Evidence Based Case Study Social Work Essay

Evidence ground Case Study loving crop EssayEvidence ground suffice (EBP) refers to integrating professional competentise with the best available foreign question, and incorporating the views of service mappingrs (Beresford, 1996). Evidence establish devote has received its reputation by examining the reasons why interventions are necessary (Duffy, Fisher and Munroe, 2008). Within my beamment EBP was in-chief(postnominal) for refining my ferment out so the service utiliser was willd with appropriate accompaniment for her various(prenominal) guide in full. I someonea my EBP to carry out research to t apiece what consequence alimentati aced or rejected the use of a detail intervention in spite of appearance this case I apply a mien approach. The principle of loving rick intervention is to provide good practice and should be based on a decision-making character reference model (Preston-Shoot and Braye, 2009). This fashion model operates on four purpos es- The code that avouchs a decision companionable work ethics and NISCC codes of conduct Information to ensure a well-informed decision cognition drawn from research, possible action, practice and other professionals. In addition to tycoons and duties of well-disposed workers, legislation embeds nonions of alliance, respect, rights and anti-discriminatory practice, which are key elements in complaisant work practice (Preston-Shoot and Braye, 2009).My practice schooling fortune confused working with adults with a culture disablement in a day negociate setting. The benefits of the day centre were to provide a service for local sight to access concord in living with, or caring for someone, with a schooling disability. Northern Ireland statistics aim that in 2008 there were 9,460 people with a encyclopaedism disability in collision with Trusts (www.northernireland.gov.uk). From the 9,460 people with a learning disability there were 2,574 benefiting from beari ng management, 42% (1,086) of whom were cosmos beared in their avouch homes and 35% (898) creation condole withd for in residential homes solely for the use of people with learning disabilities (www.northernireland.gov.uk). This evidence based case study is based on fille A, a 35 year old woman, who has a learning disability and Spina Bifida resulting in her using a wheel chair for mobility. Within the past a few(prenominal) years mislay As family flavour has changed dramatically. In previous(prenominal) years fall behind A had lived in the community with her elderly parents, who dod for her. She is one of ternary children and has two older brothers. leave out As induce, after being diagnosed with Dementia, was admitted to a residential parcel out home. Her paternity after having been moved to residential care himself passed away in November 2008 callable to his physical health. daughter A straightway resides in a private nursing home and attends day care three days per week. In March 2008, there were 75 residential homes in Northern Ireland solely for people with a learning disability providing 898 places (www.northernireland.gov.uk). fall back A has been previously diagnosed with MRSA it is currently located in her toe, having been previously present in her urine. Treatments from the residential care staff view the transmission under control, however the infection still remains. The fresh death of her become plays a significant role in frivol away to the woods As behavior and continues to affect her complaisantly and emotionally.Some of the stereotypical assumptions I had in front get together lose A were that because she had a physical and learning disability that she would be hard to communicate with, that she would pay off limited savvy and limited literal skills. I have challenged this opinion and realised that send away A is a very competent individual with good communicating skills, and can give tongue to her like s and dislikes proficiently. As for her physical disability this does non affect her cognitive or cerebral functions. I had to a fault do the assumption that as cut d admit A had MRSA that it could easily be cross-contracted due to a lack of association and education. After researching the issue and contacting infection control within the Trust I deducted that MRSA is a problem within clinical settings but can be easily controlled with proper preventative procedures. This can be identified as a risk, but should not be a reason to curb or discriminate neglect A.After having initially met swing A, liaised with her neighborly worker, accessed her case file and Tuned In to her life issues, I met with break loose A to prepare for the initial perspicacity and gather selective information into how best to accompaniment her. My role with little girl A was to provide a re ratement since the changes in her circumstances and the death of her father. My role was to determine what s upport she may need, and to complicate her wishes and olfactionings.AssessmentHistory has shown that there has always been an importance to prizement in social work, but since the 1990s there has been specific importance to a new form sagaciousness to include risk. The National Health military service and Community Care strike 1990 stresses the importance of inter-agency collaboration and a multi-disciplinary estimation treat (Trevithick, 2000). The purpose of an sound judgment may seem evident that is, to assess the needs of individuals who may need service of run and/or support. In recent history however estimate seems to mean a relationship