1. Recovery-Oriented Approach (ROA)
“Recovery is a personal journey which involves discovering a new and valued sense of identity outside of a mental illness; while accepting change despite limitations that arise from the illness, its treatment and personal and environmental conditions (Queensland Health, 2005).” A Central aspect of the recovery journey is the importance’s of hope. Hope encourages holding the belief that change can and does happen when concentrating on strengths rather than weaknesses, looking at the future rather than the past and celebrating small successes (Jacobson & Curtis, 2000). Jacobson and Curtis believe that hope lays the groundwork for the process of healing to begin (Jacobson & Curtis, 2000).
Recovery oriented approach focuses on the uniqueness of each individuals journey while taking into consideration the individuals socio-environmental factors, while looking at the characteristics of the whole person. (Bland, Renouf and Tullgran, 2015). Furthermore, the importance of focusing on strengths, positive outcomes and language recovery is highly important. As we need to focus on the goals, hopes and dreams of the person, rather than the symptoms of the patient. While understanding the person’s right to have access to the same opportunities as everyone else (Bland, Renouf and Tullgran, 2015). It had been found that the Recovery Oriented approach fits well within the Australian Association of social workers code of ethics and core values.
2. Planning Considerations
Planning consideration involves a five-step process that takes a deep look into preparation, gathering data, weighing up the data, analysing the data and making use of the analysis. These steps need to be considered as they help describe a logical process that helps guard against forgetting important elements. However, having these steps in place might not work correctly as planning needs to be an ongoing process whereas these five steps are just a guideline (Bland, Renouf and Tullgran, 2015). Additionally, it is important to look at how the referral came about, who initiated it and what expectations they may have been. It is important to discover whether the person at the centre of the referral understand its complexity and whether you are placing your client at risk due to the manner or purpose of the assessment. One of the most important considerations is the awareness of the interview setting and meeting space to ensure your client feels safe and comfortable (Trevithick, 2010).
Another key component is, mindful case notes and reading skills that need to be taken into consideration as all information recorded about a client should be impartial, accurate and completed with care (AASW, 2010). The AASW code of ethics states in section 5.2.5 it is essential to report only relevant details, reframe from using emotive or derogatory language while acknowledging the basis of subject opinions whilst protecting client’s privacy and others involved (AASW, 2010). Furthermore, under practice standard 7.1 and 7.2 it is important to record information appropriately whilst maintaining information in accordance with ethical principle and relevant legislations. Another key element to planning consideration is self-reflective practice which is a reflection of the process of critical self-determination, as it is the process of personal assumptions underpinning practice (Yip, K 2006). It is based upon the psycho-dynamic theory, which focuses on the unconscious and conscious aspects that are transferred between the worker and client (Yip, K 2006).
3. Prioritizing problems using key life domains
April is impacted in different ways by ongoing daily struggles. For example, she struggles to have positive social relationships since moving to Adelaide, this has caused her feeling a sense of dread due to feeling anxious when at social functions, feeling ‘on edge’ about her job, not doing usual enjoyable activities, avoiding going out rather spending most days sleeping till noon and avoiding and withdrawing from close family and friends. These are contributing factors to not feeling a sense of belonging nor love. According to Maslow, humans need to feel a sense of belonging and acceptance among social groups and to feel love and be loved both sexually and non-sexually (Maslow & Langelf, 1943). In April’s case, she has become vulnerable to loneliness, social anxiety and shows signs of depression due to the absence of her psychological needs.
Additionally, her quality of intimate and sexual relationships has decreased to a minimum since her move, she is currently dating josh who seems to make an effort in supporting her. However often Criticizes her, in particularly about her weight which is damaging her self-esteem. Maslow also noted that all humans have a need to feel respected, accepted and valued by others to help boost one’s self-esteem (Maslow & Langelf, 1943). Having josh put her down is hindering her self-esteem growth. Furthermore, April has become disengaged with josh losing the willingness to invest time to the relationship and eliminating her personal growth to flourish. These are strong indicators that April and Josh’s relationship is stable as she is experiencing psychological abuse. It has been found that April struggles to make it past Maslow’s second hierarchy of needs, seeing her struggle to reach her full potential in life is the reason in which this has become a major prioritizing issue. When addressing the sense of belonging it will help promote empowerment and self-worth.
Following on from this it might be important to discuss the life domain of managing/dealing with stress. April has been impacted from managing and dealing with stress for most of her life. In Aprils case her major stress stem from, her being bullied for her mixed race which lead her to believe she was ‘unattractive and fat’. From this it led her to be embarrassed about her mix heritage, rather than holding pride. She also began to feel extreme anxiety from the attention she received from boys at school. Further leading to a traumatic event of her being pressured into sex an issue in which she wants to leave in the past. For April to talk about the traumatic event it would be an initial step towards healing. However, sometimes talking about it can be a negative and impact the recovery process. In April’s case her attitude to leave it in the past seems to be an indicator not bring up the event, as it may cause further harm and affect her recovery. Additionally, she may not want to open up about the event as she may feel a sense of shame, stigma of being the victim, and being blamed also told the event is her fault.
Another, Stress in Aprils life could be her current life change of moving from a small country town to Adelaide. The stress of a new start, new house, the struggle of making new friends and trying to rediscover herself all stress points in her life. These can be psychological stress as it can influence the way in which one thinks about oneself and the world around them. April struggles with her physical appearance, she lacks care towards her appearance and interest in cleaning her apartment. As a result, for feeling unattractive at school through to not enjoying drama class nor work. From these previous events April seems to be trying to control her surroundings by evading people and places. These issues are taking away her quality of life but make daily interaction and communication difficult.
