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Category Archives: Social Work Practice

Call to Duty

Young people today are exposed to more than every due to the accessibility of online content and technological developments. The pressures we knew as just part of growing up morphed into potentially dangerous situations with the ability to overwhelm the senses. Young Minds developed a youth led campaign to create a coalition fighting for the mental health and well-being of all young people. Out of this initiative Young Minds Vs was born. It launched in January 2014. Their goal is fight the rising pressures by:

– raising awareness of their campaign

– representing the campaign in the media and galvanizing the voices of children and young people

– working with local and national decision makers to influence services for children and young people

– partnering with organisations seeking to promote mental health among young people.

Young Minds Vs has consulted with 5600 young people to find out the big issues that are affecting them today. The outcomes revealed the biggest pressures facing young people today are:

– sex

– bullying

– school pressures

– lack of support and help; and

– future prospective i.e. – unemployment

As professionals it is our duty to help young people achieve stable living environments free from oversexualization, being harrassed due to perceived differences, with appropriate support for development and solid prospects for the future. It is up to the adults in the lives of children to make sure we are safeguarding and protecting them frrom mature content and situations which can impede their development of positive self esteem, healthy relationships and assure them there are places to get help should they need it at any point in their development.

Over the next couple of weeks I will be tackling the facts of what Young Minds Vs research has found, what is currently on offer to assist with these issues and what more we could be doing to ensure young people can grow with minimal external pressures to derail their development.

 

 

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Posted by on October 24, 2014 in Social Work Practice, The Social World

 

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Substance Abuse Top Up

I think we are all aware that people use drugs and alcohol for a number of reasons, to self medicate, escape, experimentation, pressure, the high, because it is socially acceptable in some circles, to block out pain and a myriad of others specific to each individual.

This post is just a top of some of the types of substances and the effects on the body.

Drug categories:

  • Stimulants: e.g. – amphetamines, ecstasy, speed, cocaine, caffeine, MDNA, ephedrine, nicotine, taurine, crystal meth, Yaba, khat. They create fake messages in the brain, telling the body that it’s under stress. Blood to skin decreases, the body is less able to cool itself and overheating is a risk. Heart rate speeds up and blood vessels to the heart constrict. The liver releases sugar into the blood, reducing the body’s energy stores.
  • Depressants: e.g. – alcohol, heroin, cannabis, downers, GHB, opiates. They slow messages between the body and the brain. Signals from the eyes and other senses reach the brain slowly. The heart rate drops leaving the body with less energizing oxygen. Breathing rate decreases, risking lung infections. Messages to the muscles are slower, arms and legs unable to move well.
  • Hallucinogens: e.g. – LSD, magic mushrooms, toads (secretions). They cause increased heart rate, nausea, changes in sense or perception of time, intensified feelings and sensory experiences, seeing, hearing, touching, or smelling things in a distorted way or perceiving things that do not exist
  • Prescribed: diazepam, lorazepam, Valium, prozac, morphine, cough mix/codeine, methadone, paracetamol, risperidone, ritalin/stratoren, inhalant, opiate painkiller. These are prescribed for pain relief, drug replacement, anxiety, seizures, but as we know can be addictive and abused.
  • Legal highs: too many to name as they can be purchased from anywhere. This can include glue, paint etc.

Categories are based on what the substance does to the body not the effects or side effects.

For further information:

http://starlite.crchealth.com/what-do-drugs-do-to-your-body/

http://www.nhs.uk/Livewell/drugs/Pages/Drugsoverview.aspx

For children: http://news.bbc.co.uk/cbbcnews/hi/newsid_1610000/newsid_1610400/1610400.stm

http://www.dailymail.co.uk/femail/article-104764/Recreational-drugs-body.html

https://www.youtube.com/watch?v=JNpYCxFTmqI

 
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Posted by on October 22, 2014 in Social Work Practice

 

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Good Practice in Making Referrals

This is just the list of things I find crucial in referrals, as some one who has made and was in charge of accepting them. Please feel free to share any other points you feel help in this process as well.

