JOURNAL REPORT OUTLINE

Field experience:

One memorable experience with a client was interacting with Mr. AD, who was seriously ill and limited in his wheelchair. The experience was challenging, and empathy and sympathy were the dominant emotions emotions due to the patient’s state. This specific client had many physical disabilities, the key ones being central nervous system (CNS) demyelination, cerebral palsy, seizure disorders, and other complex medical conditions. Communication was mostly done with the patient’s caregiver, and the little conversation with the patient involved him speaking with nods or writing on his iPad due to his lack of speech. The SW also assessed asking questions from the client’s mother, who acted as his caregiver (Corey et al., 2018). The responsibility of the SW in this case was to be an observer, observing the patient’s condition, interactions, and needs and then providing the family with the appropriate services.

Significant information:

The first significant information about this client is that he was a referral case. A doctor referred the client because he had significant medical and physical issues. In the referral, the conditions listed for this client were seizure, cerebral palsy, hydrocephalus, CNS demyelination, spinal rods, hydrocephalus, and extreme physical weaknesses. The client was bound in a wheelchair and required 24 hours of full care. Since the client had surgery in December 2023 and another surgery scheduled for August 2024, there are indicators that the client has ongoing medical needs. The client’s mother is the primary caregiver and thus provides full care and aid, especially for daily living, such as bathing, oral hygiene, dressing, and feeding, among other daily activities. The client is severely limited and needs all the help he can get.

Relevant Factors:

The three relevant factors that must be considered keenly are this patient’s medical and physical condition. The patient has severe medical issues, including skin conditions, orthopedic issues, and serious neurological challenges. The second factor is developmental and physical factors, such as the fact that the patient could not speak even though they could understand. The client had only to nod when saying yes or no. In some cases, he spoke using an iPad with voice commands. The other factor is the family and social life of this client. The mother is important to this patient as the primary cagier. The mother also offers him emotional support. The client’s social life is limited because he is a wheelchair user. Cultural and social factors include the fact that he is a Raider fan, and the supportive relationship between the client and his mother is important and calls for family-centered care. In the case of this client, the client is at his lifecycle stage of late adulthood, and severe physical limitations mark that. From the group development stage, the care team can be said to be functioning within the norming stage of Tuckman’s model. What cannot be overlooked is that the SW, the medical experts, and the caregivers know the patient’s needs and work collaboratively to help the client. When considering the community program development, the program stage, in this case, is one of program implementation. Services such as In-Home Support Services (IHSS) and medical services are all in place. Regarding the research process, this case presents a data collection and assessment stage. The SW and medical experts collect data and reports, which are crucial for making informed decisions.

Description of Relevant Factors:

The relevant factors in this case are economic and environmental. The client uses a wheelchair and only depends on the mother for support and care, which means that the mother does not have time to take care of their financial needs. Secondly, the client has undergone surgery and is scheduled for another, which is also financially constraining. Therefore, The family needs financial support like medical insurance and domestic needs. The environmental factor relevant for this client is one where all the medical experts should be around him on a 24-hour basis (Corey et al., 2018). When looking at this patient’s medical conditions, it means that he should be under the care of medical experts and nurses all the time.

The identified strengths are that the client has a dedicated caregiver, his mother. He feels safe and cared for when with his mother. Another strength is that he can communicate with the aid of an iPad and nod his head even though he is severely ill with communication, cognitive, and mobility challenges. Even so, the family faces many needs, the primary one being financial needs. The medical condition of the client calls for serious treatment that is expensive. Another need is constant medical support and aid from nurses and experts. The house is not the best environment for this client, whose case may be an emergency at any time. The additional information needed is on how the family is meeting their financial needs and if they are getting any support from government agencies and organizations.

