Loss and Grief in Social Work Practice - Case Study Example

Grief and loss Name: Instructors Name: Course title: Institution: Date: Introduction Counselling as a profession and discipline is a complex issue. It requires intensive understanding of the issues at hand and the patients being handled. Grieving and loss are some core issues that require counselling to treat. A wrong diagnosis or application of a wrong theory in analysing and responding to a problem could be disastrous. This paper seeks to assess a hypothetical case whereby a young male adult who witnessed the death of some of his family members has relocated to Australia. In Australia, he lost the only person he was close to. Furthermore, he has faced racial discrimination. The paper shall apply a number of theories to analyse the case and propose possible interventions. Summary of the case Deng is a 21yr old male living in the outskirts of Brisbane. He is Sudanese by nationality living in Australia as a refugee supported by government social payments and a local NGO that is overseeing his schooling. Deng has been living in Australia since 1999 when he was brought into the country as a teenager by an Australia Oxfam worker, Ashford Clint, who felt the need to rescue the young boy from jaws of death in war and famine ravaged in the Darfur region in Sudan. According to Deng, he witnessed the killing to his two elder brothers and his father and also his mother and younger sister being repeatedly raped by militiamen from the northern part of Sudan. He says he witnessed this as he lay injured in a heap of carcasses of their animals that had been caught in the fierce gunfight. Deng was rescued from the scene of the battle unconscious from excessive bleeding and rushed to hospital. Due to poor health facilities in the Darfur region, Deng lost his left leg which was amputated just above the knee. According to Oxfam affiliated doctors, the leg could have been saved had the young boy been taken to a hospital with necessary facilities in time. Unfortunately, the fate of the rest of Deng’s family, his young sister and mother, has never been known. In Australia, Deng was fitted with a prosthetic leg. Doctors hoped that this would give him back part of his life that he lost. Having never attended school, Deng had to start from the elementary classes here in Australia. This again exposed him to emotional discomfort besides the grief and loss over his family and loss of country. He lived with Ashford in Brisbane. Unfortunately, Ashford Clint died just 3 months after bringing Deng into Australia. Due to his overbearing height and physique, many people did not see the need to adapt him as they assumed he was an adult ready to take case of himself. Ashford’s death according to Deng ultimately erased any traces of hope he had in making it in life. He started evading school and engaging in unsocial behaviour. Due to his age and body height, he felt pout of place attending school with very young children. He because rebellious and with no adult to guide him in life, he dropped out of school. He is easily irritated and has a bad temperament. He is constantly ranting that had his family been alive, he could be leading a better life. From his physical appearance, it appears that Deng has let himself go. As he walks, there is a squeak from his prosthetic leg. Again he walks in a stupor as his prosthetic leg is shorter than his other leg. This is s assure of indication of his financial status as he cannot afford to acquire another prosthetic leg that matches with his height. Interview transcript Q: You have lost your family and your sponsor. What keeps you going in life? Deng: The hope that one day I will be reunited with what is left of my family hoping that they survived the ordeal. Q: How have you coped with the situation and memories of the ordeal. Deng: I feel very lonely most of the time. I am sleepless most of the nights and when I sleep, I wake up dreaming about the ordeal. I wake screaming and very sweaty. This has been happening almost on a daily basis. Q: Have you considered professional help at any one time. Deng: Before Clint passed on, he had enrolled me to a professional psychiatrist. However, I felt that the psychiatrist did not understand me well. So I did not continue with the treatment. Q: So how different was life after your brothers died? Deng: Before violence broke out in Darfur and our village was attacked by a group of militiamen, we had a relatively peaceful life. I would spend my days in the pastures together we my brothers. We were very close as brother and friends. Both my brothers had been initiated while I was just about to be initiated into adulthood through a number of rituals. After the attack, the arrangements for my initiation ritual were halted. Q: Do you think your living in Australia has had any improvements in your life? Deng: the fact that the quality of life here in Australia is far much better compared to the one at home. However, I feel the need to go back to Sudan one day and trace my mother and younger sister. The loss of family is the greatest loss one can have and it cannot be compensated by anything. I thus vow to give it my all to find them. Q: Do you think you have emotional problems. Deng: Everyone in this world undergoes emotional upheavals. So I could not say with total conviction that I do have emotional problems. Q: In the recent past, you have run into problems with authorities. What do you have to say about that? Deng: I believe that I do not have a problem per se. The police are unfairly targeting me as they always do to all immigrants. Q: Does that mean that you feel you that you are a victim of racial discrimination? Deng: Yes. Majority of the people view me as a social misfit and a criminal. Again, I have encountered discrimination on another level, my prosthetic leg. This was one of the major reasons I could not fit in the school system since young children who happened to be my classmates taunted me a lot. I wish to be around my people. I feel misplaced and disoriented from my country, people and culture. Theory Effects of prejudice Different forms of prejudice may contribute to a long term effect on the victims health, education, socialization and ultimately to their general happiness. People in Diaspora are highly likely to face prejudice in one way or the other. They are always disadvantaged especially if they have suffered a loss or losses in their previous life. In this case, instead of them getting help, they are burdened by the need to cope with the injustices in the new country. According to studies, people who suffer discrimination have a higher tendency of suffering psychological difficulties or depression. In Australia, 25 percent of people experience some sort of discrimination in regard to race, national background or ethnicity. Besides, pre migration experiences in religion or culture affect a person’s vulnerability to mental and emotional stress as well as their adjustment in bereavement. Gender is also a significant factor in the way people react to loss and grief. Men generally are stronger both emotionally and physically and they therefore have the strength to withstand loss more than women. However, this may vary with individuals. Women on the other hand are emotional and freely relieve their emotions in the best way they can, hence bereavement moments are often very overwhelming. Loss and transcendence Coping with a loss a person is changed in a way. Any loss and the way this loss is met