Field Two Journal 5
Field Experience:
The experience between the social worker (SW) and client A can be described as challenging but educative at the same time because A has a hearing problem and ADHD. As a result, communicating with her and calming her down was difficult. However, it offered the SW a chance to learn more about how to work with clients with such complex challenges: Field Two Journal 5.
During the home visit, the social worker met with the client, who is an 11-year-old girl with complete deafness, non-verbal, and ADHD. The mother is, however, concerned over the recurrence of her conduct of self-harm, like banging her head on the wall or hitting herself with objects.
In this situation, the SW was an assessor having conducted a comprehensive assessment of the situation. The SW was also an advocate, pushing for the welfare of the client, thus proposing the IHSS for A. The SW was also a facilitator, guiding the discussion with A’s mother, asking questions about A’s behaviors and helping to clarify her needs.
Significant Information:
The first and most important information about the client is that she is an 11-year-old female with bilateral hearing loss. The client also has ADHD and severe constipation, and the mother is worried so much about her conduct of self-harm. Her mother clarifies that A’s behavior of self-harm started when she was young, but now the challenge has resurfaced.
Overall, her mother is concerned about her safety due to her deafness. Therefore, these medical conditions like ADHD and self-harm are the main reasons for her referral.
Relevant Factors:
The factors that are likely to help in understanding this situation and planning well for intervention are the client’s deafness, self-harm, cognitive and emotional development, as well as her independence as an individual. The client A is completely deaf and this affects communication with her. Also, A harms herself by knocking her head on the wall or hitting herself with objects. This conduct places her life at risk.
The family factor offers important information needed for planning interventions. The client’s family is her mother who is her primary caregiver. She also lives with her grandparents and cousins, who sometimes can offer help.
A social factor that can affect this client is communication challenges, and her act of self-harm can also affect her interaction with others and even place her life in danger. Finally, her psychological state is also of great significance, knowing that she has emotional challenges that are leading her to self-harm.
The client is in her middle childhood stage, which is between 6 and 12. The assessment confirmed that A’s behaviors and abilities align with children her age, except for her hearing impairment and self-harming play behaviors. The group development stage is manifested in the ongoing care that she is getting from her mother and the support she is getting from her extended family. The community development stage that is reflected here is the eligibility determination phase, where the client’s needs are examined to determine if she qualifies for the IHSS.
Additional Relevant Factors, Strengths and Needs Identified, and Additional Information
The economic factor observed is that client A is in a supportive home environment. The mother faces challenges with employment because she is the primary caregiver, and this may present financial challenges even though it is not mentioned. The need for IHSS services is a sign that the family is facing financial constraints.
Moreover, the environmental factors that influence this situation are the home and school. The home is clean, safe, and habitable for A. The presence of her mother and extended family offers a strong support necessary for the management of her condition.
The strengths of A are her high independence, strong support from her mother together with the extended family, and also the school offers accommodation. The needs are, however, in her lack of communication tools—she needs communicating tools for her safety and independence. The other need is her safety from her conduct of self-harm, as well as the need to advocate for inclusive services to help her.
Integration of Theory & Practice:
The first theory that applies, in this case, is the strength-based theory, which can be used to explain how the client is empowered in accessing the existing resources, their support network and making any other resources needed for her well-being available to help her manage her condition (van Wormer & Link, 2018). The second theory that applies is the Person-in-Environment (PIE). This theory places the welfare of the patient first but explains that the environment, the social surroundings, and the economic situation affect the client’s well-being.
In this case, the environment of A is excellent because of her family and the general safety but finances are necessary to help her thrive (van Wormer & Link, 2018). The third theory is the case management and advocacy theory, which explains that coordination of services is important for a patient’s well-being. Therefore, coordinated efforts between the SW and primary caregiver and also with medical experts can guarantee that A will manage her condition well.
The Problem-Solving Process
The problem-solving stages, in this case, are information gathering, evaluation, and engagement. Engagement is the earlier stage that involves meeting the client, knowing them and their environment, social and economic challenges. This is manifested in knowing A, her mother and her family (Corey et al., 2018).
The information-gathering stage follows, and here, the social worker collects information through asking questions and observing. The information is then recorded for future use. Evaluation comes last, where the SW evaluates A’s condition, the environment, and her home, then decides to offer IHSS.
Applicable Paradigm(s)
The three chosen paradigms are medical, social system, and humanistic paradigms. The medical paradigm applies in this case because A is involved in self-harm and is completely deaf. Therefore, the client needs medication for her emotional challenge and also intervention on how she can communicate effectively (Corey et al., 2018).
Next, the social system paradigm can be used to explain the social support A is getting from her mother and the extended family (Corey et al., 2018). Lastly, the humanistic paradigm is applied here to explain the priority given to the welfare of the client because the SW has taken note of the primary role her mother takes in giving her primary care.
| 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:
Social work values are primary and so the SW used them in A’s case. Dignity and self-worth were used when the SW noted that the client has to be involved in their care plan and the interventions given (National Association of Social Workers, n.d.). The mother was also involved, autonomy was given, and decisions were made with her approval.
Integrity as a value was also applied in this scenario, where the SW collected all the information without bias and in a trustworthy and respectful manner (National Association of Social Workers, n.d.). The value of service is also manifested in the initiative made by the social worker to provide quality service to the client and ensure she can manage her health effectively.
Personal Reactions:
At first, I felt sympathy, which affected my emotions. However, after gaining composure, I was confident in conducting the assessment, observing, and recording. I am confident and believe that proposing an IHSS for the client was the best option for her based on her medical condition and the financial demands her condition is placing on the family.
What surprised me in this incident was the resilience of the mother, where she dedicated her time to her daughter and was extremely concerned about her welfare despite the financial demands. The dominant emotion throughout the case was empathy. I believe the client can do better with some consistent support from relevant stakeholders.
Outcome:
The intervention was effective because A managed to get a solution to the communication issue, and most importantly, she was able to work on her emotions to prevent her from self-harm. Through the initiation of IHSS for A, her needs were given priority, and the SW advocated for the support she needed. Therefore, it is evident that the initiative was successful.
The SW hopes to use this experience and what they have learned to improve on interaction and working with clients like A (Rothman, 2018). In the future, the SW will work on their emotions to ensure that emotions like sympathy do not hinder their capability to offer services to patients.
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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Question 
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.
Field Two Journal 5
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?