Recovery-Oriented Approach to Assessment - Case Study Example

Social Work Assessment Justine Mental Health Case Study Recovery-oriented approach to assessment The concept of recovery-oriented approach owes its origin to 1970s and 1980s consumer movement. Ever since that time it continues to be further developed and utilised internationally by people who have lived experiences in this domain (Slade 2009; Anthony 2007). In mental health settings this is employed in many different ways. Even though there is some ambiguity around its transition to practice or around its definition but broadly it includes principles centered around self-determination, self-direction, person-centered and individualised care; consumer empowerment, integrated and social care; personal growth non-linear journeys and healing, peer support, and approaches that are strength-based. Psychologists have divided the outcomes of recovery-oriented approaches based on their clinical significance or parameters of personal recovery. When cessation or reduction of symptoms occurs, it can be bracketed within clinical recovery which tends to restore social functioning. But when personal growth is achieved through a holistic process, it is termed as personal recovery. In all, recovery-oriented approach emphasises social inclusion, hope, self-management and goal-setting. In the social worker settings, recovery is primarily based on a coaching relationship between the consumer, like Justine in this case, and the social worker and thus involves achievement of overall wellbeing through holistic approach, which is normally away from the pathological view but very close to building strength at the individual level (Davidson 2008). This type of setting aims to deliver that part of mental health service component that helps consumers like Justine to maintain a satisfying and meaningful life, apart from creating a self-determined and self-defined personal identity either with or in absence of any significant pathological overview of the symptoms (Shepherd et al. 2008). Given what Justine eloquently explains regarding occurrences with her life so far and the fact that she is fully aware of the current situation, recovery-oriented approach to her assessment and case would be highly suited as against the traditional medical model. This is because recovery-based model has been found to be far more effective than the other one as the latter focuses on dysfunction or defect within a patient (Mosby’s Medical Dictionary, 2008). Recovery from the condition in which Justine's case falls is a relatively new concept. A consensus statement that has been previously developed has termed recovery from a mental health condition as a journey of transformation and healing and rendering a person with mental health issues as capable of living a healthy and meaningful life while developing full potential in the community he or she lives. This statement was developed by a group of mental health consumers, providers, family members, researchers, advocates, managed care representatives, accreditation organisation representatives, local and state public officials (SAMHSA, 2004). Justine very well recognises her state of mental health and needs to be reassured that the condition does not need to be chronic or lifelong and that there is hope for her. This background makes her understand the goals of the approach easy and that attaining a meaningful life again, just as the period she terms as "happy most of the time" is very much round the corner. Key factors in this case To understand the key factors in Justine's case that need to be considered before undertaking a recovery-oriented assessment and case management plan, it is important to go deeper into the transition of her life. First and foremost she is an offspring of a mixed race, which has led her school mates tease her often. That she believes that she is "unattractive" shows that she is not comfortable with her mixed race identity. It is, however, a point of importance that this seeming "inferiority complex" is not her own in the making but sort of imposed by external behaviours that she has been encountering at school. On the personal note she seems to have been brought up well so much so that even though she was close to her mother, but she turned to her father when she had problems of serious nature. This means that she had capability to make choices on her own and give them a logical dressing too. That might be her inner confidence, though unfortunately masked by an inferiority complex, but an important factor that could help her in attaining a satisfactory life once again. This trait of hers also reflected in her academics where she outshined other students in her class. That she terms this period as the "happy" one indicates she felt rewarded in her achievements, which signifies a positive outlook and progressive bent of mind. Or, in other words, her life till then was streamlined and completely focused; until attention from boys started distracting her - another external influence that encroached on her private space. Despite the fact that this was the beginning of her long hurdled life ahead, it is highly commendable to note when she says she prefers to forget that time as "past should stay in the past only". This reveals her high degree of optimism and also her willingness to look forward to the future. This is advantageous for a social worker who would work with her on her condition. Negative occurrences from her school days and the subsequent aftermath have made Justine scared of society since she believes that components from it have been instrumental in robbing her of happiness. As a result of this she prefers social detachment – even if it does not bring any positive results to her, it does not do any damage too. This is why she feels anxious when social functions are thrust on her without any prior information. Over a period of time she has bracketed even her parents into this disturbing social fabric; one reason why she now evades them as well. Justine’s case could be dubbed as a cooperative one as she provides even the minutest details of her life in a very elaborative manner. Bland, Renouf and Tullgren (2009) have remarked that in order to handle mental health cases properly, it is important that they must be thoroughly knowledgeable on the case, should have values and skills relevant to the same and must be able to assimilate the lived mental illness experience. Understanding consumer perspective plays an important role in establishing a healing relationship with the consumer. Rapport building with consumers who detest social proximity is both an art and a tricky part in such social worker-consumer associations. Patron of the bar, with whom Justine got friendly, seems to have built