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A reflection of a Social Work Experience
As reiterated by Parker (2010) reflection is a central tenet of a social work education program. It is particularly important students attached in placement settings as social workers. Reflection gives those involved an opportunity to review their experiences, how they made decisions and how they could have improved the situation with better approaches. A critical reflection enables those working in social contexts to reconstruct and reconsider social discourses that are dominant in their settings. In this paper, I present my reflection experiences during the time of social work placement. This reflection experience specific relates to a case of a drug addict who I deal with during this time (Schon, 2002).
The particular case involved a man whom because of confidentiality issues I will name BF. BF is an African-American who lives in the outskirts of New York. The man was referred to our organization by the local authorities specifically to receive assistance from the experts. A review of his background shows that BF has on several occasions involved in petty criminal activities. The reason for involvement in these misdemeanors was to obtain money to quench his seemingly growing addiction. Further, BFs history of substance use goes for more than a decade with some social work interventions which had seemed not to work, otherwise he could have been a changed man. Some of the interventions he had received were depot injections which were meant to deal with his psychological difficulties and which he had found to be distressing.
During the whole intervention process, I usually met BF in a secluded room, which was usually one of the offices in our organization. This was to ensure confidentiality and stop distraction while the interventions were taking place. In other occasions, I could take BF for a walk while going for other appointments as well. This was a strategy to make him become closer and therefore be able to reveal more of him. This worked well since he became more open regarding his issues.
The setting for my placement was on a non-governmental organization which helps individuals who are engaged with drug and alcohol abuse recover from their problems. This entity is particularly involved in connecting alcohol and substance users to access various treatment options for their condition. These various treatment services include provision of counseling and advice sessions, methadone scripting, and rehab. Other services provided by our organization include support groups, detox and alternative therapies. Furthermore, the organization endeavors to support the wellbeing and health of individuals in the recovery process as well as their families. Additionally, the organization deals in various interventions in harm reduction including group work, substitute prescribing, onsite needle exchange, care planning, and group projects. In this organization, there are also special personnel who provide individualized and psychosocial recovery services to clients who need them.
While undertaking the intervention program for Mr. BF, there are many occasions where I was required to apply the various models which I had learned in class in regard to social interventions. Among these include the parfit model (1984), wellbeing model, need concept model, the Maslow model and the strength perspective. Both of these modes provide an effective social work intervention for individuals with social problems. Though I was dealing with just one individual, I found that it became easier when I sought the help of my colleagues and seniors in addressing issues that I was not very much conversant with. According to Ruch (2002), it is important to work in a team and seek assistance from colleagues and senior in social work context.
I also had to rely on various Acts and Legislations to ensure that the safety and rights of the patient were maintained in the whole process. Among these Acts and Legislations included the Drug Misuse Act, Care Act, Capacity Act and Mental Health capacity Act. Others were human rights Act, Mental Health Capacity Act, and Equality Act.
Prior to crafting my intervention plan for Mr. BF, I had to acquire important information regarding his condition from him. In this perspective, I used information from Taw’s book, “Social Perspectives” (2005) which stipulates that the core values in the social intervention model including having a holistic look at the individual and his situation, listening to their perspective while avoiding being bias and anti-oppressive practice. These aspects were very helpful for me during the time with BF. Furthermore, I began my assessment on BF’s psychological aspect during the first session alongside other aspects. This enabled me to note how his psychological issues were having a toll on his physical body.
After performing an assessment on Mr. BF, I came to a conclusion that the man was addicted to drug abuse. Therefore, I was careful to ensure that the patient gets the necessary help as required. I also noted that various interventions to help BF in his drug addiction had failed to work because of the consistence use of the substance. He had used the substance for a long time and for large doses to the extent that the intervention required was stronger. Thumbs (1994) points out that consistent abuse of drugs alters the normal functioning of the brain which makes the victim unable to control himself/herself. These changes were clearly depicted in the behavior of BF, who was not only seen aloof, but also restless as he was not able to stay in one place for a long time. Johnson, (1973) explains that when a large part of a person’s brain has been changed, quitting becomes so difficult, even if the patient feels like doing so.
The interesting thing about this engagement was that BF was ready to receive help on how to stop taking the substance despite his inability to do so. This is because he had finally found his actions regrettable as they had done no good to his wellbeing. I found out that this sense aligned with the Parfit model, specifically the theory of self interest. According to this theory, individuals make self interest as their supreme rational concern which also instructs them to make sure that their life is generally well.
As per this theory, individuals would not prefer to act in ways that would be detrimental to their future wellbeing (Parfit, 1995). A good example would be the irrationality of a teenager girl who engages in premature sex while knowing that such a behavior will jeopardize her schooling and future life. This therefore brings a conclusion that many individuals engaging in illegal activities do so out of their will. This made me ask BF on what could have influenced him to engage in such a behavior. He openly told me that he was brought up in a dysfunctional family where there were always family feuds. This deprived him of peace and love and thus with assistance of his peer group, found solace in heroin and alcohol. This observation concurs with the articulation of McLellan et al (2001) who points out that majority of individuals engage in drug abuse as a way of easing their suffering from depression, anxiety and other psychological issues. Indeed, emotional problems are a critical burden for many that they can use anything which they believe could suppress it.
Looking specifically at this case, I saw it fit to seek the help of other practitioners in the department. I came to an understanding that in many cases, Social workers may not succeed by working alone and they need a team to compliment their services (Trevithick, 2012). I took a step to locate a healthcare professional and provided him with the information about the condition of the patient. However, the professional in addiction matters had to work in cohort with me so were three people in this case. Nonetheless, I had told BF why it was necessary to want a doctor in this case.
