SWM 107 Field Education Practicum

Write a 1500-2000 word critical reflection on the role play, focussing on:

  • How the service user understands health, wellbeing and the social determinants of health, and how you engaged with this understanding to build rapport
  • Describe how you demonstrated social work competencies for practice, including your legal, policy and statutory responsibilities, thinking about what worked and what could be improved next time
  • Reflect and describe the social work approaches and / or policies that influenced your decision-making process, and what programs and services might be helpful for this service user.
    You are required to utilise eight scholarly articles to complete this assessment.

Solution:

Reflection

The role play part 1 involved the interaction with Raqel (name of the actual student) on the loneliness she has been feeling as she is focusing to enter her High School Certificate year. The loneliness has been occurring to her due to her physical disability which is her inability to independently walk without assistance which is a profound limitation of any individual. In the role-play session, confidentiality and the safe space decorum was maintained for the patient to feel free to talk about her triggers and feelings. The social determinants of health and well-being for the patient were not aligned to the feelings that propagate that patient accepts her disability in her life. As for her understanding of health and well-being, the patient considers herself as a burden on everyone else around her as well as on herself. The suicidal thoughts are prevalent, to a moderate extent. As per the legal and statutory guidelines, the patient has been made aware of her condition which will require a duty to protect in the future if the conditions remain the same or worsen, as the patient has described incidents of physical and verbal violence as well as desires to end her life (APA, 2020). The social determinants of health in the society are majorly being self-reliant, independent and being able to perform the basic functions to sustain life. These social determinants are absent in the patient, and she is well aware of that (Gould, 2016). The reason for her suicidal tendencies is that she is dependent on people around her and her friends are not quite interested to help. The idea that others consider her a dependence or burden is the cause of Raqel’s mental condition, which is a clinically manic depressive disorder. In this therapy, she was made well aware that people like her, who either have one or the other physical disability have their voice and brilliance. A conversation was induced to understand her point of view on the idea of being dependent and how she would like others to be around her. This provided an idea of what is missing in her life leading to her mental condition as well as presented her concerns about her body which currently she is unable to accept. Raqel’s understanding of her health and well-being is poor as she looks down upon herself. This was understood when she was tried to be presented with ways in which she could feel special and normal like everyone else. The rapport was built with Raqel by describing the incidents of various influential individuals who were disabled but made sure to live on their terms (APA, 2020). The talk started with greetings and progressed forward with tackling her concerns about her body. The patient was made comfortable by not referring to her as someone who has a disability but as someone who just has a different way of operating than others. By building a rapport like this, the patient conceded to talk normally about her concerns and issues after certain apprehensions.

The major ordeal in getting the patient to express her concern was that Raqel considered herself to be a complicated case that cannot be solved as her disability cannot be cured. For the patient, the disability is the cause of her loneliness and not her lack of self-acceptance. During the session, I exhibited the social work competencies by convincing the patient to talk about her concerns. Care was taken to make sure that the feelings of Raqel are not sidelined and the patient’s perspective is not completely nullified. The impact of the patient’s disability was also considered on the people around her, which led to an understanding that Raqel’s concerns about her, the cribbing and whining are the reasons which have made her friends distant from her rather than the fact of her disability (Gould, 2016). Once this was understood, further conversation was done to reflect and make the patient understand where she could be at peace with herself both psychologically and physically. In this situation, the duty of care was proactively taken care of as the patient has discussed the tendency to end her life. (Dravnieks, 2020). The primary step in the therapy session was to create comfort with the patient in which she can talk about the difficulties she faces with her body. Once she adapted to that comfort zone, it was easier to talk about what she could do to be self-acceptant of her own body. In this session of 25 minutes, it was finally accepted by the patient that her main concern is the lack of self-acceptance as to why does it happen to her only. As a duty of care, she was given a number of free online helplines which could counsel her for the suicidal tendencies even after the session is over (Dravnieks, 2020). In conditions like these, the patients have already undergone both physical and mental trauma, hence the process of recovery cannot be pushed (Clark, 2019). Keeping that in mind, the patient was counselled in a way through which she felt heard and wanted to come back to share more. This was a big step in the session. There were certain aspects of the session which could have been improved like Raqel should have been given the liberty to decide when she wanted to have the next session and if she felt comfortable in speaking about certain personal details related to her accident. Speaking about such conditions can be traumatizing for anyone, but I directed her to talk about those details and did not consider her will regarding that. In the next session, care will be given to protect the concerns and wishes of the patients. It has been proven that people will mental disability is 2-4 times more likely to die from cardiovascular disorders (Gould, 2016). In the case of Raqel, this risk increases even further due to her existent condition of physical disability.

