Attention Deficit Hyperactive Disorder - Essay Example

Reflective Placement Case Study Introduction Reflective practice helps define quality social care. It forms one of the crucial cogs in the practice for most social workers (Gould and Baldwin, 2004). It allows these social workers to review their activities and their interventions, as well as decisions involving client care (Knott, 2010). This review allows them to assess the impact of their decisions and interventions and to evaluate how and what they can change in their future practice. It also allows them to learn from each client case, and to establish how individual nuances and differences for each client can make each decision different (Doel and Shardlow, 2005). This case study is about my placement as a student in my final year within a Youth Offending Team. This was the first case which I handled. It was the case of a young offender with ADHD. ADHD was a disease which was not alien to me as my own teenage son was also diagnosed with the condition and this affinity helped me understand his case even more. This reflection shall apply the Gibbs Reflective style which shall review the case and analyse my actions and as well as feelings while caring for the client (Devon County Council, 2010). Description of the service user and his situation Client X was diagnosed with Attention Deficit Hyperactive Disorder. As a student, he often does not attend his classes and he generally had poor school attendance. Based on my contact with the school on a weekly basis, I was able to gain an update on the child’s condition. I discovered that the clients would often collude with the child in order to not attend his classes and his appointments. He often evaded appointments with the Youth Offending Team and his parents would often enable him to miss these appointments. In the course of my placement with client, I was able to establish that X’s father worked as a refuse collector and the mother had a history of addiction to prescription medications, and she would often relapse in her addiction. X was previously under the children protection register for four years because of neglect. His name was later removed because the family proved that they were now able to provide him with adequate care. During my home visit, I was able to ascertain the living conditions under which X was living. This further helped inform my practice and the best interests of the client. The home was of poor standard with little furniture; it was untidy, and had a strong unclean smell. The family had four cats and a dog in their small flat; and a cat litter was in the front room beside the settee. In general, I noted that the client’s home was poorly maintained. During my supervision, I observed that client X was poorly dressed and poorly groomed. He had a poor attention span and was often hyperactive and aggressive in his actions. This is common among ADHD patients (Wender, 2000). He was also using drugs, mostly cannabis, and did not understand why these drugs were dangerous to him. The client was also irritable, especially in answering my questions and in generally dealing with me. He also expressed that he had trouble sleeping at night and could even go for days without any sleep at all. He was also impulsive in his actions and decisions, often acting on a whim even if it would put him in danger. These are all hallmarks of ADHD (Lougy and Rosenthal, 2002). I was involved in this case as it was the first case I encountered and I was also interested in handling it, being the mother of a teenage boy with ADHD. Gibbs Reflection Description (What happened) During my first interview with Client X and his parent, I introduced myself initially and explained what my role was as a student in his care. Although the client was already aware of the referral order process, I still made sure that he and his parent understood my role and my intended activity and relationship with them (BASW Code of Ethics). I also asked the client and his parent if there were any concerns they wanted to be addressed. I gathered all the data I possibly could on the client and the circumstances around the offence. I then completed an Asset and Initial Panel Report. On the day of the Panel report, I supported the panel members by answering the questions; I also supported client X and his family, advocating, negotiating, and reaffirming the decisions made by the panel (BASW Code of Ethics). I also contacted the school on a weekly basis and communicated with his year supervisor in order to gain updates on the client’s behaviour and attendance. I then communicated such data back to the client during supervision. I applied the ASPIRE model in my care, as well as the GCSE applicable laws and policies. I also considered the applicable communication theories and observation elements relevant to my case. I also applied anti-oppressive policies and anti-discriminatory practices in order to protect the client. Feelings (what I was thinking and feeling) Initially I was nervous and anxious about handling the client’s case. I thought that I did not have enough skills and knowledge to assist and guide the client in dealing with his social care issues. I also felt that I may be too emotionally affected by the client’s case because I would be seeing him in the eyes of a mother, not as a student and a future social worker. I felt anxious about applying the skills and information I have gained as a student in social work because I felt that these skills and information may not be sufficient in handling the client’s case. At the same time, I also felt excited and eager about being in the actual practice setting. I was eager to test my skills and my personal fortitude as a future social worker. I was also nervous about not being effective in my role during the placement. I was afraid to fail and I was concerned about making things worse for my client and his family. I did not discriminate against the client based on his ethnic, racial, economic, religious, gender. As a result, I ensured that anti-oppressive and anti-discriminatory practices