the child upset.
Explain
Reasons for choosing this model
The object relations theory is important to society since it seeks to identify the basis of human interaction in society by evaluating in an attempt to understand, the various factors motivating individual actions and attitudes that either result in cohesion or conflict among members in a particular society. I also received inspiration from the extensive amount of literature that is available in this field. Daniel (2001) explains that the study of psychoanalytic theories in which the object relation is apart is important for seeking to find methods of causing redress to various social problems brought about by a breakdown in understanding between various parties. Furthermore, the information provided by the theory about the importance of early family relationships to individual behaviour fascinated me since it assists me to understand why many of my peers behave so and may act as a guiding point to helping those individuals suffering from personal problems to seek care.
Use of theory in the treatment
The theory might be used by psycho analytics in the treatment of a diverse number of conflicts whether those problems exist in an individual, between different individuals or among different members of certain groups (Klee 2000). Though there are several theories that can be used in the treatment or resolution of conflict, the object relations model is quite effective. This is because the model goes to the formative stages and tries to establish the underlying factors that have led to those conflicts. The experts in this field have experienced success by assuming that problems in early childhood form an important part in the development of personal self-esteem and how such a person relates with others in society.
By understanding the various factors that cause you to enter or act in a certain way it is possible therefore to correct conflicts by trying to discover what the truth is and where fantasy or unconscious self causes you to view things in a manner that is inconsistent with the truth. This allows a person through the help of a professional to come to terms with the truth and decide whether to embrace or escape it and this acceptance of the actual truth is what constitutes healing. Klee (2000) further asserts that a therapist’s main role is to provide the patient with a comfortable environment in which he can allow himself to view his dysfunctional nature so as to confront it. Though this is not easy it is important and great patience and skill are needed on the part of the therapist since the client developed this nature in an attempt to survive comfortably in the social set-up.
Benefits of the model in certain settings and with certain populations
The model is beneficial since it allows therapists to try and reform delinquent or criminal behaviour as a way of making society a better place. There are several adolescents who are rebellious and may sometimes engage in destructive behaviours in an attempt either to blend in or raise their self-esteem. This model allows for these teenagers to be made to realize that their wayward behaviour is caused by problems rooted in their childhood and enables them to reform and lead better and productive lives. The same can be applied to criminals whose destructive actions may be traced to problems in their early stages of development.
Another model compatible with object relations
The newly formulated theory of the mind can be used hand in hand to combat the various interaction disorders that occur among individuals in society. Leslie (1991) explains that it is one’s ability to relate to beliefs, desires and knowledge within oneself or in interacting with each other. It tries to make people understand that the status of the mind is usually the cause of the various ways that people relate. It is how we develop an understanding of the world and this differs from person to person and this difference might be a cause for human friction. Therefore this theory would be compatible with the object relations since both appreciate that human action is based on how an individual views different circumstances. This view is therefore the most important factor in determining human personality.
Limitations of this model
The model requires a patient to confront the problems that exist within him since infancy when he learnt to manipulate through acting or distorting things in a particular way. For a person to acknowledge that he is acting in such a way as to be basing his actions on fantasies and low self-esteem is at the least hard to achieve. It is time-consuming and requires the dedication of a person to accept he is wrong in perceiving things in a certain manner. It is therefore important to incorporate other models like the ego model so as to extensively exhaust the problem. Lastly, the complex nature of what is expected of a client requires one to be aware of what he really is and look deep within himself to evaluate where his disorders arose from. Therefore children who have not reached such a level of personal analysis can’t participate effectively in such a process that requires internal reflection.
References
Leslie, A. M. (1991). Natural theories of mind: Evolution, development, and simulation of everyday mind reading. Cambridge, MA: Basil Blackwell.
Just like any other field in social sciences, Social Work has been marked by the influence of various personalities. People like Achmat Zackie, Alexander the Great, Altman Dennis, Anne (Queen of England), Anthony Susan B. Apuzzo, Virginia, Arden Elizabeth, Atherton John, and Baden Powel have left great impacts in the field of social work. However, this paper focuses on the life of Jane Addams, the daughter of John Adams, a former politician of the United States.
Biography of Jane Addams
Jane Adams was born in Cedarville in the State of Illinois into a successful and large family in the north. By the time she was eight years, four of her siblings had died. She was not brought up by her mother because she passed away when Jane was two years old.
Like most children, she had most of her childhood spent reading indoors, playing outdoors, and attending church service and Sunday school. At age four, she was attacked by Potts’s disease (tuberculosis of the spine). This made her back curve and she also had other health complications. The curvature made her have lower self-esteem because she thought of herself as being ugly.
As a child, she loved her father greatly. This is portrayed in the stories she wrote in her (1910) memoir; Twenty years at hull house. It was her father’s wish that she pursues higher education near home. He, therefore, enrolled her at Rockford Female Seminary currently called Rockford College in Illinois. In 1881 she completed her studies at the college earning herself a college certificate. Her father died the same year and her family members moved to Philadelphia where she joined Woman’s College to satisfy her medical career dreams. However, this dream was not fulfilled because she dropped out along the way due to health problems originating from the curvature in her back.
She passed away on 12th May 1935.
Social Welfare Policy That the Jane Adams Influenced
Brown (2003) says that at a very early age, Jane Adams had wanted to do great things in the world. Her dreams were big right away from her teenage years. She had a great interest in the poor and this was motivated by her mother’s generosity in Cedarville. Thinking of democracy as a social principle inspired her greatly. However, being a woman, she was not sure of her role in enhancing the same. Nevertheless, she felt that it was not right for women to be put under pressure to marry and focus their attention on their children and husband. Looking at her surroundings, she realized that as a result of social problems like immigration, urbanization, and industrialization, there was a need to come up with a solution for settlement. Jane Addams initiated the formation of the Hull-House Reform Movement to look into residential problems around Hull-House. The group created settlement houses for densely populated urban centers for immigrants from Russia, Greece, Italy, Germany, Mexico, etc. The group also provided daycare facilities and kindergartens for mothers who were working. The complex extended to also provide employment bureaus, libraries, art galleries, classes for English and citizenry, museums, art and music classes among another extended array of events of culture.
