Assessment of Health Cases - Essay Example

Assessment Case Study For disabled people and their families more than impairment, the attitudes and reactions of other people become more difficult to tackle. For counselling or any meeting with such people and their families, this aspect should not be neglected because life becomes hell when others are discriminating against you for no fault of yours. According to Wilson, (2003, p. 7) " In most cases disability is unpredictable, unexpected and mostly unwanted. Having a disabled child can undermine the parents' sense of security, which is based on the known and expected order of things." So as a social work professional my main motive should be to inculcate a positive feeling in John and his family and guide them to lead a more meaningful and confident life. The two most important models related to disability are the medical and social models. For assessment of John's case, I would follow both the models as "Both the medical and social model aim to 'cure' disability, the former by curing the impairment and the latter by curing the environment and social attitudes. This indicates that, despite the polarity of their views of the world and the opposing positions they occupy, both models aim to improve the state of disability." (Wilson, 2003. p. 22) When a disabled child is small, his condition does not bother his parents much, as bringing him up is like bringing up a normal child, as at that stage all children are dependent on their parents for their needs. It is when the child grows up (during their adolescence stage) as is the case of John who is 15, that the parents as well as the disabled child realize the reality that that their situation is different from the rest and is going to remain the same. This is the time when parents get totally dejected. Since I am going to meet John and his family at such a critical stage, I would keep in mind that he and his family need emotional support more than anything else. For family members the burden of shouldering the responsibility of a disabled person takes a toll on their psyche and might frustrate them so much, that they start abusing and cursing the disabled person. They might not allow the disabled person to do things according to his liking by pointing his incapability to him. During the assessment meeting I would look into this aspect to determine whether John is getting proper care and love by his parents and siblings or not. If I find something amiss I will try to focus on this aspect so that John and his family members are able to deal with their unfortunate situation in a better way. I would see to it that every positive change begins from home. Since John is so used to of his family members being an intermediary between him and outsiders, I will try to encourage John to express himself as much as possible in the first meeting so that he gets comfortable with me and sheds his hesitance as my main objective is to improve his condition more than that of his family members. Both John and I will have to struggle a lot to understand each other because of his critical condition. I will try to systematically organize the service delivery in accordance to the policies and programmes designed by my team to deliver the best possible service to John and his family. Since assessment meeting is not only about John, but his circumstances too, I will try my best to organise, systemise and rationalise the information provided by John's father in his letter as well as my face-to-face communication with his entire family sensitively to get the crux of the whole situation. In this case, I will totally abide by the viewpoint of Coulshed and Orme who have rightly pointed out that "assessment is not just an event, for example the production of a profile on someone or a report for the court; it is, as indicated, a way of continuously collecting and synthesising available data, which includes thoughts and feelings, in order to formulate 'treatment' plans." (1998, p. 21) Through the letter of John's father it as clear that in the past he has not got much help from the social workers and it is on the basis of referral from someone who found my organisation's services helpful that he has contacted us. So I have to conduct this initial meeting in such a way that the user wants to move further rather than get alienated. Research point out that for valued and effective practice and services to meet the needs of John and overcome common disabling barriers; a vision is required. Simply checking out his developmental history, perceptions of his parents and sibling's regarding his condition and getting an account of care being provided to him are not enough. I will have to bring out John's views and reactions through mostly non-verbal communication so that I am able to come to the conclusion that exactly which is the best way to help him out keeping in mind whether that can be afforded or not. Since social work is a profession in which there is more demand than supply, I will have to keep in mind the available resources to fit in the requirements of John. I will have to be very accurate and rigid about the facts and recheck the information provided to me because on the basis of my rigid assessment, my team would be able to devise the most effective way of meeting John's needs and remove the barriers of his growth and well being. Smale et al., 1993 have provided the following guidelines in Coulshed and Orme, (1998, pp.28-29), that in following ways effective services and practices can be provided to meet the needs of John. " facilitate full participation in the process of decision making; make a 'holistic' assessment of the social situation, and not just of the referred individual; help create and maintain the flexible set of human relationships which make up a 'package of care'; facilitate negotiations within personal networks about conflicts of choices and needs; create sufficient trust for full participation and open negotiations to actually take place; " Social work is always committed to rights and justice. According to Sapey (2002, p. 184) " Despite policies based on the assumption that all disabled people need support and care, social services are generally provided for those people without the ability to survive and progress, particularly those who live in poverty." In the context of these policies even though John's parents can afford to look after him, it is the responsibility of the social care professionals to provide services to all. So my first meeting with the family would be based on the assumption that we will surely provide John