Health and Social Care - Essay Example

Table of contents Cooley, M. (2007). Teaching Kids with Mental Health & Learning Disorders in the Regular Classroom: How to Recognize, Understand, and Help Challenged (and Challenging) Students Succeed. Minneapolis, MN: Free Spirit Publishing. 15 Cooley, M. (2007). Teaching Kids with Mental Health & Learning Disorders in the Regular Classroom: How to Recognize, Understand, and Help Challenged (and Challenging) Students Succeed. Minneapolis, MN: Free Spirit Publishing. 15 Thomas, D., & Woods, H. (2003). Working with People with Learning Disabilities: Theory and Practice. London: Jessica Kingsley Publishers. 16 Thomas, D., & Woods, H. (2003). Working with People with Learning Disabilities: Theory and Practice. London: Jessica Kingsley Publishers. 16 1. Introduction This report is built upon the experiences – past and present, of Sean, a college student, who has shown agitation while living at the parent’s house, and wants to move out – so as to live on his own, and spend more time with his girlfriend. Sean is reported as having moderate learning difficulties since his childhood, which makes him feel isolated and lonely, at times, though he has a few friends at the day center. The reasons pushing him into his decision of moving out of the house include his mother’s excessive control over him – to the extent of discouraging his having a girlfriend. Also, the mother and the father choose leisure activities for him and decide the clothes he should wear – besides making many of his decisions regarding his looks and what he is supposed to wear. Sean’s case raises dilemma over the wider initiatives of the multidisciplinary team, which is supposed to aid him in overcoming the learning difficulties and gain the ability to live an independent normal life. This multidisciplinary team should comprise of teaching assistants, school authorities, close friends and relatives, teachers at the day center, and co-curricula instructors – whose focus will surround the following: How can individuals with moderate learning difficulties be supported towards the development of self-independence life skills? How can individuals with these learning difficulties be offered support during and through the administration of learning at school, practical areas and the home, in developing effective societal living? This report explores various viewpoints on learning difficulties, reviewing related theories, practice guidelines and research – towards offering recommendations to be used in countering the issues identified. 2. Perspectives on moderate learning disorders and difficulties The discipline of learning disorders and disabilities has been changing, due to the impact of a number of factors and debates in the areas of, defining learning disorders in the aspect of discrepancy scores, outline the borders on how specific a learning disorder should be, categorizing treatments on the basis of scientific reliability, and putting into operation, instructional policies, which work towards the best interest of the affected individual. Another area of controversy is what the causes of disabilities are, and how best to support and address the needs of the victims. Over time, the social model perspective has been given regard in addressing the issues facing these individuals, but a medical model perspective may offer solutions towards addressing the needs of such individuals on a case-to-case basis, thus administer the best support and intervention from multidisciplinary teams. 2.1 Social model perspectives A social model perspective, often, tends to look at major learning disabilities, including moderate learning difficulties from the perspective of rights and responsibilities, social inclusion, social care systems and citizenship – not addressing the potential hazards that come with this outlook (Beresford, 2002). The shift from a biomedical view to disabilities towards a social perspective implies that, in some quarters, healthcare institutions like the NHS has redirected resources and attention from meeting the needs of people with disability (Duggan, Cooper, & Foster, 2002). This is, especially, an issue as the proportion of individuals with disabilities – moving into adulthood has been on the increase, since the last 20 years, as the case has been with those facing complex learning difficulties like autism (Ryan & Thomas, 1987). This is clear from the example of U.K. Due to the shift from biomedical approach, Primary Care Trusts (PCTs), which could be a vital vehicle in addressing the needs of these individuals and their families, have been subjected to immense financial pressure, thus are fighting to survive with the multifaceted commissioning agenda (Gilbert & Scragg, 1992). The organizational division characteristic with the local authorities has also resulted to declines in certain areas – with regard to good practice in addressing the needs of these groups, as opposed to the way the case was in the 1980s. Resource constraints at NHIS and local authorities are also to blame – as having caused a tightened eligibility criterion, which subjects a number of vulnerable individuals with inadequate services. For instance, in the case of Sean, the funding at the local college, where he was learning independent living skills was cut, forcing him to change to another institution (Bradley, Ashbaugh, & Blaney, 1994). A positive operational linkage between basic care, secondary care services and social care is crucial in addressing these individuals and their careers, towards the realization of valued lifestyles. The major irony with the case of the U.K is that what works is known clearly, but employing the good practices to realize it has not been developed into the standards of administering healthcare to these groups (Race, 2002). This model is helpful in addressing the issues surrounding learning disabilities, as it is helpful in replacing the notions of dissimilarity, and non-addressable conditions, just like other medical conditions. Based on this model, the individuals may be taken through formal diagnosis, which helps them identify with others with similar conditions – which offers them a platform for improvement from the condition. The major drawback with this model is that it confers less sympathy for learning difficulties victims, as they are viewed with some degree of fear, due to the view that they are maniacs. This is demoralizing on the part of the victim, as it results in discrimination, which may lead to the development of low motivation and self-esteem (Beail, 1995). 