The settlement house strategy as a solution to the housing problem was adopted throughout America and Europe. It was seen as an internal solution to settlement problems for urban residents because it allowed the government to serve the public through the people who lived within the community.
Furthermore, the people got skills through the strategy, which empowered them to help themselves, and this increased sustainability of the program.
Murrin, Johnson, and McPherson (2008) say that the group further initiated projects like the Juvenile Protective Association, Immigrants’ Protective League, Juvenile Court, and Juvenile Psychopathic Clinic. The group also put pressure on legislators to create laws that protected children and women and this took place in 1893. Through the group’s efforts, the Federal Children Bureau and the Passing of the Federal Child Labor Laws had taken place by 1916.
Jane Addams also wrote a lot of books and articles on the activities connected to Hull-House. She also spoke actively, locally, and internationally on various topics related to social welfare.
In the years around the beginning of the First World War, she greatly campaigned against the war and lobbied other women to support her cause. Her peace movements across nations were channeled towards attempting to prevent the war. Jane Addams’s peace campaigns were carried out through the Women’s Peace Party which converted to Women International League for Peace and Freedom (WILPF) formed in 1919 with her as the first president.
Her influence in society was marked by legislation on child and women protection which she campaigned for in writing and speech, the settlement solution to poor urban dwellers as well as her peace movements, she was the first American woman to be awarded a Nobel Peace Price in 1931.
Conclusion
Jane Addams is celebrated for living a life directed towards society development, children and women protection, and empowerment of the poor. Her ideas continue to dominate economic, social, and political reforms not only in America but also across the world over.
References
Brown, V.B. (2003). The Education of Jane Addams. Pennsylvania: Pennsylvania Printing Press.
Clinical social work is tailored to provide healthcare support to people with psychological, psychosocial or bio-psychosocial disorders. A case of psychosocial symptoms of ill children may include sorrow over the illness, fearing to die and fear of being alienated. Also, the effort invested in unraveling the physical status and results of illness. At higher levels of the professional work has resulted to expertise referred to as the advanced clinical social workers. The scope of work coupled with code of ethics demands high levels of confidentiality and privacy as the right of the clients have to be protected and respected. Prior understanding of the skills and role in the social work fraternity is fundamental; mainstream physicians may not immediately appreciate their psychosocial importance for patients at the hospital. This can further extend to the family members of the patient. This means their services may stay withdrawn even in cases where they are much needed unknowingly. The scope of professional practice for advanced social workers entails: providing interventions based on founded diagnosis. Due to diversity of knowledge base there is a call for specialization in a certain field. Cases handled may be intrapersonal or of family dynamics; abnormal growth and behavioral disorders; trauma, illness as well as cultural impacts. This requires high level of adept in case assessment and management, treatment planning, analysis and evaluation of results, diagnosis precision and in depth knowledge and skill in social work. Summers and Barber (2003) and Betan et al., (2005) have from there different perspectives shown that therapeutic relationship between patients and therapists would prevail primarily because of training and years of professional practice. Whether or not a patient struggles with variations of culture, class, ethnicity, race, age, sexual orientation, spirituality or gender would depend on capacity and adept of the therapist.
The concept of empathy entails a social element that allows one to attach or generate closeness with another person’s circumstances in terms of physical, social or psychological experiences. This creates a nexus between the two. According to Summers and Barber (2003), the concept of empathy is a primary ingredient in therapeutic treatment. Parties involve a professional clinical cum social worker while the other is seeking treatment services. The professional party seeks to provide attention to provide professional solutions to enhance wellbeing of the other (Summers & Barber, 2003). The connection explores thoughts, feelings, attitude or situation. The clinical social workers should act in a expressing how they perceive, experience, understand and recognize the mental concerns of the other. Professionally, this should be expressed in a manner to relay emotional attachment as if have undergone similar experience before. In this case the feelings are communicated in a constructive and realistic way (Summers & Barber, 2003). The ultimate of the concept is to show the party that the professional is fully aware of the state they are in a compassionate way. Clinical social worker in expressing will become sensitive to the pressing concerns of the clients and apply their solutions in a way showing understanding to their state. In expressing their state the client may outburst and vent on a person working to help them, hence adequate preparedness is required in order to avoid mishandling them. To listen, provide and vicariously recognize the felt needs are prioritized in clinical social work. Closely linked to the concept of empathy is sympathy. Though, sympathy relates to a feeling of sorrow on what the client feels. It mainly experience among relatives than at professional when contrasted with empathy. Nevertheless, the client vent out thus the recipient should properly conduct that show restrain and understanding.
Therapist-patient alliance exists when a collaborative bond in which communication between the parties enhances this. Ultimate achievement is a positive working relationship conducive for both. The level at which both parties communicate at each can provide a gauge for the health of the alliance. The communication is nurtured by a prevailing positive feeling towards each other. A common purpose is identified by parties so as to focus the relationship. Both should also identify and recognize the objective role that should be played by each. Finally, a bond cements the relationship. The bond should preferably be empathetic. Depending on circumstances, the concept of alliance should requisite to treatment. On the side of a clinical social worker, the concept of alliance can be achieved overtime through exposure in practice or through professional clinical training. In some this is inherent. Through clinical training, the necessary skills are identified and acquired. This is achieved by gaining confidence and skill through exposure to higher challenges and induction on specific professional requirements. In advancing the concept of alliance, therapist should have prior consent that clients may have initial negative feelings against therapy. Therapists should take the initiative to ameliorate them by applying interpersonal skills. Interpersonal relationship will prevail as the patient pre-treatment expectations communicated in a manner that improvement foreseeable. As the alliance warms up the level vent out and hostility begins to fall down. Clinical training that exposes the therapists to further skills on nonverbal communication of the client comparatively has greater advantage in achieving empathy and alliance as this impacts on identified behavioral traits. More disturbed patients are better handled with enhanced behavioural techniques; this needs continuous improvement for both training and practicing therapists to better their skills (Summers & Barber, 2003). Data has been used in alliance building between the therapist and patient. Patient data may be applied to train therapists to identify possible difficulties and correlating through pairing both patient and therapist data. According to Summers and Barbers, (2003) achieving adept in the concept of therapeutic alliance is progressive throughout training and professional practice. There is increased skill among professionals in implementing therapeutic alliance, perfected talking skills and management of circumstances with years of practice. Building skill in alliance during patient and therapist relationship is greatly influenced degree of exposure to these kind scenarios. However age may be limiting though fine tuning skills afterwards through accumulated practice hours and handling of more complex conceptual cases. Clinicians become more focused with duration of professional practice. Depending on the interpersonal capacities to grasp some aspects of the concept of alliance are efficiently acquired compared to others. According to Summers and Barbers, (2003) formulating goals and scheming tasks may be acquired efficiently than bond development. A comparison of bond scores showed that those with greater experience were relatively higher (Summers & Barber, 2003).
