Field Two Journal 4

Field Experience:

The experience during the interaction between the social worker (SW) and a client called A can be described as informative and meaningful. The SW observed the client’s condition, his environment, caregiving, and his eligibility for in-home support services (IHSS). Notably, A was under the care of his daughter as the primary caregiver:  Field Two Journal 4.

As a caregiver, A’s daughter played a crucial role in interpreting and providing additional information about A’s health and daily challenges. A showed frailty through physical limitations that were evident, shaky hands, and inability to stand on his own. A detailed observation of A’s condition and environment was documented.

During this interaction, the social worker acted as an observer, an advocate, and a facilitator. As an observer, the social worker carefully observed and noted the physical condition of the client, his home environment, and how he performs tasks. As a facilitator, the SW engaged A’s daughter when discussing his care and helping her navigate through her needs while recognizing her role as his primary caregiver. Then, as an advocate, the social worker pushed for a better environment, care, and resources to help A manage his condition better.

Significant Information:

A is a 72-year-old male with chronic health conditions. Among his illnesses are kidney disease, diabetic neuropathy, and high blood pressure. With all these medical issues, this client needs quality care. In addition, A has a prosthetic leg and uses a walker for mobility.

The client also has physical limitations, as already seen, and this makes it difficult for him to take charge of domestic tasks. Another significant factor to take note of is the bladder control issue that demands medical assistance and also requires medical appointments with professional doctors. Due to the medical condition and the demands that come with it, the client is referred for an IHSS.

Relevant Factors:

Some of the relevant factors to consider in this case are the medical state and the psychological, social and environmental needs of the client. After the assessment during the home visit, the following essential factors were noted: firstly, A’s chronic illness, mobility issues and cognitive challenges affect his daily tasks. Secondly, his daughter is his only caregiver, and his bladder has issues, but A refuses to use diapers; his daughter is worried.

Thirdly, their financial resources may not be enough for him because currently, they are relying only on their personal resources, which may not be enough based on the medical expenses. The other relevant factor is that there are cultural, spiritual and language factors that the social worker should give priority when working with this client because it seems that these factors influence his perception of the care he is given.  The third factor that is very important to consider is that the client is in his late adulthood and is currently experiencing a physical decline. While his daughter is offering the much-needed care, she cannot give the medical care that is given by professionals.

Additional Relevant Factors

The finances needed to meet the medical needs of A is an additional relevant factor. The fact that A has to depend on the family’s finances for his medical needs creates a challenge for his well-being since he cannot get private care services. This state means that he has to rely on IHSS and the care he gets from his daughter. Despite these challenges, the home environment is clean and habitable for him, and if he can get IHSS, his condition can improve.

Integration of Theory & Practice:

There are three major theories that can be used in this specific case the first one is the Person-in-Environment (PIE). PIE theory argues that the well-being of a patient is shaped by the social, economic, environmental and even personal factors that surround the individual. Therefore, if this theory is applied to this case, it reveals the effectiveness of family support, like the care he is getting from his daughter. It also helps the SW see the importance of economic resources in bettering the condition of this client

Another theory that can be applied here is the strength-based approach. This theory focuses on empowering clients by identifying their existing resources, their support networks, and skills (Rothman, 2018). When applied, one can see that the client has strong cognitive abilities and is motivated to maintain his independence. Also, using the same theory, one can see that his family is actively involved in his care, as seen in the role played by his daughter as a caregiver.

The other theory that can be used in this case is the case management and advocacy model. This theory is important in this case because it supports the coordination of services in cases where the health status is complex. In the case of client A, effective case management theory involves monitoring caregiving stress and connecting the family to additional support resources.

The Problem-Solving Process

The stages involved in this case are engagement, information gathering and evaluation, and intervention. Engagement is the first stage, and it involves connecting with the client and his daughter. It creates rapport to make sure that the client communicates without fear. It also offers a platform upon which the SW examines and deals with issues like language barriers.