2.2 Medical model perspectives The medical model perspective of mental learning difficulties is a sociopolitical approach, by which learning disability or illnesses is viewed as a physical condition, which is inherent to the individual, which may cause disadvantages to the victim or the individuals quality of life (Race, 2002). The medical model holds that curing or at least managing the disability fully or partially – circles around identifying the learning disability from a detailed clinical approach – through scientific comprehension according to healthcare practitioners – towards establishing control for it or changing its course. The medical model approach holds that a just society employs resources towards healthcare in the pursuit to cure the difficulties medically; towards offering the victims a relatively normal life (Social Services Inspectorate, 1998). Further, the close linkage of this model and the social model will limit the flaws of this approach, including that it revolves around a societal inclusionary practice and a universal design in the administration of healthcare services. On the basis of a hybrid application of the two perspectives, the world health organization (WHO), ICF categorization takes into consideration, the social facets of disability, as opposed to looking at disability as a biological or a medical dysfunction (Ryan & Thomas, 1987). This model closely links with advocacy support, which pushes for the realization of the needs – both psychological and social – of individuals like Sean (K217, Learning Guide 11 model). 3. Discussion 3. DISCCUSSION 3.1 The contribution of theory Theories offer a framework towards creating an understanding of the learning difficulties of individuals like Sean, as it offers insights regarding the analysis of the situation. The theories offer guiding principles to social and social health care services, towards addressing practical learning difficulties like that faced by Sean, since his childhood, and one which has not been addressed in a comprehensive manner. This is the case, as attempts at addressing the case failed, for instance after he had to drop out of the college – where he was learning independent living skills. The range of theories consulted by practitioners and other intervention-related parties, whether informally involved or formally acknowledged – as they all influence, the choice of support and care for victims of these conditions (K217, Learning Guide 13). Theories on learning disabilities have also shown that psychological therapies are often not used with people with learning difficulties. This is the case, as their learning disabilities are often used as an exclusion criterion, despite that there is a wide range of therapeutic opportunities to be used on such cases (Bichard, Sinason, & Usiskin, 1996). The theories range from those connecting learning difficulties to bio-medically traceable causes, psychological coverage of solutions and social intervention modes. The different range of theories argue as the most befitting explanation ad solution for learning difficulties, though a integration of the range – to create a holistic bio-psychosocial approach would be best at explaining the causes and proposing the relevant solutions for these cases (Beail, 1995). The contribution of theory is that it helps practitioners and other involved parties in striking a balance between the ranges of theoretical orientations. This is the case, as assuming a purely biological perspective in explaining Sean’s problem, they would argue that his case may be associated to the difficult birth and the elderly nature of the parents, especially the mother – thus, only supportive interventions would be offered, for instance the continual support of academic assistants to such students. Although the role of psychiatry may be contested, biological psychiatry may offer solutions, which biological approaches would not offer in explaining learning disabilities. This is the case, as psychiatrics is able to offer crucial diagnostics model and relatively interventions for learning disorders, as it offers a closer look at the influence of psychological and social factors. A little different from this approach, Cooley (2007) argues that psychiatry should draw from biology; as such understanding will be helpful in realizing advances in the field (Social Services Inspectorate, 1998). On the other hand, a purely social theory approach would argue that learning difficulties is just another way of prototyping the people who feel or appear a little different from the rest, in terms of perceived differences. However, it may recognize the reality of conditions like psychological disposition, depression, and learning difficulties, but insist on explaining the conditions on the basis of the social conditions surrounding the individual in question. In the case of Sean, the justification may be the deficient upbringing offered by the elderly parents or the continual pressure and control by the parents throughout his life to his current age. These are also related to the psychological theory explanation of such cases, as they would link the deeds of close or related groups and other situations that they may have been subjected to, as the cause for the disruption of Sean’s learning abilities. Based on the inferences from the theories, it is clear that psychological therapy may be greatly helpful in addressing the case of Sean (Race, 2002). The adoption of a holistic approach to mental health (K217, learning Guide 2) will help redirect the interventions offered to Sean, from those of support and unending assistance from instructors at school and other learning areas, to that involving the development of life independence skills and abilities. This would be a great step ahead, towards the realization of quality life for him, as it will change him from a fully dependent person to one, who is fully dependent on himself, and even capable of being depended on. Examples of the strategies that may be used here include, breaking learning activities