According to Summers and Barber (2003), there are three measures that can be applied in the concept of therapeutic alliance. The first is the Helping Alliance scale that consists of a 19-item scale. This involves a questionnaire posed to a patient responding on the amount of benefit have had from an administered therapy. In the recent times the questionnaire has been revised. The revision has focused in ensuring that the measuring of alliance is improved towards independent responses on gains made (Summers & Barber, 2003). The second type of measure is the working Alliance Inventory is based on sub-elements: congruency on tasks to be implemented, harmony in setting goals as well as how well the patient and the therapist relate with each other (Summers & Barber, 2003). This type of measures is developed based on two versions: the self report as well as the observer rater (Summers & Barber, 2003). The observer rater version has been identified as reliable in interrelating. The working Alliance inventory consists of 36 items (Summers & Barber, 2003). The final is the California Psychotherapy Alliance Scales (CLAPAS) (Summers and Barber, 2003). The CALPAS questionnaire is multidimensional. The questionnaire consists of 24 items (Summers & Barber, 2003). It is a self report approach. The reliability of self report from patients is higher than that of therapists. There are four level at which CALPAS measures therapeutic alliance between the patient and the therapist: the status of the patient in building a subjective relationship during the therapy, bases on which the bonding functions affectively; the way in which therapist construe and apply the concept of empathy with the patient and the consent on how goals have been set as well as treatment has been scheduled (Summers & Barber, 2003). Ratings per item are at 6 point likert scale (Summers & Barber, 2003). In most cases high intercorrelations while using CALPAS measures have been obtained (Summers & Barber, 2003).
The state of resistance occurs when a therapeutic attendant administers hypnotic sessions with no significant progress expressed by patient. The concept of resistance is articulated in the Freud’s Theory of resistance. This concept is manifested by patients’ obstinacy with regard to conversing, recalling or thinking about a past experience that may worry them much or create fear. In such a case a deliberate effort in the behavioral is observed in tending to avoid the disturbing ideas (Betan et al., 2005). Depending on circumstance resistance can prevent the context of information from reaching awareness, while in others may withhold material and deliberately avoid with awareness. According to Betan, et al., (2005) therapists’ role should be partly to create a working relationship that is responsive to fears and expectations. In practice, psychoanalysis therapy is primarily regarded as the re-education in order to resist intrapersonal resistances. This is reflected in a responsive manner by the patient in their feelings and behaviors towards the therapists. The therapy is administered in a manner responsive to patient’s attitude, thoughts, feelings and behavior. The patient experiences a self-fulfilling. The concept of resistance can be modeled in two ways, were in the first instance of patient condition fails to improve because of benefits that are attached to their status, for example, the socio-economic or physical status of the patient. In the second model case considers the main causal symptoms manifested partially as tradeoff for other psychological concerns. In either of the models as much as there are many contributing factors some underlying factors still influence and remain an understood or unearthed. These are associated with some motives. Rooting for an intellectual insight in overcoming resistance could be through revisiting the disturbing situations, staging similar circumstances as experienced before or working through to provide direct that therapy to the patient. This involves subsequent psychoanalysis procedures. During the therapy, the patient is gradually transformed procedurally through treatment. In working through their status the patient is aided to really understand their prevailing conditions as part of main therapy. It is recommended the therapist remains impartial throughout the process (Betan et al., 2005). This provides the opportunity for comprehending the full dimensions of the concept of resistance. Transference may persist with resistance. According to Summers and Barber (2003), research on the concept of alliance has shown that patients have responded with high scores. This means that in cases of low scores, such cases should be attended to.
Repairing alliances concept involves undertaking actions that restore an environment between patient and therapist that allows for a collaborative and a functional relationship. Well founded therapeutic relationship is sustainable when there is ability often repair alliances (Summers and Barber, 2003). In repairing the alliance the therapist follows a sequence of procedures. The therapists present a window for the patient to express any thoughts, attitude, feelings and emotions of reaction towards therapy or therapist. Then the therapist empathizes with the patient’s condition while expressing understanding, showing dignity and subjectively affirming the patient’s concerns as experienced. Lastly is the redressing the negative concerns of the patient. There is need to acknowledge the personal contribution that led to the strain as restoration protocol of a working relationship is underway. An additive procedure can be implemented so that it provides a window for evaluating whether a treatment package is impacting positively in the repair interventions. The procedure applies a cause and effect dimension. This is evidence based as a measure of the impact made. Alliances should not only foster cordiality but also indicate in the earliest opportunity any outcome that lead up to a strain. Hence, in averting the strain the therapist should apply robust flexible technique. Therapist could deploy active social elements such as keen listener during oral communication, exhibiting empathy as well as posing questions gently in mending and maintaining a streamlined relationship. This is feasible considering an alliance can be a predictor of the ultimate success and how interventions have been applied and their consequent results. As therapy tends to full repair, therapist should maintain their awareness on those negative feelings that could lead to a past experience. In any event, the therapist should respond openly and non-defensively manner.