In the therapy session, the bigger goals were set to integrate the hope and optimism into the patient regarding her disability and to provide a sense of self-acceptance (Mackelprang, 2012).  Even people with Alzheimer’s have the similar anxiety of dependence and never being able to recall what they forget. (Moore, 2014) As the patient lacks a positive self-identity, the course of therapies will be based to resurface the pride and creation of a self-identity that is positive to encourage her for the preparation of High School Certificate grade (Mackelprang, 2012). It will be important to sensitize the patient about the potential stressors in the school life which need to be handled in future for avoiding the relapse of these feelings of anxiety, verbal aggressiveness and physical violence. In the subsequent sessions, Raqel will be subjected to verbal sessions in which ideas of avoiding the self-violence as well verbal aggressiveness will be referred to. Without completion of the therapy and before elimination of the feelings of suicidal attempt, Raqel will not be declared fit to return back. The patient has been made aware of the National Disability Insurance Scheme Act 2013 under which the Australian resources have been set to be modified as per the ease of the disabled individuals (Class reading, Slide Number 49). Before the start of the session, the patient was made aware of the policies of therapy and informed consent before which genuine participation of the patient will be expected.

In this session, the social work approaches for Raqel have been the Crisis Intervention model as support is being provided to the patient to channelize her attention in a certain fruitful direction as well as making her inceptive towards her body. The presence of a disability is never treated as anything which cannot be considered normal. The acute episodes of the social model of disabilities are handled by personal assistance wherein the patients are given 24*7 convenience to call and handle the acute episodes (APA, 2020). For the said user, some multiple organizations and policies will be for help. LifeLine, E-headspace, Reach Out and National Sexual Assault, Family and Domestic Violence Counseling Line are some of the few that were introduced to the patient in case of any help after the session or at any time after that (Class reading, Slide Number 3). The crisis intervention theory highly affected the decision-making effect as they were quite prominently stringent on the boundaries between patient’s emotions and personal involvement.  Every step in the session was outlined by the social model of disability which has been followed throughout. The National Disability Insurance Scheme (NDIS) was also introduced to the patient as it would be helpful for school selection for Higher School certificate classes as well as provide the proper benefits from the government of Australia.  (Class reading, Slide Number 50) The programs and services were introduced and the progression was made with the idea of self-acceptance, stemming from the zeal of being able to live life again as it was before the accident. These were the ways through which role play was conducted and now this reflection will provide an insight into the room of the development.

References

Gould, N. (2016). Mental Health Social Work in Context (2nd ed.) Routledge. Chapter 2 –       Developing Socially Inclusive Practice.

Mackelprang, R.W. (2012). Disability. In Gray, M. Midgley, J. & Webb. S.A. (eds.). The SAGE       Handbook of Social Work. Sage Publications, pp.547-563.

Class Reading, 2022, Psychosocial Health and Wellbeing in Social Work Practice, Slide Number 34-50.

APA. (2020). A Matter of Law: Psychologists’ Duty to Protect. Https://Www.apaservices.org. https://www.apaservices.org/practice/business/legal/professional/duty-protect

APA. (2020). Guidelines for Assessment of and Intervention with Persons with Disabilities. Https://Www.apa.org. https://www.apa.org/pi/disability/resources/assessment-disabilities

Clark, J. (2019, May 8). Remembering Martin Buber and the I–Thou in counseling. Counseling Today. https://ct.counseling.org/2019/05/remembering-martin-buber-and-the-i-thou-in-counseling/

Dravnieks, R. (2020, April 28). Duty of Care and Dignity of Risk – What does it mean? Interchange WA. https://www.interchangewa.org.au/blog/duty-of-care-and-dignity-of-risk-what-does-it-mean/

Moore, J. (2014). Still Alice Official Trailer #1 (2015) – Julianne Moore, Kate Bosworth Drama HD [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=ZrXrZ5iiR0o

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