mingled with need and available resources (Whittington, 2007, p23) leading to a question if this is ethical or effective practice? There are m any purposes of an appraisal, for example to assess risk, to assess need, to act as an advocate for someone and also to carry through agency and government insurance policy (Whittington, 2007, p25-26). Coulshed and Orme (2006) explain that opinion is an ongoing process where the purpose is to reckon people in relation to their environment it is a basis for patternning what needs to be done to nurse, improve or bring more or less change with the service exploiters start outicipation. The initial preparation for the assessment with pretermit A included chating her social worker and perusal her case file. This enabled me to gather information to dispel any preconceptions I had round meeting this service user. The social worker passed on her association of leave out A, much(prenominal) as medical conditions, family circumstances and finances, and also any previous problems that had occurred. I felt it was principal(prenominal) to work in partnership with dribble As social worker so I could keep her up to date with events, and also contact her if I required advice almost Miss A. The purpose of Miss As individual assessment was to gather information by in teracting and communicating with Miss A and others involved in her care, this was also to gain a holistic perspective to her needs. Her assessment was guided by legislation such as, the Chronically Sick and Disabled Persons Act (NI) 1978, which places a duty on health and social services to investigate a level of need, and also the Health and Personal Social Services (NI) roll 1972 which stipulates a responsibility to provide mortalal social services for the promotional material of social welfare for the general public (http//www.understandingindividualneeds.com). As a dumb set in motion of assessment I used Smales (1993) feignings of Professional Care which were useful in gathering measurable information about Miss A. I used the procedural and questioning model to gather information into how Miss A felt about certain issues in her life, such as the affliction of her father, contact with her other family, and other issues she felt were working or not working. I used these met hods of assessment as this followed Trust guidelines. I used The Model of Professional Care to gain a holistic understanding of information. I also included the Exchange model in the assessment as I pull ahead doed Miss A to be the expert of her own life. I regain the use of the Procedural model was useful in certain aspects of the assessment as it worked in collaboration with the Trusts format of assessment and worked as a form of gathering information, but discover I could have used more of an Exchange model to communicate in effect with Miss A rather than just form filling. I have Smales method of assessment provided me with tools to dish Miss A identify factors that were important for her to maintain, but also issues she would like to change. By working in partnership with her I felt we would have an open and trusting working relationship.I also focused on Person Centred Planning (PCP) in regards to the assessment with Miss A. Person Centred Planning, which evolved from t he White Paper a government policy known as Valuing People, suggested four key principles Rights, Independence, Choice and Inclusion as a proposal of changing services (Thompson, Kilbane and Sanderson, 2008, p9). This policy also facilitateed inform guidelines for Northern Irelands Equal Lives Policy (2005). Person Centred Planning focused on finding out what is important to and what is important for (health and unhurtty) Miss A. I found PCP a continual process of earshot and learning, by rivet on whats important to Miss A now and in the futurity (Thompson, Kilbane and Sanderson, 2008, p27). By using psyche centred tools, such as a one page profile, I gained knowledge of what was important to Miss A including her family, her dandy and her independence, as well as knowing what was important to keep her safe and healthy. I used a person centred approach to make others awake of Miss As great personality characteristics as well as the attend and support she would like. I feel th is was fundamental to demonstrate that Miss A is a person behind her disability. I found by using this approach was an essential skill in understanding Miss A and helped me to be anti oppressive and progressively support her needs One particular piece of legislation which I found to be significant in the assessment of Miss A was the Human Rights Act (1998), which identifies Miss As right to family life. Since the death of her father and the institutionalisation of her mother due to her mental health, Miss A has been experiencing disintegration of her family and has lost the support committed to it. The Human Rights Act could have a great significance as Miss A needs emotional and physical support to visit her mother and has not been receiving it therefore her right to family life is being impeded. The assessment identified that contact with her family and friends are imperative for this right to be upheld. thence as a result my role was to facilitate this right, and help to suppor t Miss A in retaining family contact.The main objectives we (Miss A and I) identified within the assessment were That Miss A had limited support to help discuss the death of her father. That Miss A was not receiving contact with her mother or other family and would like to.From the identification