Initial interpretation of the countertrasference concept had the notion that therapy is susceptible on the unconscious feelings of the therapists’ psychoanalysis (Betan et al., 2005). According to Betan et al., (2005) Freud was the first to conceptualize countertransference. This is in recognition of the possible reaction that could be exhibited by the patient towards the therapist. Overtime the scope extended comprehensively into emotional and behavioral aspects. Thus, this needed a facilitation mechanism rather than abandoning this therapeutic branch (Betan et al., 2005). In this design, an active and interactive association was fronted to allow for insight into the patient’s emotions and behavior associated to their experience. In this case, the therapists are drawn into the patients to empathize with their feelings (Betan et al., 2005). In this case the concept of countertransference is a composite of psychoanalysis and practice thereof. By definition the concept of contertransference takes into account the recognizing and understanding of the feelings and emotions of the patient; their affective responses towards the therapists and their behavioral conduct Transference involves finding fulfillment and satisfaction with emotional feelings of another person (Betan et al., 2005). Transference manifested in a prototype character (Betan et al., 2005). Research into management of countertransference has related certain situations. For instance, people undergoing depressing are vulnerable to experiencing more often reactions, to a proportion more or less matching their self-criticism. Also people that are sensitive to being rejected tend to experience higher frequency of rejection in their relationships (Betan et al., 2005). This is because internal feelings manifest as they strive to make this work in their relationships. Rejection is associated with a possessive and alienation behavior. Functional interpretation of concept of countertransference response considers deviation caused by reactions by patients confirming unresolved conflict through behavior and emotions. Some of the behaviors that could be manifested include unusual quietness, disregarding a subject, switching elusively matter under discussion and expressing dissatisfaction. Betan et al., (2005) study on patients’ personality and the contratransference phenomena variables on age, gender, race, class, literacy level and span of therapy were focused on. There was no significant difference along the variables with patients. The study engaged data from clinicians, psychologists and psychiatrists. The data in the three sample exhibited similar trends. Betan et al., (2005) considers traumatic experiences with survivors of childhood sexual molestation as sensitive. There is the eminent challenge posed by the clinician as they seem to be too inquisitive or detailed accounts of the experience from a patient. Alternatively, the clinician should enquire from the patient a sum up of the events that relate actually being molested. The degree to which to trace boundary between either is subjective as the element of intimacy on divulging very personal details may instill fear related to the traumatic event. Consequently, the clinician is bound on whether to apply the divulged information or maintain the information as a secret. Holding back the details by the therapists could translate to unwillingness by them not to talk about the substance of the trauma experience of the patient. There is an inherent conflict lessons in distinguishing what are the sensitive issues during the clinical exercise as well as what has functional objective for use during therapy.
Betan et al., (2005) employed three measures for the concept of countertransference. The first one is the clinical data form. This measure an array of aspects related to population dynamics, illness diagnosis as well as etiology (Betan et al., 2003). The first step involves the therapist presents personal details to the patient on general professional background, theoretical understanding, location and mode of professional practice and gender. Similarly the data regarding the patient is relayed to the therapist. This contains age, gender, ethnicity, education level and so on. The clinician then provide the patient’s ratings on adaptive functioning, developmental and family background of the patient. The second measure type is the Axis II diagnosis (Betan et al., 2003). This is used to measure axis II disorders. The clinician is tasked to opt, either a criterion of DSM-IV axis II diagnoses is present or absent (Betan et al., 2003). The criteria are randomly ranked. The third measure is the Countertransference Questionnaire (Betan et al., 2005). This has a questionnaire with 79 items. According to Betan et al., (2005) the therapist provides ethically recommended, psychometrically sound tools for measuring Countertransference tendencies. The items rate mental and behavioral tendencies of the therapists onto to the patient (Betan et al., 2005). Limitations with these three measures include: self-report measures used in the assessing concept of countertransference. This is disadvantaged in the fact that the observer is not independent of the process of assessing. The independent observer may divulge further details on particular patterns of the therapist (Betan et al., 2005). The assumption is that the therapist was reliable and provided all relevant data towards the study. According to Betan et al., (2005), the training background of the therapist forms a primary part of the causes of self biases. There are therapists trained as MD while others have PhD training (Betan et al., 2005). Both are deemed to produce data that are different from each other. The second limitation is the therapist feedback rates. This is linked willingness of the therapist to spare more time to participate in the study. This means limited spared to reflect on the responses provided (Betan et al., 2005).
In advanced clinical social work, the use of concepts in gauging the level of adept in the skill applied may be presented by some challenges (Betan et al., 2005). These include: establishing the criteria for setting limits especially the lowest one; the range of variation that can be allowed and the impacts on residents and patients during the data collection (Betan et al., 2005).
To me, ‘Leadership for healthcare system’ was an opportunity to accumulate significant experience. The practical work, design and overall content helped me to understand the concept more thoroughly. Throughout the work, I have learnt about the practical application of the module. This learning experience helped me to enhance the boundaries of my knowledge, and subsequently realize that leadership in a contemporary healthcare organization is a tremendous responsibility and a key component in any establishment’s performance. Upon completion of this module, I understood my strengths and areas needing improvement as a learner, leader and nursing professional. I also came to acknowledge that, having devoted some time to honing my skills and mastering my imperfections, I am fit to bear this responsibility.
The level of learning I received from this work motivates me to gather more knowledge, continue to work on this topic and become a better person and professional. From the beginning of the task, I was dedicated to learning more about this subject. I gave my best effort to this module and worked hard to meet the expectations of my professors. I not only focused on the learning concepts but also made sure to participate eagerly in different class activities, as well as group projects conducted in the Institute. I emphasised active participation, as I learned that these activities would be helpful in developing my leadership skills in the healthcare system. As per my consent, the course was designed to meet the student’s needs, as well as enhancing their utility. I have pondered my learning, and how this section has contributed towards improvement of my leadership qualities, by reflecting upon a variety of theories. In this commentary, I will also mention the aspects of my personality I must improve, so that I can solidify my reputation in the job market. Furthermore, I will specify what did not go well for me in this module, and what I will try to accomplish in the future.