This stage is followed by information gathering (Corey et al., 2018). At this stage, the SW observed the client and documented his health condition, his home environment, and the services offered by his primary caregiver. The next stage is the intervention stage.

The main observations made were the feasibility of A’s current care plan, considering his daughter’s ability to continue providing full-time support. The case highlights the importance of these stages in addressing client needs and addressing caregiver concerns.

Applicable Paradigm(s)

The first chosen paradigm is the medical paradigm. This paradigm applies because A’s chronic conditions mainly influence his behavior and functional limitations. The amputation means that he needs serious wound care, and his shaky hands also mean that he has neuropathy, thus calling for proper hygiene and medication management (Rothman, 2018).

The second paradigm is the social system paradigm, which involves the client’s ability to function. In this case, A gets care from his daughter. Another area is communication because he is a Spanish speaker but an English reader (Corey et al., 2018).

Another issue is his lack of cooperation; for instance, he refuses to wear diapers. This could be a decision made based on his cultural inclination.

The third paradigm is the humanistic paradigm, which emphasizes the importance of self-independence (van Wormer & Link, 2018). This theory also looks at the personal welfare of the client in relation to the people he socializes with and relates to. In this case, the daughter plays that critical role.

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 a source of need satisfaction	Make conflict conscious	Create a climate for growth, self-exploration	Change specific behaviors, habits,  and thoughts
Length of Treatment	Varies depending on the diagnosis	Short term preferred	Long term (years)	Short to intermediate (months)	Usually short term

Social Work Values Involved:

One social work value that was employed in this case by the SW is the dignity and worth of the person. This value calls for the social worker to respect and uphold the inherent dignity and worth of the person (National Association of Social Workers, n.d.). In this case, it is manifested in respecting A’s desire for independence despite his physical limitations.

The second social work value applied in this case is service. The value of service emphasizes the social worker’s role in providing service. In this case, this value was manifested when the social worker gave priority to the services provided to the client (National Association of Social Workers, n.d.). The SW not only approved the client’s need for IHSS but also advocated for crucial services that he needed.

The third social work value that was manifested in this scenario is integrity. This value is manifested when the SW behaves in a trustworthy manner. In this case, the social worker conducted the assessment transparently and ethically, ensuring that A’s needs were accurately documented for IHSS eligibility (National Association of Social Workers, n.d.). Thus, the value of integrity was manifested.

Personal Reactions:

I felt comfortable and confident in conducting a thorough assessment of the client and advocating for his In-Home Support Services eligibility. Most significantly, during this process, I was comfortable in creating the right balance between empowering the client and practical interventions, as well as ensuring the dignity of the client and his independence. What surprised me was this experience’s revelations. Firstly, it revealed the extent of A’s daughter’s caregiver burden.

Language barrier was also an issue, but with the help of the daughter, the challenges were solved. One of the emotions experienced was empathy. I felt empathy for the client and was concerned about his health situation, especially the fact that he was struggling to move.

Even though these challenges emotionally moved me, I remained engaged; I showed resilience, and I also communicated effectively to ensure the welfare of the client. I dealt with my emotions through maintaining professionalism, seeking guidance, reflective practice, and being guided by the ethical framework of social work.

Outcome:

The intervention was effective because A’s limitations were identified and proposals made to ensure that his condition can be managed effectively. Through the IHSS, his needs were taken into consideration. The initiative ensured that the SW advocated for caregiver support and engaged him in decision-making regarding his health. The SW intends to use what they have learned to give better support to other clients in the future because, through this event, the SW learned that cultural sensitivity in care planning, prioritizing caregiver support, and a comprehensive needs assessment are essential for future actions.

The SW, in the future, intends to use alternative incontinence solutions, advocate for community transport for chronically ill patients, strengthen caregiver support, and ensure there is proper follow-up for all affected individuals. The SW developed SW competencies and developed behaviors that effectively help them work with clients from different cultural backgrounds.

References

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

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

Rothman, J. (2018). Advocacy and social work practice. Pearson.

van Wormer, K., & Link, R. J. (2018). Social work and social welfare: A human rights foundation. 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?