of objectives Miss A and I fixed to work towards solutions by preparing a work plan.PlanningAfter the initial assessment was carried out with Miss A we proceeded to work towards formulating a care plan and targeting her objectives. A care plan provided clear information for everyone involved with Miss A and helped work in partnership with her and the Trust. For a person centred care plan the word support is used in druthers to care because the verb implies that support is there to help people achieve their goals and ambitions (Thompson, Sanderson and Kilbane, 2008). A support plan is developed by the person with help where necessary, and it describes how the person intends to be suppor ted in order to live their own life (Thompson, Sanderson and Kilbane, 2008). I feel the use of a support plan with Miss A, rather than a care plan is an anti-oppressive method, as it incorporates Miss As feelings and opinions into how she wishes to be supported. I used the formulation of a support plan with Miss A to record the objectives she would like to meet and used these to fake an intervention. It was clear from the assessment and one page profile that limited contact with her mother was an issue, and that the death of her father had a significant impact on her life. I then proceeded to investigate theory of loss and grief as I had never experienced a loss of Miss As magnitude before. I found the Kubler-Ross Model and the 5 responses to grief to be particularly informative. (Goldsworthy, 2005). This theory helped inform my knowledge and in turn helped me be empathetic to Miss A. I was able to identify that Miss A can experience the 5 stages of grief and that they are not nece ssarily in a specific order. I felt Miss A was at two stages of grief, some days she experiences anger at her father leaving, and other cartridge holders she has deep feelings of depression of losing him. I was able to use Kubler-Rosss model to identify these stages in Miss A, and also to advise her that these feelings were part of the universal process of grief. The assessment also identified that Miss A had a lack of support in discussing her feelings of grief. Research suggests that people with learning disabilities experience many of the emotions of mourning but are limited in the opportunities they have to resolve their feelings of grief (Cathcart, 1995 Elliot, 1995 Read, 1996). There are many reasons for this and Murray et al explains that historically, professionals, parents or carers of individuals with learning disabilities believed that those in their care did not understand the concept of death and thus were unable to grieve for the loss of a love one (McLoughlin, 1986 Elliot, 1995 Read, 1996 cited in Murray et al. 2000). Kitching (1987) and Bradford (1984) highlight that the capacity to grieve is not unfree on a persons intellectual ability, but that a person with learning disability may experience grief in the same way as a child. Therefore research shows that people with a learning disability experience grief and loss but have a limited support network to discuss it with. I used this research to formulate a plan for the intervention with Miss A and we think that I could be support for discussing her grief. From the assessment and care plan with Miss A, and following discussions my practice teacher, I discussed that I would use counselling skills to help support Miss A with her feelings of grief. I felt Miss A needed her emotional needs met since the feelings of the death of her father were so dominant. Miss A and I also fixed that I would facilitate visits to her mother for emotional and physical support, as her mother was in the latter sta ges of lunacy and Miss A found it hard to communicate with her.Intervention precept for Counselling InterventionAfter having conducted an assessment and care plan with Miss A, and building a vibrancy over numerous meetings, it was decided that a counselling intervention would be the most appropriate form of support for grief. My practice teacher and I felt that if Miss A had the opportunity to discuss her feelings this would help her grieve more effectively and perhaps help her cope better.The two models of counselling that are prominent in social work are the work of Carl Rogers and Gerard Egan, who base their counselling approaches from psychodynamic work about inner thoughts and feelings. Both counselling theories reflect the social work value of accepting the individual, using skills in listening to the information that is given, and work towards a joint understanding and decision making about ways introductory (Coulshed and Orme, 2006). I focused on researching counselling theory to help me understand how I could help Miss A through her grief. Trevithick explains that within social work, humanistic approaches to counselling have been particularly influential, specifically with the work of Egan (1990) and Rogers (1961), primarily because they promote personal freedom and are consistent with anti-discriminatory practice and anti-oppressive perspectives (Trevithick, 2000). I found that the Rogers (1961) Person Centred counselling informed me that I could show flat positive regard for Miss A and understand that she is the expert of her own grief. I also analysed Egans (1990) clever sponsor Model and found it to be an effective theory for an approach to counselling. I found that the structure and framework of the model and the three stages were useful as a guide to follow. I found that although this method of counselling may not be as person centred