When thinking about making a referral it is important to:

– discussing the issues prior to the referral with the client (what are your concerns, why do you believe this referral can help, what is the stance around confidentiality, will you be asking for updates if so how much detail,)

– explaining the pros and cons of engagement with the client

– discuss timing with the client – when would it be proper to refer if now is not the time

– decide or assess the level of need and if it is a matter for referral or if consultation would suit the situation

– talk to the agency about the appropriateness of the referral and establish a working relationship for future reference if consultation is good enough

 

If the client has decided they are willing to work on the identified issue and consultation isn’t appropriate:

– be clear about what I would like the service to do for my client

–  be able to articulate the clients needs appropriately

–  have at least a minimal understanding of what the organization does

– understanding what the service you are referring to can offer

– understanding the limitations of the service you would like to refer to

– not being bullied into making a referral by managers to “cover yourself”; this helps no one – not you, not the client and not the service you are referring to

– make sure forms clearly outline what the current issues are and your recommendations (if you have any)

– make sure you let them know of any other services involved (with consent if client is voluntary)

– make sure they are aware of any statutory measures in place to which they may need to be party and understand how much of their treatment or working processes they can share

– if possible, share your own assessment as appropriate

– if participation in the service if part of an intervention or care plan, make sure they have a copy of that

 
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Posted by on October 17, 2014 in My Practice, Social Work Practice

 

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What Social Work could learn from Pyrex

I know the title is a bit weird, but you know I will take you on that journey. Pyrex is a hard heat-resistant type of glass. I have a rectangular Pyrex pan that I use to make my macaroni and cheese. The pan itself reminded me of one of the major skills social workers need, transparency.

Transparency is a working principle implying openness, communication and accountability. I find it a good analogy for social work, or what social work practice should be. My pan is completely clear so when my mac and cheese is baking (working) it is easy for me to see what is happening within the pan (social service structure) from every angle. I can’t see the substance within the mac and cheese, but I can see that things are happening, that change is happening. When we work with our clients, because we don’t live with them, they cannot readily see what we do to help them. But, if we are transparent from the outset (and I will explain what this transparency look like in practice) then we set a foundation for the relationship where there are no surprises. They know what to expect and give them a degree of certainty. It is a matter of respect, facilitating their self-determination and decision-making as well as creating and honest working relationship.

Comparing social work to Pyrex is just my way of saying we need to be working in a way that we are happy for anyone to scrutinize because we are being open and honest and are communicating our process of helping to clients and superiors as best practice.

In social work true transparency means that, as a practitioner you are having discussions with your clients where you are

– clear about what your role is and how you will execute it

– clear about what you’re required to do and at what points

– clear about the steps you need the family to make

– telling your clients the consequences of noncompliance, honestly (discussing all their options)

– clear about the outcomes you need to see to shut your service

– understanding they don’t want you there and acknowledge it

– working with them, not doing things to them or for them, clearly outline everyone’s responsibilities.

– [in assessment] clear about the information you need, why and how it will be used (reassuring them that they will be given copies and are able to comment

– [in planning as a matter of respect and collaborative working] clear about what needs to be done, who is doing it and agreeing to help the clients with issues they consider important as well and scheduling a review

– [in review] acknowledging what they have done well to date and what still needs to be done

That’s my list. I am sure there are other things you can think of that show transparency in the working relationship. Please feel free to share. Let’s keep good practice flowing.

 

 
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Posted by on October 15, 2014 in Social Work Practice

 

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Referral vs Consultation in Social Care

Working with partners and other professionals could be a great step in professional development for social workers. There is a culture of making referrals to specialist services to address issues our clients face. Social work interventions have the potential for more depth than they have ever been allowed in its history here. In the last few years, local authorities are stepping up to give social workers with skills in systemic practice. The view is helping make interventions more robust so they have a greater impact, improving outcomes for family.

The focus of systemic practice is composed of two elements: working within a clearly identifiable process and retaining a focus on what is happening and why¹. I can see the validity in helping social workers understand these key issues but the development of social workers is not going to happen through one particular model, but that is for another day.

The referral culture in children’s social care limits the work social workers are doing with their clients. It puts clients in a place of having to regurgitate their stories repeatedly to professionals. There is a better way, a way that would help us create more defined and stronger relationships with our clients, reduce duplication of work and re-establish social work as experts in working with people. Consultation, on a larger scale, is the way forward.

A referral is an application to a specialist service to treat a specific issue. However, as we know from working with people, there are varying levels of need. In my view, referrals should be saved for the higher levels of need. Higher levels of need are where the issues are entrenched and need specialist treatment outside the scope of social care or remit of the organization. Issues such as clinically diagnosed mental health disorders, long-term substance misuse, dual diagnosis patients, etc.