influence a person’s life and self infinitesimally, moderately or even largely. However, when loss is conquered, one is able to recreate their life and self altogether. Loss and transcendence appears in two major phases: One Phase: this entails mourning which is characterized by the grieving and the searching for replacement stages. Another Phase: This is the resolution phase. In looking for resolution, this phase entails seeking for replacement of the loss and the integration of what the loss really means. In life, a person seems to be mainly in either of the two phases. There are different levels of transcendence which include primary or the loss itself, secondary level, holistic, self conceptual and the metaphoric level. Disenfranchised Grief This is the grief that a person undergoes when they suffer loss that is not or can’t be acknowledged openly, mourned publicly or supported socially. This theory seeks to recognize the hidden sorrow. Contrary to most of the individually embedded ideas of grief that originate from the psychology and psychiatry fields, Kenneth Doka, the developer of the theory considers the social milieu within which bereavement occur and the social effect on individual grief. This view conforms well to the social workers view of person in environment. Ambiguous loss A person may suffer loss of a loved one not only through death, but also through ambiguous absence such as imprisonment, kidnappings, separation, the brain injured, stroke and Alzheimer patients. This loss also causes grief and living with such grief is as traumatizing as loss through death. Social workers should also focus on helping victims of such loss to get through bereavement. Kubler-Ross grief Model This is a model which entails five major stages of grief. They include: 1. Denial: This is the refusal either consciously or unconsciously to accept information, facts or reality regarding the situation involved. It is a perfectly natural defense mechanism. Some people can remain locked in this stage when experiencing a traumatic effect that can be overlooked. However, death is not easily evadable indefinitely. 2. Anger: Anger builds through blaming others for the loss. It is manifested in a variety of ways. People dealing with loss can be angry to others especially to close family or friends, or to themselves. Thus, there is no need to be judgmental to anger from such people suffering loss. 3. Bargaining: This is a stage that involves seeking compromise by negotiating. This is usually common with the terminally ill patients who tend to bargain with their God for a chance or forgiveness. However, bargaining does not offer a sustainable solution especially in matters of death and life. 4. Depression: This is some sort of acceptance with emotional affection. It is natural for anyone to feel sad, fear, uncertainty, regret etc. as it shows acceptance of reality. This stage is also labeled preparatory grieving. 5. Acceptance; according to Kubler-Ross, this is the last stage that involve acceptance. It is basically about showing emotional detachment to the loss. This however varies with individuals. Analysis Deng is experiencing different levels of grief and loss. He is in denial over the death of his father and two brothers. The fact that he witnessed the deaths makes it even worse. Though he witnessed the execution with his own eyes, he is yet to consciously accept that it happened and move on with life. He has refused to adapt to a life far away from his native country. He reminisces about his childhood days. He still visualises and imagines how things would have been had life continued uninterrupted. As such, he is denial of the fact that things have changed. On another front, Deng views himself as a victim of racial discrimination. He believes that the police force is unfairly targeting him and his fellow immigrants. Given hi social profile, he appears prone to committing crime. He is better about the social and political system in the country which he feels does not understand him well. He is thus vulnerable to temptations of acting against the wishes of the society and system to get even. For instance, he does not understand that he taunting and mocking is common among young children as part of growth and development. Taunting emanates from the ability often children to notice differences in certain issues amongst individuals. Although he does not report to have assaulted of any of the children whom he attended school with, he is likely to have been tempted to assault the children in revenge. Deng is also grieving the loss of his sponsor Ashford. This makes it a complicated case of grieving in the sense that the young man has not been able to establish any emotional attachment to anything new of his life. He is still thinking and yearning for the lost life back in Sudan. The promise of a better life for him as promised by his sponsor Ashford was taken away by death. To Deng, there is nothing valuable in this life. All he had in his country, family and sponsor is gone. He needs to identify another reason to live and commit to it. In the even he fails to see another valid reason to live, he might turn suicidal. At the moment, he harbours remote hopes for reuniting with his mother and younger sister. These hopes prevent him from settling down in Australia and starting a new life. In part, disenfranchised grief is evident in the fact there is no social support to acknowledge and appreciate the loss of country and family that Deng faces. The fact that he is living in a foreign country, with no family and close fiends implies that he has no one to open up to and share his experiences with. He has no one to share his fears with and he finds bonding difficult. In part, one can deduce that he fears bonding and getting close to people as he might end up losing them again. The death of Ashford as his sponsor worsened an already bad situation. Deng does not trust psychiatrist help. On his arrival in Australia, he was enrolled in psychiatrist treatment whom services he did not find helpful. For this reason, the any psychiatrist he receives must be encased in a friendship approach, what he currently needs is a friend and not another professional to psychoanalyse him. A friendship approach will be important in making the young man feel valuable. He feels no self worth and thus makes no attempt to be helpful to other people or the society in general. He spends his days loitering in the neighbourhood doing nothing important. He needs to rediscover his purpose in life and be helpful to other people. This way, he will feel valuable and appreciated and help him rediscover his self worth. Deng needs to be liked p with an adult mentor to guide him in life. As a legal adult by age, he cannot be adapted and neither is he likely to be open to the idea given that he has been discriminated against in the past. Therefore, he needs to be encouraged to link up with a person or a bother family from an immigrant community that he feels is discriminated. The idea is to allow him identify some mutual problems facing an individual or a family facing ‘similar problems’ as he is and getting close with him or them. The case of Deng, is just an example of many cases narrated from war ton countries. Many families are separated and broken as a result of war. Surviving individuals and left grieving and facing the feeling of huge loss. It is the prerogative of counsellors and professional psychiatrists to assist such people rediscover their life back. Read More