as Rogers it could be more effective in assist Miss A understand her own grief as it followed a certain f ramework, could empower her and could be evaluated over time. This theory helped inform my practice by helping me realise that I do not need to be a qualified counselor to support someone I just need to be able to actively listen, to use empathy and be reassuring knowing that Miss As agenda is paramount. I consider this in itself to be a person centred way of counselling.I decided to follow a combination of Rogerian method and Egans approach to help support Miss A as an intervention. I decided I would use the structure of Egans model to help build a logical, consistent framework to the intervention, while using the marrow squash principles of the Rogerian approach to demonstrate my skills and set, such as working with respect, empathy, genuineness and good active listening (Coulshed and Orme, 2006).Counselling officeEgans Skilled Helper Model form of counselling provides a incorporated and solution focus basis. It is a three stage model in which each stage consists of specific skills that the helper uses to support the service user move forward (Nelson, 2007). Egans model is described as a three-stage process identification of the service users current issue(s) identification of the service users desired situation and the formulation of an action plan to achieve this. This process is facilitated by the ingenious helper using the skills outlines by Egan (Nelson, 2007).The goal of using Egans model with Miss A was to help her manage her grief and better understand the norms associated with it, such as anger or depression according to the Kubler-Ross Model. Egan (1998) claims his model is to help people become better at helping themselves in their usual lives. To provide Miss A with the empowerment to help herself grieve. The use of Egans Skilled Helper Model was to explore how Miss A felt about her bereavement. I used it to ask open questions about how Miss A felt about her father. We explored her past and discussed her relationship with her father befor e his death. I also used this stage to focus on aspects of her father before he died and what she missed about him, this was to explore and gather information about what her relationship was like with her dad. I was able to use a spue of skills to gather information about Miss As grief. Trevithick (2000) explains that social work skills are the degree of knowledge, expertise, judgement and experience that is brought into play within any given situation, course of action or intervention (Trevithick, 2000). Some of the skills I incorporated into Egans counselling were active listening, I used this skill with a range of non verbal cues to indicate to Miss A that I was raise in what she was saying. I concentrated on active listening as Miss A was portraying feelings and knowledge of the death of her father which was a sensitive subject and needed my full concentration. I portrayed active listening by nodding, giving eye contact and facing Miss A which were successful in helping build a rapport with Miss A, thus helping her open up. Another skill I feel I used well with Miss A was empathy. I feel I portrayed my feelings of empathy by responding fittingly to her answers and reassuring her that her thoughts and feelings almost grief were normal. I found myself using Empathy a great shell out with Miss A as I had never experienced bereavement before and she helped me understand how it felt. Its easy to imagine how someone feels, but when youre face up with helping them I felt I really needed to place myself in her shoes. I also found I made good use of silences with Miss A, I used these to give her time to reflect on her thoughts and answers. I have found by doing this that the meetings were paced better, and showed that she was the expert of her own grief and I was just there to listen and to ascertain her. I found that by using Rogerian person centred skills like genuineness, empathy, communication and active listening I was able to understand Miss A and show her that I was there to support with her agenda. Throughout the discussions of grief I feel Miss A was able to vent a potentiometer of her feelings that she had since her fathers funeral. I feel I was able to support her understand those feelings and help her recognise that anger, depression, or denial are normal feelings that many people in her situation suffer.Throughout Egans Skilled Helper Model and each of the seances with Miss A I found that she responded well to being able to discuss her feelings with someone. The Rogerian influence on the intervention enabled me to build trust, partnership and a good rapport with her facilitating an open working relationship and providing her with support.Some of the determine I tried to incorporate into my counselling and indeed my relationship with Miss A were empowerment and self-advocacy, by letting her know that her agenda was central. I wanted to nominate a balance of power and to provide a supporting role rather than a dictator r ole, which I feel I achieved by being able to listen to her views and incorporating PCP. Social work has a distinctive value base with beliefs and principles playing an important role in practice (Thompson, 2005). Challenging my values has helped me to treat Miss A with unconditional positive regard, and with the respect and dignity she deserves. I have challenged my values anti-oppressively by researching MRSA and not making assumptions about the condition I have challenged my stereotypical