Helping Relationship in Social Care - Case Study Example

Helping Relationship in Social Care The problem Marian has to deal with is a very complicated and stressing one. I understand how oppressing it is to feel that you're deprived of the usual things, the ones that other people take for granted. I would try to do my best for to help her to feel a little better, and to comfort her, for not to let her negative emotional state influence her physical well-being as it sometimes happens with people who suffer from some complicated illnesses. At the beginning I would listen her carefully, using the active listening skills, and participating emotionally in the dialogue. Ursula O'Farrell in her book First Steps in Counselling (1998) advises that the therapist should use several active listening skills when working with the patient. Those are: Using Acceptance Responses Repeating Paraphrasing Asking Clarifying Questions Summarizing In the same time, James T Hardee, who wrote an article about empathy in communication (2003), emphasizes that the specialist should obligatory use it when communicating with his/her patient. Thus I would listen attentively to Marian's story, repeating some of the key words in her speech, for to make sure that I understood her correctly. I would paraphrase some of her sentences, for to feel that we are talking about the same things, and than the problematic issues are clear to me. I would ask some clarifying questions if there were some unclear issues in her story. I would summarize the story after the end of her monologue, for to make sure that my view of the situation is correct. The confidentiality of information they share is an issue of concern of every client, so say the authors of the Ethics And Issues In Contemporary Nursing (2001), Margaret A. Burkhardt and Alvita K. Nathaniel. The clients usually trust their social worker with the information that can be harmful for them in case it would spread. The fact that the client shares confidential information with his social worker means that he/she trusts his/her worker, which is one of the key points in building healthy and mutually beneficial relationship between the client and the social worker. Considering this fact, I would ensure Marian that her story won't be foretold to any one unless she asks about it. I also would thank her for the credit. Here is the text of my possible answer to Marian. Marian, I would like to thank you for the credit. I'm very glad you told me about your feelings, as now I know what exactly disturbs you, and I can try to help you cope with it. I see that being unable to perform the usual tasks, to be unable to do the things other people take for granted is one of the main issues of your concern. It's normal that you still cannot believe that it happened to you, but our task is to help you make up your mind with this situation, and to concentrate our efforts on making life easier for you. I understand that you're angry that it happened to you, that you can't live the life you want to live any more, but you should realize that being angry will not solve the problem you have. And it's no use to keep those feelings up to you. You can express your angriness; moreover, you should do it, unless you want it to ruin you from inside. You can always tell me about your feelings. Maybe it would be a good idea to confess your feelings to your husband, for to let him feel you trust him. I see you feel betrayed, as you body, the only thing that really belongs to you, has let you down. But maybe it's time to consider the hypothesis that your illness is not your body's fault, nor it is yours or your ancestor's No one is guilty that it happened to you, and you shouldn't concentrate on finding the scapegoat for that. It would be much more useful to devote your time to learning to cope with your illness. You say that you feel all you are missing out when you look at your girls. But still you can see your children; you can spend time with them, and present them with your love. It is the most valuable thing for children, the best thing a parent can give. Parents can express their feelings in different ways, and picking children from school is not the best and the only one. When you are together with your family you give them all of your love, affection and care, and, believe me, it's of much greater importance than giving your daughters a ride to Irish dancing and swimming. You mentioned you see your illness as letting your daughters down. If you think it over I'm sure you will realize that this statement isn't correct. Your illness is not your fault; you cannot say that you let your kids down by becoming ill. The things are that your family isn't like the ordinary one any more, but it doesn't mean it became worse. Moreover, you can give your daughters some empowering lessons, using your illness. Your girls can learn to take care about their loved one and, realize that there are things they have to do on their own. It's very positive that you concentrate on the good moments you had with your family. Positive emotions are vital for your condition, as your psychological state influences your physical well-being correctly. I think you should try to spend more time together, as a family, for to let your children and husband feel you are there for them, despite of the fact you are ill. In the times when your physical condition is poor you should remember that it will become better, and that there are people who love despite regardless of your illness, people who value you, and not the set of functions you were able to perform. Remember, that letting your family know that you love and value them, is of much greater importance than preparing food for them or cleaning the house. There are several concerns Marian expressed in her speech. 