During the entire process, I had to focus on adhering to the Human Rights Act, which ensures that the patient’s confidentiality in intervention processes were maintained (Gallop, 2011). Moreover, the patient was also given the necessary information pertaining to the kind of intervention and the expected outcome. According to article 3 of this HRA (1998), the private life and the family of the patients should be protected (Amos, 1993).
I had to emphasize to BF on why he needed courage for his condition to be leveraged considering the hard work that the case required. Scientific evidence suggests that for strong addiction cases, medications and treatment may be necessary to assist in the recovery process (Johnson et al, 2014). Furthermore, despite his strong case, successful management of the condition was possible, thus giving him hope. Indeed signs of hope were reminiscent in BF’s face when I assured him that he was going to be freed from the yoke of addiction and regain control of his life. I told him that in this endeavor, he needed my support and those of other practitioners that would be needed in this case.
Many substance users face discrimination and stigma from the society and professionals (Thompson, 2012). In light of this, practitioners must be conscious on how their assumptions and values influence their intervention approaches with the patient and their family. This is because if not handled properly, this can become an obstacle to identification and intervention of the problem. Practitioners are therefore, required to adhere to the stipulated guidelines on antidiscrimination (Seden, 2011).
During the course of the assessment and intervention, I had to take into perspective the anti-discriminatory practice both from my side and other practitioners that were taking part in this case. As pointed out by Razack, (1999) a practitioner’s awareness in anti-discriminatory practices are vital in collaboration across ethnic, racial, cultural and social boundaries. Nonetheless, it is significant to note that my believes, culture and view on the anti-discriminatory practice could influence the decisions and intervention process (Wilks,2005).
In this case, I found the relevance of empowering and motivating the service user in changing and making use of the recommendation and strategies we devised for him. In this endeavor, I utilized the Model of Change which stipulates that individuals can only change in stages. The cycle of change theory was particularly important in designing the appropriate intervention plan. According to this theory, drug addicts go through six stages of change. These include pre-contemplation, contemplation, preparation/determination, action, maintenance, and finally relapse. However, the model allows for a possibility for individuals to move back and forth. Relapses or slips occur when individuals who have been in the action stage choose to alter their minds and return into their previous stages (DiClemente, et al, 1998). In regard to the change model stages, individuals who are not ready to identify their situation and make the necessary changes are in the stage called the precontemplation. This is irrespective of the level of their addiction or the seriousness which their use of substance has caused to their wellbeing. Furthermore, these groups of people could remain at the same situation for sometimes but they can decide to change at a later time (Mental Illness Fellowship Victoria, 2013).
Mr. BF was apparently not in this stage considering his readiness to take part in the intervention program. Nonetheless, I reiterated to the patient the danger, harm and risk that the habit causes not only to his current and future life but also to others, relatives, friends and neighbors. I reminded the patient that at his age, he really needed to settle down by having a family and that it would be difficult to find a wife with his behavior. There was also a possibility for Mr. BF to cause his family members grief considering his behavior. I significantly put sense into Mr. BF head owing to his positive reaction that if he real needed to maintain a family, keep a job and be accepted in the society, then he strongly needed to embrace our intervention program positively. This sense actually encouraged him a great deal as he needed to be like other “stable” members of the society who had families, jobs and were not tagged with behavior that did not add any value to his life. In gaining his confidence, I had to establish trust and rapport and commended him for the bold step he was taking. Rather than criticizing him, I appreciated his commitment to change and the decision to take this initiative.
In essence, the experience with Mr.BF the drug addict gave me the opportunity to apply various recovery models and intervention approaches to help the addict. The willingness and readiness of the patient to receive help made the whole process to easier. This also made the patient himself to be a partner in the whole process. However, the hard part of the program was the fact that the addiction level for the patient had become too deep. It should be noted that the patient had been subjected to various interventions which had not bone fruits. Therefore, we needed more resources, time and different kind of strategies to deal with the problem. The best part of this program was when I began to see withdrawal symptoms from Mr. BF, an indication that the strategies we deployed had began working, after a shorter time.
During the entire process, I relied on Gibbs (1988) reflection model and Johari Window model of reflection. Both of these theories provided a cyclical approach to the social work intervention reflection. The models attest that reflection cannot be a linear process; rather, it is an ongoing and consistent process. This was particularly the situation on my case as I did not go through the reflection stages in a consistent basis. Rather, I was moving forth, back and sideways between these stages. In many occasions, I found myself returning from my starting point several times prior to reaching a holistic comprehension of the exact situation while considering and incorporating all the systems that had an influence to the scenario.
According to logical thinking, recovery may simply imply “a return to normal”. Though there are a broad range of traits and behaviors which may be considered as normal, drug use and addiction falls under abnormal category. In typical sense, addicts are faced with psychological, personal, and/or genetic issues which require a holistic approach. These issues may increase when the chemicals commence destructive work.
My thoughts and journal of critical events enabled me to comprehend the kind of work I was undertaking. They also made it easier for me to make sound decisions and justify the considerations and actions for this specific intervention. Another part which I found invaluable was support from my seniors, colleagues and other experts who helped in this case. As Yip (2006) points out, reflective modes are quite vital especially during the initial stages of the reflection. In this light, I was quick to develop and adapt the model which I found to be the most appropriate.