Doctors hoped that this would give him back part of his life that he lost. Having never attended school, Deng had to start from the elementary classes here in Australia. This again exposed him to emotional discomfort besides the grief and loss over his family and loss of country. He lived with Ashford in Brisbane. Unfortunately, Ashford Clint died just 3 months after bringing Deng into Australia. Due to his overbearing height and physique, many people did not see the need to adapt him as they assumed he was an adult ready to take case of himself.

Ashford’s death according to Deng ultimately erased any traces of hope he had in making it in life. He started evading school and engaging in unsocial behaviour. Due to his age and body height, he felt pout of place attending school with very young children. He because rebellious and with no adult to guide him in life, he dropped out of school. He is easily irritated and has a bad temperament. He is constantly ranting that had his family been alive, he could be leading a better life. From his physical appearance, it appears that Deng has let himself go.

As he walks, there is a squeak from his prosthetic leg. Again he walks in a stupor as his prosthetic leg is shorter than his other leg. This is s assure of indication of his financial status as he cannot afford to acquire another prosthetic leg that matches with his height. Interview transcript Q: You have lost your family and your sponsor. What keeps you going in life? Deng: The hope that one day I will be reunited with what is left of my family hoping that they survived the ordeal. Q: How have you coped with the situation and memories of the ordeal.

Deng: I feel very lonely most of the time. I am sleepless most of the nights and when I sleep, I wake up dreaming about the ordeal. I wake screaming and very sweaty. This has been happening almost on a daily basis. Q: Have you considered professional help at any one time. Deng: Before Clint passed on, he had enrolled me to a professional psychiatrist. However, I felt that the psychiatrist did not understand me well. So I did not continue with the treatment. Q: So how different was life after your brothers died?

Deng: Before violence broke out in Darfur and our village was attacked by a group of militiamen, we had a relatively peaceful life. I would spend my days in the pastures together we my brothers. We were very close as brother and friends. Both my brothers had been initiated while I was just about to be initiated into adulthood through a number of rituals. After the attack, the arrangements for my initiation ritual were halted. Q: Do you think your living in Australia has had any improvements in your life?

Deng: the fact that the quality of life here in Australia is far much better compared to the one at home. However, I feel the need to go back to Sudan one day and trace my mother and younger sister. The loss of family is the greatest loss one can have and it cannot be compensated by anything. I thus vow to give it my all to find them. Q: Do you think you have emotional problems. Deng: Everyone in this world undergoes emotional upheavals. So I could not say with total conviction that I do have emotional problems.

Q: In the recent past, you have run into problems with authorities. What do you have to say about that? Deng: I believe that I do not have a problem per se. The police are unfairly targeting me as they always do to all immigrants. Q: Does that mean that you feel you that you are a victim of racial discrimination? Deng: Yes. Majority of the people view me as a social misfit and a criminal. Again, I have encountered discrimination on another level, my prosthetic leg. This was one of the major reasons I could not fit in the school system since young children who happened to be my classmates taunted me a lot.

I wish to be around my people. I feel misplaced and disoriented from my country, people and culture. Theory Effects of prejudice Different forms of prejudice may contribute to a long term effect on the victims health, education, socialization and ultimately to their general happiness.

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