Following on from this it might be important to discuss the work, leisure and education life domain. April has recently lost interest in previous pleasurable activities such as her enjoyment of educational studies, drama class and attending work. April outshone other students at high school and was elected as a student representative. After high school, she attended university and graduated from an undergraduate degree and planned on returning to complete a post graduate degree. Education used to be something she really enjoyed and it was noted that high school was one of the happiest times of her life, but recently she has lost interest in pursuing any further education leading her to burn out.
April is employed in retail but does not like her job therefore has lost the motivation to attend and look for a new job. She describes feeling ‘on edge’ when getting ready for both her work and drama class. These problems can be linked to her feeling as though she does not belong nor feels accepted to these specific social groups. This shows presenting issues of anxiety and depression symptoms occurring, for example, depressed mood, loss of interest or pleasure in activities, loss of energy and the feeling of being on edge (DSM-5, 2013). The anxiety would be a contributing factor to distress or impairment in social, occupational areas of functioning.
4. Social Work Theories/Models of Practice
Strength bases approach is a useful theory as it focuses on supporting existing strengths, opposed to focusing on and staying with the problem or concern. It looks at what works for the client, how it works and how it can be developed to the client’s abilities. The strengths perspective understands empowerment as the central element to practice as it allows clients to make choices that give them more control over their presenting problem (Cowger, 1994). Its main focus is that everyone has potential and unique strengths and capabilities that define who they are (Rani, 2015). Strength based approach sees resilience as a goal that provides a conceptual map and guide to prevention and evaluation. Ensuring it is client driven and focused with a sense of hope, realistic goals and expectations (Rani, 2015).
It is clear April has many strengths she is intelligent and hard working to complete University and become a student representative who outshone which shows strong leadership skills and determination. Additionally, she has a loving family and friendship group which helped April discover her dependence and values, while helping aid her personal identity. She has a diverse culture of indigenous and Anglo-Saxon ancestry which helps build character, being open-minded, holding empathy towards other cultures and creativity which can be seen from her talent in drama class. These are thing we are able to grasp however it is important that we help guide April to discover her own strengths so she is able to build upon her empowerment and self-esteem.
However, it seems that more social connection would benefit April as the need to belong is where April runs into a road block. When looking at her environment it is full of resources so it is important to identify them as it will help empower her to improve her goodness-of-fit, while assisting in the recovery approach. To get April engaged back into the community we will use her skills and strengths she already holds and use her strengths to teach her how to deal with other tough situation in her life.
Another theory that would be helpful in April’s case is Crisis intervention as the stress in April’s life is impacting her normal day to day functioning levels. A crisis is an acute disruption of psychological homeostasis, when one usual coping mechanisms fail and there is evidence of distress or impairment (Robert & Ottens, 2005). Roberts seven stage model consists of the following, Assessment, Rapport, Identifying the problem, Feelings, coping skills, Action plan and Follow up (Robert & Ottens, 2005). By implementing Robert’s model, we need to define and understand the problem from the client’s point of view. As a worker, we will need to conduct a biopsychosocial assessment and a suicide assessment.
Additionally, it is important to build rapport by ensuring genuineness, respect and acceptance is shown to the client (Robert & Ottens, 2005). When identifying the crisis, it is important to focus on the client’s current problems, the one that caused the crisis leaving us to ask why now. Once the crisis has been identified it is crucial the client expresses feeling about their current situation. Having the worker perform active listening skills during this stage is crucial. During the fifth stage the worker and client begin to look at coping skills to benefit the client. Through the sixth stage we begin to look at strategies that empower the treatment plan, for example removing the means, negotiating safety, future links, decreasing anxiety and decreasing isolation. Furthermore, it is important the crisis worker plans for a follow up with the client to ensure the crisis is being resolved and evaluate the post crisis status.
From this it is important to work alongside April to gather a full understanding of the crisis that is persistent at the current time. The use of a crisis intervention plan would be helpful in this case to gather a sound understanding on the exact issue that is concerning April; leaving us to discover the straw that broke the camel’s back. When this is achieved It will be critical to allow April to express her concerns while we use active listening skills to challenge her responses to help her open up. When we have gathered a sound understanding on the presenting issue we are able to look at strategies that will help empower April. We will finally follow up with April to ensure the crisis is being resolved.
April may want to address her feelings of being on edge, or her anxiety when at drama class, work and at social functions, however this issue is dependent on the issue April raises. The use of crisis intervention will help promote self-determination and autonomy of April as the intervention seeks for her to make informed decisions on her own behalf.
5. Ethical and Legal Implications
As social workers, it is important to adhere by the code of ethics as it expresses the values and responsibilities which are essential to the profession (AASW, 2010). An ethical consideration that might need to be thought about in April’s case could be the value of respect for persons. Due to the fact April has stated she doesn’t want to talk about her sexual encounter. As social workers, it’s important we respect the inherent dignity, worth and autonomy of April. Additionally, it is important to provide a duty of care to avoid doing harm. We could cause harm to April if we were to explore her previous sexual encounter, leading us to cause harm and affect her recovery process. This is important as April has the right to self-determination whether or not the social worker believes they have made a right decision. Furthermore, it is important that we obtain knowledge and understanding of Aprils racial and cultural affiliation, identities, values, beliefs and customer while working with her (AASW, 2010). While it is important to respect diversity, and ensure anti-oppressive practice is at use, while seeking to prevent negative discrimination and oppression (AASW, 2010).
Bibliography
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Yip, K 2006, ‘Self-reflection in Reflective Practice: A Note of Caution’, The British Journal of Social Work, vol. 36, no. 5, pp. 777-788.
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