1. She feels angry and lost as she is deprived of the possibility to live like she lived before the illnesses. These feelings can be explained using one of the theories of grief and loss Katherine Walsh-Burke wrote about in her book Grief and Loss: Theories and Skills for Helping Professionals. It is the theory, which says that change is a lifelong condition. Any time a change is experienced a person loses something, even if the change is positive, like giving birth to a child, marrying or transferring to a better working position. The more emotionally charged is the change, the more intensive is the reaction to loss. In our case the client lost the ability to move by her own, the thing that is one of the basic for every human being, the one that allows a person to feel him/her self-sufficient and independent. As you realize, this thing is of a great value for the client, thus her response is so emotionally charged, she feels herself angry and betrayed. One more explanation for the client's feeling is that she doesn't feel safe because of her poor physical condition. For many people the fact that they use a wheelchair means that they become vulnerable to various dangers people who walk by their own can escape. The need in safety, which's one of the basic according to the Maslow's hierarchy of needs, is not satisfied in her case, thus Marian feels angry, betrayed and unprotected. (Share, McElwee, 2005) We see that the client still can't believe that it happened to her. According to Elisabeth Kubler-Ross she is on the first stage of grief, the stage of denial. It's one of the most complicated stages, and it is very important to pass it and transfer to the next ones. (1969) 2. The client feels that her body has betrayed her Marian, like most of the people, who live on our planet, got used to the fact that her body is the thing that belongs to her, and that is under her control. Her negative feelings can be explained by the theory of grief and loss. The emotional response is so intensive because of the value of the thing lost. The social workers that prefer psychodynamic approach may say, that Marian is transferring the blame for her illness on her body. Subconsciously she is afraid that it's her who is guilty of it, and she is trying to find a scapegoat for it. Her body cannot defend itself, that's why she chose it as the object. 3. Marian feels guilty to her children, as she cannot give them what healthy mothers are able to give to their children. Marian's feelings can be explained using the behavioral approach. From the early childhood Marian saw the set of behaviors that characterized motherhood. For Marian being a mother means taking children from school, and bringing them to Irish dancing and swimming, going to the Zoo. Marian sees she is unable to perform those things, thus she feels she is a bad mother, which makes her feel guilty. I would prefer to use the person-centered approach in my work with this client. I feel that Marian is a grown up intelligent woman, who is capable of interpreting her feelings correctly. As the Person-Centered Counseling requires three conditions for to provide a climate conducive to growth and therapeutic change, I would try to provide my client with unconditional positive regard, empathic understanding, and congruence. (Tolan, 2003). I believe that the client's words should be accepted non-judgmentally. The social worker doesn't have a right to evaluate his client's words or deeds positively or negatively; he should let the client feel that he is accepted and understood regardless of their views, that there, in the counselor's room, they don't have to try to look "good", to do and to say what is expected of them. I would try to perceive Marian's problems from her perspective, let her feel that her views are valuable and her emotions are accepted. I would try to eliminate the feeling of "hidden knowledge" that sometimes exists between the counselor and the client, and let Marin feel I am there to help her, and not to evaluate her. References 1. Walsh-Burke, K. (2005) Grief and Loss: Theories and Skills for Helping Professionals. Allyn & Bacon. 2. O'Farrell, U. (1998). First Steps in Counselling. Veritas Publications. 3. Burkhardt, M. Nathaniel, A. (2001). Ethics and Issues in Contemporary Nursing. Thomson Delmar Learning. 4. Share, P. McElwee, N. ed. (2005). Applied Social Care. Gill & Macmillan. 5. Tolan, J. (2003). Skills in Person-Centred Counselling & Psychotherapy. SAGE Publications. 6. Hardee, J. T. (2003). A Focus on Patient Centered Care and Office Practice Management. An Overview of Empathy. The Permanente Journal, Vol. 7, 4 Read More