The module helped me to develop awareness about my personality and encouraged me to develop my proficiency in the field of health care. I must admit that the class activities proved beneficial in gathering pre-experience as a healthcare professional. With the course completed, I believe that the knowledge I managed to accumulate helped me to develop the basis for my career, which I wish to pursue in my homeland. When professional training is coupled with clinical experience, it helps to establish a systematic approach that covers a wide array of situations one can face in the healthcare environment (Berwick & Hackbarth 2012; (Swayne, Duncan & Ginter 2012). Just as some central and peripheral traits of character are attributable to people, value chains are applicable to clinical practice as logical components of leadership (Porter 2010). The primary activities of leadership include arranging resources and managing them, while the peripherals are concerned with outsourcing of services and equipment. These leadership tasks remain fixed over time, just as the leadership traits that are helpful in influencing people. From the course, I realized that the overarching task of leadership – any leadership – is to have a job well done. Previously, I had thought that for this purpose, a leader has to possess some set of attributes or talents that are not given to everybody. The course helped me realize that every person can be a leader. Everyone possesses unique attributes that can put them in a position of leadership; these need only to be discovered, assessed and developed. This course demonstrated just how one can discover the traits that can make them a leader, namely through a range of tests and other practices, which I will further describe.
The 16Personalities Test is an assessment method used to evaluate each individual’s leadership traits (Edmonstone 2011). The underlying message of this test is that every person has an inborn capability to lead (Porter-O’Grady & Malloch 2011). Through this test, I found myself to possess the INFP personality or the mediator. Such people are optimistic and, despite their shyness, able to flourish in a harmonious, understanding environment. My strengths, as per this test, include my ability to establish diplomatic contacts, and basing my actions on my principles. My weak side is that people often do not understand me – but then again, when in positive surroundings, I can open up and shine. This experience, particularly, helped me understand some of my leadership traits and acknowledge that I, too, am capable of leading people who might follow my ideational power.
The modes of learning impressed me because the tutors managed to create a perfect balance of valuable classroom experience, independent research on our own and practical work where the students had to engage with all sorts of people in fluid situations. For example, we were often required to engage in practical work where we had to deal with diverse people in changeable surroundings. A pairing of theory and practical experience remains unquestionably a foundational value of learning and must be encouraged – which the tutors did successfully (Shi & Singh, 2010). The combination of theory and practice showed me how I could start on a small scale with bigger projects in mind, be patient in open discussions and self-contained when I do independent research, work via different media and be an effective communicator.
Specifically, my communication skills were enhanced by the classroom activities. Group activities are also known to facilitate peer learning and assessment (Boud, Cohen & Sampson, 1999, pp. 413-426). It gave me an opportunity to discuss various academic issues and formed a relaxed environment, which made learning more interesting and easier to grasp. Group-based activities facilitated personal interactions, which I believe harnessed my critical thinking abilities. When we were asked to discuss various case studies or to present in a group, I often found myself leading the group. This increased my self-confidence as a leader. Also, as a result, I was able to discover different management styles practised by others, in addition to conflict management, decision-making and teamwork. Lichtenstein (2005, pp. 341-356) proposes that groups are like teaching communities that can positively affect academic and social outcomes as well as student achievements. They provide me with a venue that allows me to explore myself and my leadership skills. I always tried to observe my friends’ performances so that I could evaluate my own eligibility as well as educate myself. I looked forward to listening to the opinions of my friends and their debates on certain topics, which were helpful in opening windows to new ideas. Such classroom activities actually promoted the communicative approach among us and facilitated ‘joint management’ of learning.
The classroom activities also allowed us to achieve a fuller comprehension of the practical and theoretical aspects of this study (Porter 2010). These activities prepared a base that helped me to learn about myself. I found that the Johari window illuminated many things that had previously been beyond my knowledge. The Johari window is a technique used to assist people in better understanding their position in relation to others (Currie & Lockett 2011). This type of heuristic technique helped me to discover that I was perceived as a kind, giving, trustworthy, patient and sensible person. Some of these traits were unknown to me, but seen by others. As a leader, one has to pay attention to one’s strong points, and a heuristic technique can aid in a person’s self-acknowledgement. The window helped me gain a fair share of confidence by demonstrating to me some of my strengths as seen by the others. It has helped me to gain confidence and implement procedures to enhance my leadership skills. I discovered that this self-awareness tool is not only helpful in knowing myself in a better way, but also has helped to control the motion of my energies towards a positive direction.
Another aspect that was illuminated in this module was that of emotional experiences, of which I had never been fully aware. This module helped me to deal with and manage the clinical concept of ‘transference.’ Transference can be defined as the incidents that take place every day in social interaction. In healthcare, where the human factor is a point to consider, some professionals cannot refrain from treating their patients subjectively, based on some of their biases and emotions. Before the module, I had been aware that such a problem may arise, because at times it can be difficult to develop an entirely non-judgmental attitude. However, I had hardly thought transference might lead to adverse effects in patients (Slavkin 2010). This aspect of the course, therefore, helped me realize the importance of not redirecting my feelings onto the patients, based on my previous experiences, and of developing a holistic approach to every person I encounter.
‘Interaction’ was the platform that the module offered, and this was facilitated through group activities. Group activities are found to facilitate assessment as well as peer learning. They provided an opportunity to discuss different academic issues and also helped in the formation of a ‘relaxed environment’ that made the learning more interesting and easier to grasp. It was also observed that group-based activities enhanced ‘interpersonal interactions’ that tied together my ability and capacity to think critically (De Souza & Pidd 2011). In most of the cases, when I gave a group presentation or discussed different case studies, I found myself in the position of leader of the group. The fact that I was sometimes chosen as a leader can be explained by my leadership personality as specified in the 16Personalities Test: I am, by nature, a mediator and a conflict-solver, always searching for positive aspects in every situation. Additionally, my peers assessed me as a kind and trustworthy person. The interaction helped me discover that I possess certain traits that are valued by the people I work with – which increased my confidence as a leader. In addition, I explored different management styles that are practised by others, such as decision-making, conflict management and teamwork. Many researchers have shown that groups can be considered as ‘learning communities’ that can have a direct impact on the student’s achievement as well as social and academic outcomes (Best et al. 2012). The researchers also proposed that group-based activities can enhance internationally achieved and shared cognition (Kakuma et al. 2011).