                                                          CLIENT >>>> SOCIAL WORKER >>>>> SPECIALIST

In lower levels of need, I believe consultation would serve the purpose and still allow social workers to undertake the work of the remitting organization. Consultation is a discussion with a specialist about their area of expertise to get tools, techniques and guidance on how to work with a particular client exhibiting this issue. [Consultation with other professionals is also a way to understand if a referral would be appropriate to a particular service.] Consultation with lower levels of need is an opportunity for social workers to increase their working tool kit and develop further skills in working with people with complex issues. Consultations are more appropriate at the start of an issue when education and brief intervention may be enough or when there is an established relationship with a professional and their intervention is affected by the specialised issue but introducing another professional might damage the working relationship.

                                           CLIENT <<<<<< —- >>>>>> SOCIAL WORKER <<<<<<< SPECIALIST

This is not comprehensive and again, having the consultation with a specialist service will be able to tell you if a referral or a consultation is most appropriate.


¹ Thompson, N. “Social Work with Adults” in Social Work: Themes, Issues and Critical Debates, 2nd Edition (2002) chapter 25, pp. 292

 
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Posted by on October 13, 2014 in Social Work Practice

 

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Hope at all costs

Silent killers:

Cynicism: I have, unfortunately, come across Social Workers who no longer believe people want to be helped. They have been in the business for so long that they become jaded. They are unable to identify the strengths in people. It is a shame because this view can cloud ones ability to truly effect change. What we do as Social Workers is difficult. We listening to some of the worse stories. We are exposed to the worst side of society on a regular basis. I understand where the cynicism comes from but when it becomes vocal it can spread. One of the most inefficient services you can run is one where the staff don’t believe that people want to be helped.
When you give up hope for a child: I have heard the statement “well you know where he/she is going to end up” too many times.LaoTzu is to reported to have said:

“Watch your thoughts; they become words. Watch your words; they become actions. Watch your actions; they become habit. Watch your habits; they become character. Watch your character; it becomes your destiny.”

This is so true when you work with people. We need to be mindful of what we think of our clients. We won’t always like our clients but if they are coming to us for help we need to believe they have capacity to change and to help without judgement. When you stop believing children can change or that a situation can change for a child you are limiting what you are able or willing to do in order to change things for that child.

When you stop treating children like children because they are able to mimic adult behaviour: I don’t care how old a child is, if they are still a child then that’s how I treat them – age appropriately but they are still a child. I don’t believe that just because a child can mimic adult behaviour they should be treated as such. It is usually because they have been exposed to adult situations long before it was appropriate. For me this means even more that I need to help them get in touch with the child that they never got to know. When I see a child who has mannerisms of an adult, it makes me want to help more. It makes me question what happened to them. We have to remember, or set an internal trigger, that children who are exhibiting age inappropriate behaviour – over sexualized, parentified, young children able to use swear or derogatory words correctly – have been exposed to this behaviour and the parents or carers should be questioned extensively about those things to which they are exposing children.
When you stop seeing possibilities: When you don’t see that change is able to happen you become ineffective as a social worker. Social Workers are change agents. We see changes where others see problems. In my view we are that hope that others are unable to see. So, when a Social Worker is unable to see a way to make a change or that change is possible, it may be time for a career break.
When you no longer respect the small wins: Many of the people with which we work are so disenfranchised they don’t get to experience many wins at all. Sometimes, the best thing we can do with them is celebrate those small wins to help them prepare for future successes. When they can see that even small change is possible they can start building their own hope. It’s about empowerment. Respecting those small wins enriches your relationship with your clients, it gives them the sense that you believe in them – even if they don’t believe in themselves, it helps them begin to believe in themselves.

Hold Out:

Know where you are. We are told to meet our clients where they are, but it is important to our work that we know where we are as well. In order to be effective helpers it is important we understand how our work effects us as individuals and seek support so it doesn’t begin to darken the way we see the world and our clients.