into smaller, simpler steps, which are logically focused; offering multisensory models of teaching and learning, allowing extra time to complete tasks, offering models that promote the understanding of new concepts, and offering motivation models to promote creativity from the victims of these challenges. Particularly, (K217, Learning Guide 2) presents the idea that, exploring the factors that could help Sean move away from the situation of impairment to utilizing his mental capacity to the maximum, including the psychological and social support, which she needs to so as to function optimally, as a student and a dependent individual. This required holistic approach may be attained from using the bio-psychosocial approach to mental health (Cooley, 2007). Further, whatever the cause of the learning difficulties, theories on social exclusion and stigma are vital in explaining the high number of people with learning disabilities, who are forced into isolation, thus the feelings of loneliness and hopelessness, and powerless. Such a situation was the case with Sean, which made him feel that moving from the house would help him earn more control over his life, as well as help him overcome the loneliness he feels, after he is able to spend more time with his girlfriend. Further, his sense of loneliness and lack of ability to control should be addressed, as this will extend to other areas of his life, including work and relationships, like the one he is keeping with his girlfriend, in the case the internalized vulnerability is not addressed (Bradley, Ashbaugh, & Blaney, 1994). From the case of Sean, it is evident that he faces the risk of social exclusion, especially at the day center, as he is noted as noting he only has a few friends, and that he feels lonely, though social inclusion cannot be viewed as the contrary of social exclusion. This is the case, as social exclusion extends to denial of access to employment and vacancies for employment, and favorable relations of relationships and social living. On the other hand, social inclusion may be used to imply the ability to access opportunities and facilities, which may extend to cover the compulsion of individuals to live in certain ways or to take roles that affect their mental wellbeing and civil rights in a negative manner (K217, Learning Guide 13). 3.2 What can be learnt from research and practice guidelines? Research studies like that carried out by Boyle and Weishaar (2001) showed that strategic note taking increased the comprehension and the recall abilities of high school learners diagnosed with high incidence of educable mental retardation (EMR) learning difficulties. For the study, 26 students with high incidences of the learning difficulties were exposed to experimental or controlled note taking. The students exposed to the strategic note taking scored considerably higher in the areas of long-term free recall, comprehension levels, short-term free recall, and the number of notes taken, as opposed to the learners in the control group, who used ordinary note taking models (K217, Learning Guide 7). A study by Roberta, Et al (2003) showed that learning disabilities and difficulties fall victims to social exclusion, discrimination, isolation and stigma – due to the adverse effects of their learning inefficiencies. In this line, a research by an organization that campaigns for the social wellbeing of the people with learning difficulties, by the name of Mind, offered a comparative study report. The report reflected a comparison of the general population’s experiences of isolation and those of individuals with learning difficulties, from which it found that the group with learning difficulties experienced 84% incidence of isolation as compared to 29 percent among the general population. These indications from the different studies indicate that Sean’s feeling of isolation is directly linked to his inefficiencies as a person with learning difficulties. The Roberta, Et al (2003) argued that people with more social and relational links and contacts are less likely to experience high incidences of depressive attacks due to the support received from the contacts. In some cases, the lack of a close relation to confide in was established as a highly potent factor in predicting the anxiety and depression levels of the study group with learning difficulties and disorders. This clearly showed that enabling support acted as an important aspect, towards promoting the wellbeing of the individuals with learning difficulties (K217, Learning Guide 5). According to the Social Exclusion Unit (2004) report and review indicated that service providers and local authorities among other players, necessary towards the promotion of these individuals, should promote social inclusion, through extending social and moral support to them. According to the proposals offered through the report, effective support and care should take a broad application to cover the areas of caring responsibilities, education, housing, leisure, employment and benefit plans. In practical application, the care of these individuals is focused around their healthcare needs, and vocational and social needs taking secondary place – besides, not being fully incorporated. Following this line of discussion, the intervention services to be offered to Sean and other individuals like him, should not take an absolutely, bio-medical perspective, but should involve social inclusion practices and mentally rebuilding intervention, for example, psychotherapy (K217, Learning Guide 1). 