that rapport inadvertently and suggested her to seek support from a social worker. Bland, Renouf, and Tullgren have remarked that while the U.K. is not so much sure on how to deal with mental health content in the course curricula on social work (p.9), Australia is doing a great job in this direction. For its mental health students it is providing well-researched content drawn from years of experience and expertise. Social work theory or theories in the assessment Two possible relationships have been established between theory and assessment. The first, relationship theory, seeks to explain and examine the processes and nature of assessment or political and social functions that it performs. In this regard the most widely talked about theory is the social constructionist perspective. Another relationship pertains to sets of systematic ideas or their likely existence which determines which type of information can be collected, then collated and then analysed to establish understanding of a given case. Once that is done, it paves way for recommendations and which go into the making of case management plans. This theory is best used to understand the nuances of human actions and experience provide explanations for the case being assessed and yield guidelines on how to proceed with a specific consumer-centered response. All this is done by using tools and models for assessment taking. This theory has been found to be effective by qualified social workers since it sets out benchmarks vis-à-vis the metal health consumer need and methods and models of assessment (QAA, 2000). Crisp and his colleagues, on the other hand, have argued that no single theory can fit all cases (Crisp et al, 2003; Shardlow et al, 2005). Furthermore, assessment has been also viewed through several theoretical underpinnings from, for example, social psychological and psychological perspectives, post-modern perspectives and models based on social exchange and systems theories. These include, but are not limited to behavioural theory, task-focused perspectives, solutions-focused perspectives, psychodynamic approaches, discourse and narrative analysis and critical constructionism. On the whole social work theories provide a base to understand application to practice and distinctive epistemological background either with respect to the case in point or application of social work itself. These theories provide an insight into the relevance and importance of sociological perspectives behind the influences on community, group or individual human behaviour. Social functioning and development and their understanding with regard to their physiological and psychological paradigms can be analysed by using these theories. These further help social workers in choosing appropriate methods and models for assessment, which includes factors that determine testing and selection of the desired information, the types of judgments that need to be made on a specific case and also the processes of decision-making after correct risk-assessment. AASW legal implications AASW or Australian Association of Social Workers is the lone national organisation in Australia which works for over 6,000 social workers in the country. Bland, Renouf, & Tullgren (2009) have quoted AASW that in Australia social workers, irrespective of their field of practice; have some consumers who present with mental health issues. A statistics reveals that until early this year there are as many as 1,300 mental health social workers who are AASW-accredited and in private practice. As per the AASW guidelines, Justine's case is fraught with several legal implications which have been outlined either by AASW or other organisations like United Nations. A social worker dealing with Justine has to first and foremost acknowledge her rights according to the United Nations resolution that details principles for protection of mental health consumers and outcomes associated with their improvement (UN, 2001). The social worker has to make sure that his or her focus stays on the interface between Justine and her environment and is adept at recognising its cultural, economic and social impact while leaving no scope for undermining its impact on societal wellbeing and mental health (AASW, 2008; Tew, 2008). The context of social work practice is also governed by the legal processes and laws that prohibit discriminatory overtones in interaction. Special care has to be taken in case of Justine because such discriminatory remarks from her class mates form the very basis of why she is needing counseling today. References Anthony W.A. (2007). Toward a vision of recovery: for mental health and psychiatric rehabilitation services, Boston University Press, Boston. Australian Association of Social Workers. (2008). Practice Standards for Mental Health Social Workers, Canberra: AASW. Bland, R., Renouf, N. & Tullgren. (2009). Social Work Practice in Mental Health: An Introduction, Allen and Unwin, Crows Nest. Crisp, B.R., Anderson, M.R., Orme, J. and Lister, P.G. (2003). Knowledge Review 01: Learning and teaching in social work education: Assessment, London: Social Care Institute for Excellence. Davidson, L. (2008). Recovery: Concepts and application, Recovery Devon Group, UK. Mosby’s Medical Dictionary, 8th Edition. (2008). St. Louis, MO: Mosby/Elsevier. Quality Assurance Agency (QAA). (2000). Subject benchmark statements: social policy and administration and social work: academic standards – social work (available at www.qaa.ac.uk/academicinfrastructure/benchmark/honours/socialpolicy.asp#11. Accessed November 05, 2012. Shepherd, G., Boardman J., Slade, M. (2008). Making recovery a reality, Sainsbury Centre for Mental Health, London. Slade, M. (2009). 100 ways to support recovery: A guide for mental health professionals’, Rethink Recovery Series, vol. 1. Substance Abuse and Mental Health Services Administration [SAMHSA], (2004). National consensus statement on mental health recovery. U.S. Department of Health and Human Services. (available at:: http://store.samhsa.gov/shin/content//SMA05-4129/SMA05-4129.pdf. Accessed November 05, 2012. Shardlow, S. M., Myers, S., Berry, A., Davis, C., Eckersley, T., Lawson, J., McLaughlin, H. and Rimmer, A. (2005) Teaching and assessing assessment in social work education within English higher education: practice survey results and analysis, Salford: Salford Centre for Social Work Research. Tew, J. (2008). Social perspectives on mental distress. in T. Stickley & T. Basset (Eds) (2008) Learning about Mental Health Practice (pp.235-252). Chichester: John Wiley & Sons Ltd. United Nations (2001). Principles for the protection of persons with mental illness and the improvement of mental health care: General Assembly Resolution 46/119. New York: United Nations. Read More