The learning modes shown in the module also captivated me. The experience I gathered from this module was amazing. For instance, our teachers always encouraged us in our practical courses, where we were subjected to dealing with various people in different situations, and this practical, hands-on experience alternated with discussion and reflection. Real-life examples helped me clear away some of my preconceived ideas about the process of learning and practice, and shed my overly intuitive thinking. Armed with theory, I found I was capable of more than making uneducated guesses, and could quite satisfyingly work my way through problem after problem. By successfully combining a firm theoretical base and examples, the course showed how I could apply knowledge to practice and further evaluate it through reflection. Reflecting on the process of learning helps me acknowledge my accomplishments, make notes to self and enlist points for future improvement. I also find myself fully engaged in the learning process, which, I suppose, is the primary aim of the tutors. Finally, when I reflect on what I have accomplished, it helps me to see the meaning in what I do – which is priceless.
When I look back, I find myself satisfied – in fact, overwhelmed – with the module structure and the help from the organisation. In this module, the significance of leadership was highlighted. On a related note, I became eligible to assess myself in a different context. This module helped me to point out not only my strengths but also my weaknesses. I have discovered that my strengths lie in my altruism, creative energy, ability to communicate, patience when listening and discussing and devotion to independent research. These features can be observed not only by myself but by my peers as well. The windows and tests, as well as interaction, helped me rediscover my strong points anew and become inspired to further develop as a person and a professional.
On the weaker side, I might sometimes take my altruism too far. Based on my idealism, I can develop pre-conceptions that prevent me from adopting an entirely non-judgmental approach. The course helped me realize the importance of not transferring my feelings onto my clients and colleagues, which is why I am determined to find a way of distancing myself from my emotional experience when I work. Another feature with room to improve is that I tend to take things too personally, especially the tutors’ and peers’ critiques. The course has shown me that I am able to take criticism differently: instead of passively brooding upon my weakness, I can upcycle it into a point of inspiration to hone my leadership skills.
To overcome my weaknesses, I accepted help from my mentors and classmates. I also read many books to expand my knowledge boundaries and update myself on the theories, which I found confusing at the beginning. On the other hand, I also learned to control my expression of views and judgments. I came to know that being logically correct is also considered to be one of the best qualities of a leader, and is something I need to develop. I understand that having a realistic view can also make me reliable as a future leader.
Overall, I have to admit that I am pleased to state that the experience and learning I have gained from this module – and entire course-work – are of a ‘momentous nature’ for me, as essentially they helped me to advance my career. The knowledge I gathered from this module encouraged me further to gain the utmost knowledge in this subject and apply my knowledge in the field-work in the health-care system. The practical courses made me more realistic, and taught me to deal with a number of unwanted situations, about which I had been completely unaware. This step proved to be helpful in developing my leadership skills. Therefore, apart from increasing the boundaries of my knowledge, this module helped me to broaden my management approach, strategic qualities creativity and thinking skills in demanding situations, and motivated me to develop my career as a healthcare professional.
References
Berwick, DM & Hackbarth, AD 2012, ‘Eliminating waste in US health care’, Jama, vol. 307, no. 14, pp. 1513-1516.
Best, A, Greenhalgh, T, Lewis, S, Saul, JE, Carroll, S & Bitz, J 2012, ‘Large‐system transformation in health care: a realist review’, Milbank Quarterly, vol. 90, no.3, pp. 421-456.
Currie, G & Lockett, A 2011, ‘Distributing leadership in health and social care: conservative, conjoint or collective?’, International Journal of Management Reviews, vol. 13, no. 3, pp. 286-300.
De Souza, LB & Pidd, M 2011, ‘Exploring the barriers to lean health care implementation’, Public Money & Management, vol. 31, no. 1, pp. 59-66.
Edmonstone, J 2011, ‘Developing leaders and leadership in health care: a case for rebalancing?’, Leadership in Health Services, vol. 24, no. 1, pp. 8-18.
Kakuma, R, Minas, H, van Ginneken, N, Dal Poz, MR, Desiraju, K, Morris, JE, Saxena, S & Scheffler, RM 2011, ‘Human resources for mental health care: current situation and strategies for action’, The Lancet, vol. 378, no. 9803, pp. 1654-1663.
Porter, ME 2010, ‘What is value in health care?’, New England Journal of Medicine, vol. 363, no. 26, pp. 2477-2481.
Porter-O’Grady, T & Malloch, K 2011, Quantum leadership: Advancing innovation, transforming health care, Jones & Bartlett Learning, Burlington, MA.
Slavkin, HC 2010, ‘Leadership for health care in the 21st century: a personal perspective’, Journal of Healthcare Leadership, vol. 2, pp. 35-41.
Swayne, LE, Duncan, WJ & Ginter, PM 2012, Strategic management of health care organizations. John Wiley & Sons, New York, NY.
When working in a specific health care unit, medical social workers develop their specialization in a distinct field of practice. Such a specialization involves both general requirements to the profession and a specific understanding of diseases and issues of patients suffering from them. In psychiatric social work, the medical social work practice scope includes the activities identified in National Association for Social Workers (NASW) standards for social work practice in health care settings with peculiarities limited to the stated field.