attitude around learning disability demonstrating that Miss A is first and foremost a person with feelings and issues before recognising she has a disability. paygradeOn evaluation of the Egans Skilled Helper Model and my intervention with Miss A have shown that her agenda was central to the sessions, a balance of power was necessary to achieve the trust and respect of one another and that listening is paramount to providing effective counselling. I entered the sessions with Miss A being insens ible of what to expect, I was troubled that I would not have enough knowledge about grief to help support her. After the initial session I soon realised that I didnt need to be a qualified counsellor to make a difference to her understanding of grief, I just needed to be able to explain her feelings to her and reassure her that they were normal and not as she phrased it being mental. I found that by working with Miss A using the Skilled Helper Model I was able to apply my skills of listening, communication and empathy to help her understand her feelings. I have never personally had a bereavement of Miss As scale before but feel as a remove result of working with Miss A I have in condition(p) that grief is a powerful emotion for anyone to experience and it can take a significant amount of time to recover from. The only wo I have of using the Skilled Helper Model was that I feel I did not have enough time to fully help support Miss A, I feel as I had a placement of only eighty-five days I did not have enough time to fully counsel her for the best outcome. I feel throughout the intervention process I tried to maintain person centred principles with Miss A by providing her with the opportunity to discuss what was important to her. Research shows that the use of Egans model is not person centred as it incorporates the counsellor to ask all the questions, and therefore have the control but I feel by working in partnership with Miss A to discuss the death of her father was important for her emotional well being and empowered her to help resolve her grief. I also incorporated Rogers core skills of genuineness, respect and trust to achieve thisConclusion Through working with Miss A I have found the experience to be priceless learning. I have discovered that there is a spectrum of ability with adults and their learning disability. I have found that each person is an individual, and that group care is not necessarily recognising of this. In regards to Miss A I have le arned not to make assumptions or stereotypes before meeting the person, as this can lead to oppression and even discrimination. Miss A is an individual, with individual needs, and at this assessment and intervention her emotional needs were prominent. I feel I completed the aims I had intended to by supporting Miss a through her grief using Egans Skilled Helper Model. I incorporated Rogers core skills into this model to help facilitate person centred sessions, and create an understanding that she was the expert, and I was there to listen and support her. If I was to fictionalise the intervention I would use Egans model again as it provided me with a structured, logical framework to work with and provided me with the identification of the skills I needed to make the sessions successful and effectively counsel Miss A.I feel my future learning needs from working with Miss A are to use more formal language as I identified I talked to her informally using words such as wee. I feel I di d this to appear more friendly rather than her social worker, but realise this is not a professional manner to work. new(prenominal) learning needs I identified were to pace the sessions more appropriately and ensure that Miss A understands the conversation. I feel during the initial sessions with Miss A I spoke more to engage her in the discussion, and feel this was more of a nervous reaction to having to counsel Miss A. During subsequently sessions I was able to take this skill into consideration and settle quicker into sessions to give Miss A the opportunity to discuss what she wished.Overall I feel my relationship with Miss A was good, I feel the assessment and intervention were successful, and I feel I worked in a person centred way incorporating knowledge, skills and values to inform my practice. I feel Miss A felt positively about our work together as her feedback from sessions indicated that she was commodious with the support I provided.References1. Beresford, P. (1996) The Standards we Expect What Service Users and Carers Want fromSocial Services Workers. capital of the United Kingdom National install of Social Work2. Bradford, J. (1984) Life after a Death, Parents Voice 34 6-73. Cathcart, F. (1995) Death and People with skill Disabilities Interventions to Support Clients and Carers British journal of Clinical Psychology 34 165-754. Coulshed, V., and Orme, J. (2006) Social Work Practice. 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Open University Press.18. Trevithick, P (2000) Social Work Skills A Practice Handbook. Open University Press.19. Whittington, C. (2007) Assessment in social work A guide for learning and teaching London.Social Care Institute for Excellence20. Williams, P (2006) Social Work with People with Learning Disabilities. Learning Matters LtdOther21. http//www.northernireland.gov.uk/news/news-dhssps/news-dhssps-october-2008/news-dhssps-101008-community-statistics-for.htm (10/10/08) (Accessed on 8 May 2009)22. http//www.understandingindividualneeds.com/policyandprocedure/statistics.htm (Accessed on 24 April 2009)