Believe in a child’s ability to change. This may mean going outside of the traditional treatments to something that will reach a particular child but, as behaviour is learned, it can be unlearned and changed with support and positive reinforcement. As with adults, when you reward and acknowledge those smalls wins you start to empower them and help them develop hope of their own. Children need boundaries, stability and guidance. Where they don’t have this at home, or may be in care, it is crucial that, where we are involved, we are providing them with them and believing in them.

People under the age of 18 are children/adolescents. There may be those who disagree with me but as someone who has worked with adolescents who craved attention, wanted hugs, were effected by the fact that I can’t give them the attention they want and are still throwing temper tantrums – they are children. I worked with looked after children, children in care to the local authority, and many of them had horrific things happen at crucial stages in their development. Trauma in early stages of life effect a person later in life. Even as I worked with them, I recognised they were missing the childhoods they were never able to live.

Dream: See the possibilities. Believe change is possible. Believe people when they tell you they want help but be clear that you are not going to work harder than they will. It may be a fine line but you are on a way to burnout if you are working harder than your clients. Believe in people’s ability to change and communicate that, but also communicate that it is their lives and you can’t care more than they do.

Respect the small wins. Appreciate the effort it takes people to actually change. Acknowledge how difficult the journey must be for those who have traveled their own paths.

Social Workers do a hard job everyday. It takes it’s toll on us mental, physically and emotionally. We must remember to take care of ourselves so that we can continue to support, empower, encourage and care for others.

 
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Posted by on September 26, 2014 in Social Work Practice

 

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Professionals missed significant opportunities to protect murdered toddler

653This appears to be a running line across serious case reviews but it is unclear what happens once it is uttered. The one thing that is clearly done within a local authority, once a serious case review has been undertaken, is that there is a slew of either “voluntary” resignations or outright dismissals. In terms of practice however, there doesn’t appear to be a change if we are getting the same outcome/recommendation from every case review.

Of course, being me, I have some recommendations.

1- it needs to be drilled into the minds of medical staff and professionals that Safeguarding is EVERYONE’S responsibility.

This comes from a range of things from their unwillingness to report, the signing off of sick notices on the word of a parent, over reporting or escalation of details to warrant a response, unwillingness or lack of confidence in challenging parents of children with significant injuries, etc. I am sympathetic to the fact that they have a limited amount of time in which to do their exams etc. but I would challenge them with this: If this was your child being brought in by the person who you charged with their day to day care while you were working, how would you like it to be handled? Whatever their answer, that’s what you should be doing for everyone’s child. There shouldn’t be one rule for how your child is managed and how everyone else’s child is managed.

2 – professionals across the board need to become more confident in challenging parents and being more aware of the care given to children.

This includes those across housing, education, and any other public service. I have to say that I have seen partners in education really step up and are getting in right in many places but we still have work to do.

3 – this trend of blaming IT needs to STOP!

We already know there is a problem but what is being done about it. Why isn’t there a national medical database with indicators that can inform other medical professionals when an injury is suspicious, i.e. it is not discernable whether or not this is an accidental injury? Why isn’t there a system in place to alert other locla authorities to homeless families entering their area?

4 – Blame should not be the game. Change should be the game.

I don’t understand, from someone on the outside looking in, what is being done to change the way practice is being supported to ensure these things don’t continue to happen. In the case of Keanu Williams it is said that the Social Worker actually presented a “well-argued” case to have Keanu on a child protection plan but this was not taken up by conference. That is reflected in a small section. I am sure that had this Social Worker not idetified this risk it would have been on every page about how he/she failed in her duties. As a matter of fact the first line of the Community Care article says “Social workers and other professionals missed significant opportunities to protect a toddler who was murdered by his mother in Birmingham two years ago.”

Where is the recognition that a Social Worker did raise this concern and it wasn’t taken up? There is one sentence. It is not to say that there shouldn’t have been challenge or a further attempt to push the agenda (this is something that needs to be present throughout all professionals), but at least have equality in how things are reported.

There has to be themes that run through these serious case reviews and somewhere that records what these are. I am going to go on the hunt for them. I know one theme is parents who themselves have been through the care system. But there have to be others, like frequent moves etc.

Once we get the themes we can create a plan. Another theme that has run throughout is for “more joined up working.” This is just another useless phrase unfortunately. It has been talked about in circles but nothing has been done about it. How do we as professionals share the relevant information needed to protect children from abuse? How I ask?

 
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Posted by on September 24, 2014 in Social Work Practice, The Social World

 

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