Journal Report Outline

Field Experience:

The fieldwork involved working with an older adult, C, who has multiple chronic health issues. The roles of the social worker during this field experience were observing and advocating. As an observer, the social worker documented C’s physical limitations, medical needs, and environmental conditions: Journal Report Outline.

In their advocating role, the social worker advocated for additional assistance and adjustments to the client’s care plan and facilitated discussions about C’s needs and limitations. Overall, the experience highlights the significance of ensuring advocacy is client-centered, thorough observation, and the use of proactive interventions to enhance the quality of life for clients.

Significant Information:

The client, C, is an older adult. She is divorced and lives alone in a three-bedroom house with one-and-a-half bathroom. She has multiple chronic health conditions, including chronic obstructive pulmonary disease (COPD), atrial fibrillation, hypertension, Vtech, hernia, osteoporosis, arthritis, anemia, high cholesterol, kidney failure, emphysema, degenerative disc disease. C also experiences fatigue, weakness, shortness of breath, and limited range of motion—she thus requires substantial assistance with personal care, mobility, and meal preparations, among other household tasks.

Relevant Factors:

During a home visit, the social worker assessed C’s medical, physical, and mental health challenges. C’s chronic conditions require frequent breaks and medical equipment. Her mental health, particularly anxiety and depression, affects her daily struggles (Corey et al., 2018). Her lack of social support and increased pulmonary doctor visits necessitate consistent care and assistance with daily living activities.

The influencing factor is her chronic illnesses, which impact mobility, independence, and hygiene, while frequent bladder and bowel accidents increase hygiene needs. Oxygen dependency limits movement and household activities. Mental health issues like anxiety and depression also contribute to isolation (Hutchison, 2018).

Economic factors limit access to in-home support, while environmental and social factors increase vulnerability. Discrimination or oppression in healthcare and in-home support are systemic barriers faced by elderly individuals with chronic illnesses.

C is in late adulthood, facing health concerns, loss of independence, and caregiver reliance. Community program development needs adjustments due to gaps in assistance, such as increased medical visits.

C has strengths in the following areas. Firstly, C is mentally alert and self-aware, maintains a clean home, uses assistive devices, and has an in-home provider. Her needs include increased caregiving support, emotional and mental health support, structured accident management, and advocacy for additional resources or program modifications.

Integration of Theory & Practice:

The coursework in social work, gerontology, and health-related fields is valuable in assessing the client’s medical, psychological, and social needs and formulating an intervention plan (Wormer & Link, 2018). The knowledge applied herein was from gerontological social work, mental health, case management, and cultural competency in social work, recognizing C’s increased vulnerability due to chronic illnesses, mobility issues, and isolation.

The work utilized various theoretical frameworks and practice models to address C’s physical health, home environment, and social support system. It acknowledged barriers like lack of family support and increased medical needs, used strengths-based approaches, developed short-term goals, and applied crisis intervention principles to prioritize urgent needs (Rothman, 2018).

The intervention strategies involved a comprehensive needs assessment, care coordination, health and safety planning, and psychosocial support consideration, focusing on addressing health, mobility, mental health, and environmental challenges, as well as improving support for the client.

The Problem Solving Process:

Problem-solving in this case involved the engagement, gathering information, assessment/diagnostics, intervention and review, and referral stages. Foremost, engagement involved building rapport with C during the home visit and observing her physical limitations, medical concerns, and home environment. Further, information was obtained through self-reports, direct observation, and previous assessments.

Assessment/diagnostics focused on C’s needs and strengths, prioritizing issues like worsening COPD and increased medical care. Intervention included care planning, adjustments in caregiving hours, bladder/bowel accident management, and mental health resources. Aftercare/referrals included expanded home health assistance and community-based support.

Relevant Paradigm(s):

The key experience with C can be understood using Medical, Social Systems, and Humanistic paradigms. C’s physical health conditions, such as COPD, CHF, arthritis, and kidney failure, significantly impact her daily functioning and independence. Medical devices and social support are crucial for her stability. C’s living situation, including her in-home provider, highlights systemic social service challenges for elderly individuals with complex medical needs (Hutchison, 2018).

Social isolation and reduced mobility potentially contribute to increased depression and anxiety. C is mentally alert and advocates for her needs, demonstrating autonomy and self-determination. According, interventions should focus on empowering C rather than addressing medical deficits.

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:

The case applied core social work values and ethical principles from the National Association of Social Workers Code of Ethics to ensure the client’s well-being, dignity, and self-determination. These values include respecting the client’s choices and balancing safety and well-being (National Association of Social Workers [NASW], n.d.).

The social worker emphasized the importance of human relationships, focusing on strengthening relationships with in-home providers and advocating for increased caregiving hours and medical visits (NASW, n.d.). The social worker also ensured the client’s integrity by accurately documenting and reporting their condition. Lastly, the social worker applied knowledge from coursework on chronic illness management, aging, and case advocacy to guide the intervention planning.

Personal Reactions:

Being a social worker in this key experience brought mixed emotions, where I initially felt uncomfortable and anxious due to uncertainty. Nonetheless, I adapted quickly and was able to feel more competent, reducing my initial nervousness. As van Wormer and Link (2018) suggest, I took a moment to breathe, reminded myself of my comfort zone, and focused on self-talk to manage my emotions. Notably, this fieldwork experience has demonstrated acknowledging and managing one’s emotions can lead to greater resilience in overcoming challenges.

Outcome:

The intervention helped address the client’s needs. Notably, focusing on calming techniques like deep breathing and embracing discomfort is a step for personal growth. The social worker learned the importance of self-talk and reassurance in maintaining a positive mindset in challenging situations.

In future practice, they plan to recognize discomfort signs early and utilize these strategies proactively, especially in high-pressure situations. This experience has honed the social worker’s skills in managing stress, managing emotions, and adapting to new situations, thereby aligning with personal and professional development goals.

References

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

Hutchison, E. D. (2018). Dimensions of human behavior: The changing life course. SAGE Publications.

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?