help. I should make this viewpoint known to all the family members of John to make them aware that there are certain policies that would be advantageous in their situation. Not only this I would make them aware that all disabled people are eligible for benefits and services and that I would work on their behalf to pursue their rights that they have not got till now. In order to help John make understand all this in a very simple way I can take some outside help. In the words of Dockrell, Grove and Hasan (1999, p.284) " Speech and language therapists will advise on assessment and intervention for communication difficulties if needed." Or else I can take help of his family in assuring him. The ethical guidelines of the British Medical Association states that if a patient like John who is under 18 is not in a position to give consent regarding the treatment towards enhancement of his condition, his parents are legally entitled to decide about or consent about the treatment of their wards. As it is evident from John's case that he is a totally dependent human being, the policies allow his parents to take all decisions regarding his life. Since John's father was the one who contacted for help it would not be difficult for me to make it clear in the assessment report that his family needs our support and is willing to extend all help in letting us to do. While discussing about assessment of competence of adolescent children, Khan, Robson and Swift (2002, p. 504) have stated that " A patient who is suffering from a mental disorder or impairment does not, necessarily, lack the competence to consent to treatment." But this not the case with John and an assessment meeting with him would only help in determining his degree of disability rather than his viewpoints. Hence the presence and viewpoints of his parents is extremely necessary in this meeting. Going by the Congenital Disabilities (Civil Liability) Act 1976, I would try to make it clear to his parents in the words of Khan, Robson and Swift (2002, p. 315) that according to the above mentioned act "if a child is born disabled ...a person (other than the child's own mother) is under this section answerable to the child in respect of the occurrence" So I will make an assessment of John and his family's sufferings after making his family aware that if John is by birth disabled then any of his family members, most likely his father might be answerable for his condition. I will do this because in the words of Fook (2002, p. 115) "..assessment involves making a professional judgement about the problematic aspects of a situation, in order to act effectively to address the problems with and within the situation." I would take all important laws, policies and acts under consideration while determining how well John's case can be taken up by us and how these laws can be ethically used in favour of John and his family. As evident by the letter written to us by John's father that John's case is extremely critical. The fact they have not got much help until now makes their case very strong in the context of all the laws and ethics and make them eligible for optimum help and support. I will try to abide by all the values and ethics as far as possible because they would determine worth and merits of my assessment. According to Dominelli, (2002, p. 17) "Values seem contradictory and difficult to define. Yet most social workers claim to adhere to a discrete set of values that represent their commitment to certain principles that both guide their behaviour and can be used to evaluate their performance." On the basis of the most common social work values and ethics I would assess John's case based on individualisation, self-determination, controlled emotional involvement, non-judgemental attitude and purposeful expression of feelings. My strategy would be to enforce the above-mentioned values so that ethical assessment follows automatically. Other than the above-mentioned values, there are some other underpinning values like respect, dignity and compassion for John. This will make him feel that under his circumstances his behaviour and the ways he conducts himself is normal. This will also help in finding ways of being supportive to both the carers and the cared-for. The degree and manner of support would naturally vary for both the parties. At the end of the day my aim as a social work practitioner should be to be ethical in my assessment and follow all the values of my profession that is beneficial to the client. According to Copeland, 2005, "Each session supports the premise that there is hope, that people can get well, stay well for long periods of time, and do the things they want to do with their lives." (para.3) My aim would be to fill John and his family's hearts with this hope. Byng, Farrelly, and Fitzgerald, 2007 have rightly pointed out that, "Healthcare providers need to expand their understanding of what it means to include and involve users, and of the barriers and facilitators to inclusion and involvement." (para.32) I would try to abide by this guideline to emerge successful in this case.Appropriate measurement of John's family's socio economic status would help in charting out future plans for him and I would be as accurate as possible in my entire assessment. Word count: 2051 References Adams, R., Dominelli, L. and Payne M., eds., 2002. Critical Practice In Social Work. New York: Palgrave. Coulshed, V. and Orme, J. 1998. Social Work Practice An Introduction. 3rd ed. London: Macmillan Press Ltd. Fook, J. 2002. Social Work: Critical Theory And Practice. London: Sage Publications. Khan, M., Robson, M. and Swift, K. 2002. Clinical Negligence. 2nd ed. London: Cavendish Publishing Limited. Messer, D. and Jones, F. eds. 1999. Psychology and Social Care. London: Jessica Kingsley Publishers. Wilson, S. 2003. Disability Counselling and Psychotherapy: Challenges and Opportunities. Newyork: Palgrave Macmillan. Oliver, M.A. et.al. 2005. Help-seeking behaviour in men and women with With common health problems: cross sectional study. The British Journal Of Psychiatry, 186, pp.297-301. Saxena, S. et.al. 2006. The 10/90 divide in mental health research: trends over a 10-year period. The British Journal Of Psychiatry, 188, pp.81-82. 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Byng, S., Farrelly, S. and Fitzgerald, L. 2007. Involving people with communication difficulties. [online]. Available from: http://www.dh.gov.uk/PolicyAndGuidance/ResearchAndDevelopment/HealthInPartnership/TheStudies/StudiesArticle/fs/enCONTENT_ID=4127355&chk=LHsq34 [cited 30 January 2007]. Read More