Integration of Theory & Practice:

Several theories, methods, interventions, and techniques that the SW applied were taken from the course and thus informed how the situation was handled. Firstly, the Person-in-Environment (PIE) Framework was used to develop an understanding of the client and the context of his environment. The economic, social, and physical factors surrounding the patient were given priority (van Wormer & Link, 2018). System theory can also be applied because it informs how various elements interact to affect the patient’s well-being. The strengths-based approach can be used but emphasizes the patient’s strengths rather than his limitations. A biopsychological model can also be applied, emphasizing the importance of psychological and social factors in planning healthcare. The research method was the interview, where the client and his caregiver were asked questions.

The Problem-Solving Process:

The stage involved in this experience was engagement, in which the SW created a rapport with the client and family. Information gathering was also employed to collect details about the patient and the environment. Assessment is another stage where the state of the client and the environment are assessed to see the physical and environmental limitations and possible solutions to these constraints the family faces with their patients. Intervention review, in this case, involved improving communication between the providers and caregivers and ensuring the patient was constantly cared for because of his critical condition. The last step was evaluating the intervention plan and its effectiveness and finally terminating the intervention or planning for aftercare.

Paradigms to Understand Human Behavior

Choose the paradigm(s) that helps you understand human behavior in this key experience:

___Medical     ___Social Systems      ___Psychoanalytic     ___Humanistic      ___Behavioristic    

Explain your choices by discussing how behavior in this key experiences is viewed or understood.

Paradigm	Medical	Social Systems	Psychoanalytic	Humanistic	Behavioristic
Past/ Present Emphasis	History/symptoms used to diagnose	Here & now solutions sought	Strong historical emphasis, intergenerational	Here & now emphasized	Present relearning
Assumed Cause of Condition	Physical, bodily malfunctions	Unmet human needs	Internal conflicts, defenses, instincts vs. morals	Experiences that block self-actualization	Determined by previous conditioning
Therapeutic Approach	Medication, surgery, physical treatments & education	Connect person with source of need satisfaction	Make conflict conscious	Create climate for growth, self-exploration	Change specific behaviors, habits, & thoughts
Length of Treatment	Varies depending on diagnosis	Short term preferred	Long term (years)	Short to intermediate (months)	Usually short term

The Social Systems Paradigm and Humanistic Paradigm are essential in understanding human behavior in chronic illness. The Social Systems Paradigm emphasizes the interplay between various systems, such as healthcare, family, and social support, and how these factors influence a client’s well-being. The Humanistic Paradigm emphasizes the dignity and autonomy of the client, even under severe physical limitations (van Wormer & Link, 2018). Interventions from this perspective focus on fostering self-worth, ensuring their voice is heard, and promoting holistic well-being, including emotional and psychological health.

Social Work Values Involved:

The applied social work values were the principle of service that guides SW to address the physical, emotional, and social issues they face as patients. The principle of dignity and worth is applied when the client is shown respect, self-worth, and autonomy, even when they have severe physical limitations and are dependent. The specific NASW Code of Ethics applied was Standard 1.02 on Self-Determination, manifested through giving the client autonomy (National Association of Social Workers, n.d). Standard 1.05 on Cultural Competence and Social Diversity, where the SW understood social diversity and cultural differences surrounding the client. Standard 1.06 on conflict of interest is manifested when the SW ensures no conflicts of interest in advocacy for the client (National Association of Social Workers, n.d).

Personal Reactions:

I had a mix of emotions because, at first, I was apprehensive about addressing the complex needs of this client. However, the more we engaged, the more I gradually became comfortable. I was comfortable with my actions because I used the skills and knowledge I acquired during the course to ensure the client had dignity and autonomy. The surprising element is the bond we eventually created with the client (van Wormer & Link, 2018). Emotional experiences involved empathy, where I felt empathy for the client, but after developing the care plan, I hoped that the plan would work.

I dealt with my emotions by reflecting regularly on my feelings and responses to ensure they aligned with the situation. Then, I also sought support and supervision from my superiors and colleagues to help guide me whenever I came through an emotional conflict.