According to the dictionary, psychiatry is “a branch of medicine that deals with mental, emotional, or behavioral disorders” (Merriam-Webster, n.d., Definition 1). These are specific symptoms, including changes in character, strange ideas, depression, anxiety, substance abuse, and violent manifestations. The scope of the medical social work practice within the discipline may vary due to the work setting. For example, in public establishments, it could primarily include prevention initiatives and research, while in hospitals, it often involves assessment, diagnosing, therapeutic intervention, education, and development of a discharge plan. Within the discipline, if social workers are responsible for diagnostics of patients’ mental disorders and psychotherapy provision, they should obtain a master’s degree in social work and a license at the clinical level (National Association for Social Workers, 2016). Sometimes, it is acceptable to perform the stated duties under professional supervision. Psychiatric social workers should use the Diagnostic and Statistical Manual of Mental Disorders in their practice and collaborate with psychiatrists and psychologists (Beder, 2006). Education of patients and their family members on using medications, coping techniques, and following the treatment plans is essential within psychiatric social work.
Sometimes, social workers have to deal with their patient’s needs that are beyond the scope of their practice. According to the National Association for Social Workers (2016), professionals must seek further professional development in such situations. They could also resort to supervision and consultations of other experts, engaging in collaboration on various issues. These issues could involve other diseases affecting the patient’s condition or sociocultural context. Notably, chronic illnesses could result in the development of mental problems, such as depression and anxiety, while mental health issues, in their turn, might increase the risk of chronic illness development. These implications relate to heart diseases, diabetes, and cancer. If a patient has to cope with social challenges of health disparity, discrimination, and economic inequity, a medical social worker could turn to public social work services (Ruth et al., 2019). In addition, social workers should help patients develop self-advocacy skills and self-management skills to transform an ordinary patient into an activated one – the person fully engaged in the treatment process (Findley, 2013). Hence, professionals should strive to develop their knowledge in the two dimensions: within and beyond the scope of their practice.
References
Beder, J. (2006). Social work in the psychiatric unit. In Hospital social work: The interface of medicine and caring (pp. 151-161). Routledge. Web.
Ruth, B., Knight Wachman, M., and Marshall, J. (2019). Public health social work. In S. Gehlert & T. Browne (Eds.), Handbook of health social work (3rd., pp. 93-113). Wiley. Web.
Due to aging population, policymakers’ push to cut national health care costs, and other challenges home-care providers face, the total number of adult day centers in the United States has more than doubled in the past five years. There were 5,685 adult day care programs in the United States in 2019 (Ayalon, 2019). The quality of service in these centers is largely determined, in particular, with inter-cultural competence of employees, especially when working with minorities.
Population
The social worker should take into account the whole range of values and mechanisms of social integration of these groups, as each of them has specific and unique features, beliefs, social and health practice (Min, 2005).
At the same time, all these multicultural groups believe that social work “would be a great source of comfort to people in times of need” (Padilla, McRoy, & Calvo, 2019, p. 1).
Indians have rather strong believes about better effectiveness of non-traditional medicine, and the habit of smoking is inherent in almost half of male population (Sudha & Padmakala, 2017).
Chinese also have strong established attitude about effectiveness and necessity of non-traditional medicine. Moreover, Confucianism considers education of virtue as the basis of good health – when a person is virtuous, diseases do not come.
Best evidenced-based practices
The category of migrants’ access to social and health services, which are provided in a complex in day care centers, is assessed based on the analysis of several indicators, starting with what happens to a person when interacting with the health care system, determining the degree of compliance with the needs and adequacy of the medical care received, general assessment of its quality and the effect of using medical services.
A new understanding of the concept of accessibility of health care institutions and medical services has made the development of modern approaches to its study urgent, as well as the search for new measurement tools. Best practice of day care centers in this field implies development and application of appropriate KPIs (Ellen, Demaio, Lange, & Wilson, 2017; Lunt, Dowrick & Lloyd-Williams, 2018).
It should e noted that the care offered for patients is often a social model (with a focus on socialization and prevention services) or a medical model (including assessment, treatment and rehabilitation goals) provided to improve the health of participants and guide their progress in the right direction (Zhou & Fu, 2019).
The mission which the facility declares is to ensure that “every client enjoys exceptional senior care in a licensed adult day care setting” (Vatsalya official website).
The focus is shifting from looking at the use of day care center services as a specific indicator for measuring access to health services to the effectiveness of the whole process. The best practices consider social practices in these centers namely from this angle (Lunt et al., 2018).
Relatives of elderly people can take a course of theoretical and practical training, learn about the peculiarities of patient care, as well as receive regular psychological support within the framework of a “support and self-help group” (Song et al., 2017).
Regular measurement of effectiveness based on a set of KPIs is carried out.
The day care facilities provide counseling, as well as social and psychological services. Classes are held with a psychologist, both in group and individually. The psychologist would conduct psychological diagnostics and, if necessary, helps stabilize the emotional state, tells about the stages of development of a person’s growing up and facilitates finding the right way in resolving issues of intra-family relations. Elderly citizens are offered events where there is an opportunity to show their creative abilities, to realize themselves in amateur art (Song et al., 2017).
The results mean increase in quality of life indicators for elderly people of different cultural background with functional limitations and the need for outside help, by removing isolation and stigmatization, providing the opportunity to realize and maintain normal social, professional, and personal ties (Spiteri, 2016).
The results achieved imply increasing the life expectancy of the population and improving the quality of life of elderly citizens, including those with cognitive impairments, ensuring the possibility of their inclusion in active socially oriented activities, and the return of able-bodied people caring for their loved ones to the economy as an able-bodied population (Lunt et al., 2018).
Current modalities used in the facility
In general, services include nursing, social services, therapeutic recreation, dietary services (customizing designed menu), physical therapy, occupational therapy, personal care (including haircutting and shaving).
Methods of Implementing Evidence-Based Practices in the Facility
Appropriate change plan should be developed and implemented, based on ADKAR, because changes in an organization are similar to changes in the behavior of each employee, and the mistake of many leaders is that they pay attention to organizational transformation while ignoring the staff.
To teach staff in frames of newly introduced practices, it is advisable to conduct based on Kolb cycle method, to ensure effective reflection and fixing of new knowledge and skills.