were protected (Dalrymple and Burke, 2006). Moreover, I did not treat the patient differently because of his mental health condition. I also did not deprive the client of his health needs because of his poor financial condition (Dalrymple and Burke, 2006). Evaluation (what was good and about the experience) What was good about the experience was that I was able to engage in a more practical application of my skills and of my knowledge as a future social worker (Gibbs, 1988). I was able to relate well with the client as well as his parent. I was also able to relate my own experience with my son in this case because I understood the client better when he was acting the way he was. I also understood better his frustrations with himself and with his school work. This is common for any social worker and any mental health worker (Gehlert and Browne, 2011). What was also good about the experience was that I was able to apply an academic and clinical approach to the experience. Technically, I was able to follow the legal and ethical requirements of the practice and I was able to understand why these requirements were also important to the practice and for the protection of the client. What was bad about the experience was that there were moments when I knew I was identifying too much with the client and his parent (Boulton, 2001). At times, I was failing in my objectivity as a student and as a social worker. I found it difficult to stay objective, although I still managed that challenge by telling myself that I would not serve the client’s interests well by being identifying too much with him. What was also bad about the experience on my part was that there were times when I was not prepared to handle the client’s case well because I seemed to have forgotten all the essential points in my client care (Walker, 2002). This told me that I needed to arm myself with the necessary skills and knowledge to be a better social worker. Analysis (what sense can I make of it) During my placement, I was able to apply important ethical, legal, and standard practices in the social work practice. First and foremost, I adhered to the basic mandates of the Codes of Practice for Social Workers. I protected the right of the user, and promoted his interests by considering his preferences, his wishes, his choices, in relation to the services he would receive (General Social Council, 2010). The client at one point preferred to not share with me his feelings about his actions, and I allowed him privacy during these times. By making these decisions, I made sure that his preferences and his pace during the sessions would be the ones followed (Crowther, et.al., 2001). I also made sure that I was able to maintain the trust and confidence of the client and his parent by communicating with them in an open, honest, accurate, and straightforward way (Clark, 2006). At all times, I emphasized to the client and his parent that if his mental health issue (his ADHD), as well as his substance abuse issue would not be resolved or managed soon, that he may be endangering his life, his future, and the lives of the people around him. Maintaining trust and confidence is an important part of social work practice as it ensures that the client would feel comfortable relating to the social worker and that the client would also be more open and honest about his thoughts and feelings (Beresford, et.al., 2001). Honest disclosure to the social worker is crucial to the practice because it also helps prevent any future problems for the client and his family (Mullen, et.al., 2005). In evaluating the client’s case, I unavoidably had to evaluate his family history and had to consider his history of neglect and his mother’s drug addiction. I considered these incidents in his past to be contributory to his ADHD and his substance abuse. For many individuals, there seems to be a strong relationship between their childhood history and their future behaviour (Read, et.al., 2007). This is reinforced by the psychodynamic theory which considers internal processes like needs and emotions which motivate human behaviour (McCluskey and Hooper, 2000). Early childhood experiences are crucial elements which impact on an individual’s emotions and are therefore very much in evaluating a person’s behaviour (Wickham and West, 2002). In general, changes are often difficult to implement in people’s lives because unconscious and conscious mental activities are often based on one’s accustomed behaviour and traits and these qualities which often start from childhood (Biehal, 2008). The neglect that the client went through, including his mother’s drug addiction, are incidents or factors which had to be looked at in order to further understand his behaviour and his interactions with other people. The psychodynamic theory is a theory often used in social work practice and it is commonly used in handling patients who experienced abuse or trauma in their childhood years (Leiper and Maltby, 2004). Such abuse or trauma can often interfere or impact negatively on a person’s normal development, and eventually may lead to a person’s inability to cope with anxiety, personal issues, and stress (Bateman, et.al., 2006). In this case, the person’s substance abuse can be attributed to his history of neglect and his mother’s history of drug abuse. These elements may also have contributed to his ADHD with unresolved issues in his childhood impacting on the current manifestation of symptoms which all add up to ADHD (Haggerty, 2006). The functionalist theory helps explain the client’s behaviour. The client’s family is highly dysfunctional, and the functionalist theory explains how the instability of the members and their functions contribute to the client’s current situation (Crossman, 2012). The functionalist theory declares that without the parts of the whole functioning well with each other, desired outcomes cannot be reached and each member would be experiencing various issues (Crossman, 2012). The cognitive-behavioural theory also applies in this case because it helps determine the pattern of the client’s