Outcome:

The intervention is expected to be effective even though it depends on the way the client and his caregiver will adhere to the plan. From the case, a SW can learn the importance of collaboration with other experts and also learn to use ethical standards in social work (Corey et al., 2018). My next action is to explore new caregiving resources and technology that can help this client and his family. Through the experience, the SW developed critical practices and behaviors like advocating for the client’s access to necessary and valuable.

References

Corey, M.S., Corey, G. & Corey, C. (2018). Groups: Process and Practice. United Kingdom: Thomson/Brooks/Cole.

National Association of Social Workers (n.d). NASW Code of Ethics. Retrieved From https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics- English

van Wormer, K., & Link, R. J. (2018). Social Work and Social Welfare: A Human Rights Foundation. United States: Oxford University Press.

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Select a field experience and use this outline for your journal report. Be concise and protect the confidentiality and privacy of clients, groups, providers, supervisors, field instructors and staff. Submit a copy of your journal report to your Field Liaison through Blackboard.   Final version should be filed in the field portfolio. This is a professional report, you are to use third person in all areas except your personal reactions section.  You will be graded on grammar and professionalism.

Field experience:   Select a key experience with a client, client group, community, agency, supervisor, other field students, or staff.  Describe what happened and your role(s) in the situation e.g. (mediator, planner, enabler, observer, counselor, manager, broker/advocate, facilitator, catalyst, activist, teacher, trainer, mentor, outreach worker, monitor, or researcher).

Significant information:  Provide some brief background information such as, client data, presenting problem, or referral information.

Relevant Factors: Include assessment information gathered that helped you understand the situation or plan your intervention.  What individual, family, community, social, cultural, spiritual, medical, physical, developmental, psychological, and/or mental health factors influenced the situation. Explain the life cycle stage, group development stage, community program development stage, or research process step that applies.

Describe any of the following factors that are relevant: economic, political, environmental, discrimination, or oppression.  What strengths and needs were identified?  What additional information is needed?

Integration of Theory & Practice:  What have you learned in your courses that helped you understand the situation or plan your intervention?  What theory, practice model, approach, strategy, method, technique, intervention, or research method was used? Consult textbooks, course materials, journal articles, and/or instructors and provide citation of materials referenced.

What stage(s) of the problem solving process were involved in this key experience? (engagement, gathering information, assessment/diagnostics, intervention and review, evaluation, termination, aftercare/referral). Explain.

Choose the paradigm(s) that helps you understand human behavior in this key experience:

___Medical     ___Social Systems      ___Psychoanalytic     ___Humanistic      ___Behavioristic

Explain your choices by discussing how behavior in this key experiences is viewed or understood.

Paradigm	Medical	Social Systems	Psychoanalytic	Humanistic	Behavioristic
Past/ Present Emphasis	History/symptoms used to diagnose	Here & now solutions sought	Strong historical emphasis, intergenerational	Here & now emphasized	Present relearning
Assumed Cause of Condition	Physical, bodily malfunctions	Unmet human needs	Internal conflicts, defenses, instincts vs. morals	Experiences that block self-actualization	Determined by previous conditioning
Therapeutic Approach	Medication, surgery, physical treatments & education	Connect person with source of need satisfaction	Make conflict conscious	Create climate for growth, self-exploration	Change specific behaviors, habits, & thoughts
Length of Treatment	Varies depending on diagnosis	Short term preferred	Long term (years)	Short to intermediate (months)	Usually short term

Social work values involved:  Describe core social work values, ethical principles, or ethical standards that were applied in this situation.  Indicate from the NASW Code of Ethics which value or ethic you chose and how it applies to the situation.

Personal reactions:  Write about your reactions.  How comfortable were you with your actions; what was surprising; what emotions did you experience; or how did you deal with your reactions?

Outcome:  How effective was the intervention? How will you use what you learned? What will you do differently in the future? What will your next actions be? What practice behaviors from your Learning Contract did this key experience help you develop?