The Findings from the Articles
Facilities provide elderly with enjoyable, as well as educational, activities, contributing to increase of their quality of life.
Social interaction improves mental and physical health and contributes to enhancement of social cultural integration of minorities.
Improvement of self-control over activities bolster self-esteem in minorities elderly.
References
Ayalon, L. (2019). Sense of belonging to the community in continuing care retirement communities and adult day care centers: The role of the social network. Journal of Community Psychology, 48(2), 437-447. Web.
Brown, E., Mauro, A., & Friedemann, M.-L. (2014). Use of adult day care service centers in an ethnically diverse sample of older adults. Current Gerontology and Geriatrics Research, Article 4934983. Web.
Ellen, M., Demaio, P., Lange, A., Wilson, M. G. (2017). Adult day center programs and their associated outcomes on clients, caregivers, and the health system: A scoping review. The Gerontologist, 57(6), 85-94.
Lunt, C., Dowrick, C., & Lloyd-Williams, M. (2018). The role of day care in supporting older people living with long-term conditions. Current Opinion in Supportive and Palliative Care, 12(4), 510–515.
Min, J. (2005). Cultural competency: A Key to effective future social work with racially and ethnically diverse elders. Families in Society: The Journal of Contemporary Social Services, 86(3), 347-358.
Padilla, Y., McRoy, R., & Calvo, R. (2019). Rethinking practice with multicultural communities: Lessons from research-based applications. Journal of Ethnic & Cultural Diversity in Social Work, 28(1), 1-6.
Peng, C.M., Xu, X.Y., He, Q.W., Guan, X.Y., Li, Q., Suo, Y. (2016). Empirical research on the operation mode of day care service for the elderly in urban communities – A case study of Luoyang Jianxi district. Journal of Hebei Normal University of Science and Technology (Social Science Edition), 15, 1-6.
Song, M, Seo, K., Choi, S., Choi, j., Ko, H., Lee, S. (2017). Seniors centre-based health intervention programmes in the United States and South Korea: A systematic review. International Journal of Nursing Practice, 23. Web.
Spiteri, D. (2016). What do older people learn from young people? Intergenerational learning in ‘day centre’ community settings in Malta. International Journal of Lifelong Education, 35(3), 235-253.
Sudha, N., & Padmakala, S. (2017). Health practices of high school student in Kanyakumari district. International Journal of Research, 5(3), 33-39.
Vatsalya Adult Daycare (2020). About us. Web.
Zhou, Y., & Fu, J. (2019). Review of studies on day-care centers for the elderly in community. Open Journal of Social Sciences, 07(12), 322-334.
Inequalities in healthcare services cause biological, psychological and mental oppression among the elderly. Older people may be subject to treatment that does not suit their needs due to ageism inequalities in the healthcare system. For instance, when an older person suffers from suicidal thoughts, they are less likely to be committed in a mental health facility on the assumption that suicidal thoughts are logical in old age. The inaccurate perception can lead to severe consequences such as death or mental incapacitation in the long run.
The elderly face challenges of communication and attentiveness from healthcare workers, particularly patients with chronic ailments such as cancer. Doctors and nurses spend less time and simpler words explaining the patient’s condition because they feel the elderly cannot understand medical terms (Obbia et al., 2020). At the same time, healthcare workers also feel the elderly are less significant since they have lived long and instead care for the young who might have longer to live. The indiscrimination oppresses older adults by worsening their health conditions, increasing their suffering or untimely deaths due to negligence.
Empowering the Elderly Through Social Work
Social workers can empower the elderly by discussing the significant challenges they face in everyday activities and receiving equal rights as the younger generations. Talking about these issues with the concerned parties helps identify ways of involving the community, family, and institutions on how to handle the elderly (Obbia et al., 2020). Social workers can also empower the elderly by bridging the communication gap between older people and the younger generation in the community and institutions. Social workers can advocate for older people in healthcare and technological aspects, which can allow better communication (Obbia et al., 2020). For example, a social worker can offer therapy or counselling services to patients by explaining the correct diagnosis, the standard treatment and outcomes in a more caring and understanding manner. Finally, Social empowerment among the elderly is significant in improving their lives, self-worth and health. Social workers can advocate for older people’s self-help groups which involve committees comprised and headed by the population. Self-help groups empower the elderly through decision-making and creating policies that affect the group.
Psychosocial Theory in Social Practice
The social environment and experiences shape an individual’s behavior, such as the way of thinking, lifestyle, attitudes, and particular response to circumstances. When dealing with the elderly, it is more appropriate to use the psychosocial theory of development during practice. The theory argues that individuals develop through eight life stages that involve different psychosocial adjustments forming the foundation for different behaviors (Obbia et al., 2020). Thus, social workers must understand what an individual is going through for better practice and outcomes at each stage. For example, older people from 65 years and above are in the final stage of development, which involves feelings of despair and egotism. The theory also helps find ways in which the population can adapt to society, such as changes in relationships, life experiences, communication and status (Obbia et al., 2020). For example, the psychosocial theory can help understand the experiences of a retired militia whose life revolved around wars to help in developing new roles and goals.
Changes in Social Practices for the Elderly
Social work practices with the elderly have changed over time due to various aspects, including modernization, politics, and economic factors. Each elderly population at a given time belongs to a different generational experience which modifies their emotional, mental and psychological needs. For instance, older people in the 21st century belong to the baby boomer cohort who still feel young at 65 years, leading to more physical activity and emotional crisis due to unwillingness to get old (Obbia et al., 2020). The changes have influenced advancements in therapeutic methods, medicine, and new approaches to handling upcoming challenges (Obbia et al., 2020). For example, psychosocial therapies focus more on helping clients maintain the dignity of life, such as counselling on life goals and adapting to age-associated changes rather than psychotherapy, which only improves mental well-being.
Reference
Obbia, P., Graham, C., Duffy, F. R., & Gobbens, R. J. (2020). Preventing frailty in older people: An exploration of primary care professionals’ experiences. International Journal of Older People Nursing, 15(2), e12297. Web.