behaviour – from the time he thinks about it or from the time a stimulus is triggered until the predictable pattern of behaviour is reached (Holmes, 2002). Diversity and inclusion in social work practice was also applied in the case of this client. In reviewing his case, it appeared that he was not discriminated against because of his ethnicity, or because of his economic condition (Brown, et.al., 1986). The assessment and social services directed to him were fairly evaluated and attributed based on his needs and condition. Diversity and inclusion is an important element in the delivery of social services because they are part of the mandated Code of Practice (Pritchard, 1995). The Code declares the importance of “respecting diversity and different cultures and values” (General Social Care Council, 2002). This was secured in this case. Equal opportunities were also attributed to the client regardless of his ethnicity and station in life. This diversity and inclusion is also based on the anti-discriminatory practice, including the anti-oppressive practice (Danso, 2009). Anti-discriminatory practice is seen when the barriers in the access of essential services are eliminated (Strier, 2007). In this case, the client was not discriminated against because of his ethnicity or because of any other subjective or demographic considerations. To a greater extent, the anti-oppressive practices and policies were also applied in this case. Anti-oppressive practices refer to bigger considerations and applications (Barn, 2010). It considers all direct and indirect acts of discrimination, as well as dimensions of power and how these are recreated in social interactions (Banks, 2001). Additional laws also consider the protection of individuals against oppression and depression, including the Sex Equality Act of 1975, the Disability Discrimination Act of 1995, the Race Relations Amendment Act 2000, and the Human Rights Act of 1998 (Banks, 2001). These provisions were reviewed for this case and were adequately applied, especially in terms of the services which the client can access, which are not delivered based on discriminatory practices. It is also important to note that in handling this case, there were times when I identified too much with the client and his parent (Andersen and Miranda, 2000). This may be considered as transference, where I was able to relate my feelings about my son to the client. I transferred my feelings of sympathy and anxiety about my son to the client and what he was going through (Andersen and Glassman, 1996). This is a defence mechanism in psychology which often does not lead to favourable relations between the parties involved (Andersen, et.al., 1995). I would not be an effective social worker if I would have persisted in looking at the client in the eyes of a parent. From an ethical standpoint, there was a point wherein I was faced with a dilemma regarding a decision in relation to the client’s social care. Since the client was a minor, all our sessions required his mother or guardian to be present; in one session however, the client wanted to talk to me personally without his mother present (McCurdy and Murray, 2003). This ethical dilemma was resolved by resolved by allowing the client to talk to me without his guardian. I noted this during the documentation, but I also talked with the parent after the session, expressing client concerns which were discussed and which were for the betterment of the client. In handling the client’s case, I also applied the ASPIRE model (Assessment, Planning, Implementation, Review and Evaluation) (Palmer, 1997). I first assessed the client’s overall condition, social care needs, and educational as well as home states (Palmer, 1997). I then planned and conceptualized the stages and actions which can be applied to resolve the client’s issues. I then implemented this plan, ensuring that the client would receive the services, support, and attention he would need before, during, and after the panel meeting (Kane, 2010). I then reviewed and evaluated the overall impact of the services, by checking in with the client occasionally and checking in with his family and school as needed. Conclusion In reviewing my actions, as well as the client’s response and behaviour, I am confident in saying that I was effective in ensuring that the client would receive the social care and services that he needed in order to adequately deal with the ordeal and the incident. The client was cooperative and his parents also did their best to ensure that their son would benefit well under the social services available to them. I learned that I could be an effective social worker and that I found out the importance of applying legislative policies in order to protect the client as well as the social worker. Action Plan Based on the incident, I would definitely be applying improvements and adjustments in my future career as a social worker. These adjustments would include a less emotionally involved feeling in relation to clients (Pugh, 2007). I would adopt more objective actions and demeanour in order to be an effective social worker. I would also be more vigilant in reviewing a client’s history because these are all key points which would help me understand and assist my client (Sandbaek, 1999). For future clients, I would also ensure that I would have read all available data about my client’s condition – physiological and psychological – in order to be more effective in identifying their needs and to be more effective in resolving and addressing these needs (Webb, 2002). Conclusion Based on the above reflection, I was able to understand the social work practice even more. I now understood the importance of following legislative policies as well as standards of the practice. I was able to apply the important provisions under the Code of Practice which helped guide my practice. I was also able to apply various social work theories into my placement, allowing a more deliberate and academic assessment of my client and what he was going through. 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