3.3 Theory and practice According to Thomas and Woods (2003), the administration of care to individuals with learning disabilities should be done with reference to relevant theoretical models – which guide the operation of the involved parties. These parties, who are responsible for administering incorporating these individuals into the main society in the areas of social inclusion among others, include nurses, social workers, teachers and other parties working or relating with these individuals, for instance fellow learners. The practice should be informed by theoretical understanding, which offers guidelines on good practice and models that are likely to promote the improvement of the quality of life for the individuals living and working with learning disability. The administration of care should also draw from social legislation and policy, the standards of advocacy, joint agency work and crisis intervention – as these are the standards that may lead to the realization of long-term results (K217, Learning Guide 2). Also, participation and lines of power come into play, as explained through Block 3 of 217. They are vital to a service consumer like Sean, when he is receiving the services of the specialists. During practice, a balance should also be established between risk control and psychiatry, although has not always been the case, as psychiatry campaigns for mandatory treatment, and the need for support during choice-making. The similarity and differences of patients form another important concept, as prejudice against people with learning difficulties comes in. As a result, a patient like Sean faces the risk of may face rejection due to her dissimilarity, from being labeled less than competent at work or schooling institutions. This shows that toleration rates for such individuals should be cultivated within the society, as they may be of great value to organizations. An example is the case of bipolar disorder victims, who are known to posses distinctive creative abilities (Ryan & Thomas, 1987). 4. Conclusion and recommendation 4.1 Conclusions Of the two concepts discussed through this report, one is more controversial than the other, while the other is difficult to address. This is the case, as the need to keep special needs individuals like Sean at school or employment posts has been offered more importance through policy making, as they are known to operate optimally with considerable support. During this practice, general healthcare service providers are the initial point of reference, as they may be the ones to direct these special cases to the specialist can best address their needs. In the case of learning difficulties, support and offering alternative models of instruction giving is very important, as psycho-social interventions seem to offer more hope for these groups. However, there is the need to adopt a holistic approach to intervention, as this will overcome the difficulties that come in the way of practice for psychotherapists and psychiatrists, as they are often bound by the strict codes of practice that define their boundaries during practice. From a holistic approach, other social-oriented interventions like support will be offered the attention they deserve, as stigma and discrimination make the case of such patients more difficult. Addressing the sentiments of the patients is also increasingly important, as research is shedding more light on the need for a favorable self-image and social support, towards fully addressing the trouble areas of such patients (Thomas & Woods, 2003). Treatment processes should also move beyond focusing on the reduction and control of symptoms, as addressing the central causes or triggers of learning difficulties may be the key to offering these individuals optimal living. This may be realized from supporting the needs of these patients, engaging them in extra-curricular activities, as well as promote their linking to support groups. The advantage of doing this is that these groups offer support, while checking the problem areas while people like Sean are working, studying, and participating in a range of activities and fields (K217, Learning Guide 7). Some options influencing the care of individuals like Sean is increasing support and a sense of acceptance, as it offers more insights into intervention models that work for a particular case, as opposed to others. There is also an option in the area of taking Sean through psychotherapy, as this is helpful in pointing out weakness areas, which may be complemented through models like offering alternative instruction models to them. Further, based on a psychotherapeutic approach, Sean can be taken through both social and psychotherapeutic support, which will be of great importance, towards understanding the level of need he is posing, as the support he has received from his parents should be withdrawn slowly by slowly, until he is able to live a fully independent quality life (K217, Learning Guide 11). 4.2 Recommendations Based on the inferences from the analysis, these are recommended: 1. Individuals with learning difficulties should be offered uncontrolled advocacy, when decisions are to be reached on areas affecting their long-term welfare 2. Psychological support and care should be made easily accessible to individuals with the problems of learning difficulties 3. Care and support personnel should be trained on administering multi-disciplinary support as they should help address the needs of such individuals at the different spheres of life like employment, school, and the social center 4. Further support should be offered to community-based institutions in the area of advocacy and social support, as they offer closer support and services when they are needed. References Beail, N. (1995). Outcome of psychoanalysis, psychoanalytic and psychodynamic psychotherapy with people with intellectual disabilities: a review. Changes, 13, 186 - 191. Beresford, P. (2002). Encouraging caring communities. Mental Health Today, February 2002. Bichard, S., Sinason, V., & Usiskin, J. (1996). Measuring change in mentally retarded clients in long term psychoanalytic psychotherapy. The National Association for Dual Diagnosis, 13, 6 -11. Boyle, J., & Weishaar, M. (2001). The Effects of Strategic Note Taking on the Recall and Comprehension of Lecture Information for High School Students with Learning Disabilities. Learning Disabilities Research & Practice, 16 (3), 133-141. Bradley, V., Ashbaugh, J., & Blaney, B. (1994). Creating Individual Supports for People with Developmental Disabilities. 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(2010). K217 Adult health, social care and wellbeing, Learning Guide 11 ‘Understanding advocacy: justice, choice and accesses, Milton Keynes, The Open University. The Open University. (2010). K217 Adult health, social care and wellbeing, Learning Guide 13 ‘Knowledgeable and critical practice’, Milton Keynes, The Open University. Thomas, D., & Woods, H. (2003). Working with People with Learning Disabilities: Theory and Practice. London: Jessica Kingsley Publishers. Read More