The primary mandate of social work practitioners is to collaborate with diverse patient populations for the purpose of finding effective solutions for the hardships that the patients face. For decades, social workers have strived to ensure that the solutions they prescribe facilitate holistic development. However, as the needs of the patients become more complex, the social workers have had to rethink their strategies. Today, it is no longer acceptable or sufficient for a social worker to provide solutions that merely work. In addition to being effective, the solutions must also account for such issues as the psychological situation and the social environment that define the client’s health. Furthermore, it is important for the social worker to have a clear, in-depth and intimate understanding of the dynamics that shape human health. This understanding allows for the development of appropriate, culturally-sensitive and effective assessment of patient needs and the implementation of interventions that deliver the desired outcomes.
Description of Agency Setting
While it is true that individual social workers play a critical role in shaping how they work with clients, the impact of the organizational setting cannot be ignored. Various scholars have explored the impact that the organizational setting has on the mandate of social workers. For example, Ed Silverman (2015) authored an article in which he reiterates the importance of social workers understanding the organizational environment within which they work. He laments that many social workers and healthcare professionals are unable to fully attend to the needs of clients because they lack a full awareness of the organizational context. In my role as a social worker, I need to recognize that my organization influences how I perform my duties. I work for a foster care agency. Primarily, we are involved in the provision of support to vulnerable children. This agency works with such stakeholders as government departments responsible for the protection of children to place the vulnerable children with families and in homes where they can receive the love, care and support that they desperately need. In the recent past, there have been allegations that foster care agencies are engaging in questionable practices. For example, an investigation by the Guardian revealed that most agencies are driven by the profit motive at the expense of the wellbeing of the children whose needs they are expected to attend to (Davies, 2018). The agency for which I work is striving to reclaim the glory and reputation of foster care agencies and social work in general. By challenging all its employees to prioritize the welfare of children, this agency has been able to focus its efforts, processes and operations on the original mandate of the social work profession.
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My agency has a significant impact on the methods that I use when handling casework and my roles and functions as a social worker. Regarding casework methods, the agency has developed policies and guidelines that all practitioners are required to follow in their management of caseworks. For example, one of the key policies that the agency enforces strictly is respect for client confidentiality. All practitioners are expected to accord all the information that clients share utmost confidentiality. This agency is not isolated since confidentiality is one of the key values that guide social work practice (Beckett, Maynard & Jordan, 2017). By upholding client confidentiality, I am able to gain the trust of clients and encourage them to share the insights that I need to offer assistance. Providing the resources and support that are essential for casework management is another impact that the agency has on my mandate. In order to fully execute their mandate, social workers need guidance, support and resources (Perron et al., 2010). For example, as part of my work, I make visits to children at their foster homes every month. Currently, I am working on 13 cases. All of these cases involve adolescents who have turned to the agency for support. In addition to ensuring that the children are well, I conduct assessments of their families. I work closely with families to determine the services and resources that they need in order to serve the children.
As noted above, my organizational setting influences my roles and functions as a social worker. I work with young individuals from diverse backgrounds and facing a wide variety of hardships for which they turn to the agency for solutions. There are some clients who are facing difficulties in school and others who are struggling with substance addiction. We also often receive children who have suffered physical abuse and sexual violence. In addition to offering immediate and urgent help, my main responsibility is to identify suitable homes for these children and adolescents. The agency is instrumental in facilitating my functions. It has established collaborative partnerships with various other agencies and governmental organizations. For example, the agency collaborates with an organization that offers treatment for children who have been victims of sexual and physical abuse. Through these partnerships, I am able to refer clients for treatment, thereby performing my duties and functions as expected. Another significant role that the agency plays is that offers training. The social work profession is dynamic and volatile. Changes are often being witnessed and it is critical for practitioners to update and expand their knowledge base and skill set. The training that the agency provides equips me with the insights and competencies that are critical for the effective delivery of services to the diverse client populations that we serve.
As a foster care agency, one of the key functions of my organization involves reunification and adoption. Every month, the agency receives applications from families who wish to adopt children who will otherwise be sent to foster homes. Through the adoption program, the agency has managed to match children to families which are committed to providing love and support. Regarding reunification, the family often links children in foster homes with their biological parents. However, for reunification to occur, the agency must establish that the parents are able to offer support. The agency often collaborates with government agencies to conduct rigorous assessments of the capabilities of the parents.
Biopsychosocial Assessment
In performing their duties, social workers rely on models and frameworks. The biopsychosocial model is among the frameworks that help the practitioners to understand the needs of clients and identify effective interventions. Essentially, this model is concerned with the environmental factors and the physical and mental health forces that shape the experiences of clients (Dziegielewski, 2013). It offers a complete and holistic understanding of the situations that clients face. By conducting a biopsychological assessment, social workers are able to identify how various factors interact to cause clients to experience certain difficulties. In the discussion below, the results of a biopsychosocial assessment of the African American and Latino children and adolescents that the agency usually receives are outlined.
Data and Presenting Problem
As noted above, a majority of the client whose needs we try to address are from the African American and Latino communities. This fact should not be surprising. Researchers acknowledge that children and adolescents from minority communities are at a greater risk of facing such issues as sexual and physical violence and homelessness (Friedman et al., 2011). On average, the agency handles 24 cases involving children who have suffered abuse every month. These children present with a wide range of problems. Whereas there are some who are homeless, others have endured years of physical and sexual violence. There are other children and adolescents who are referred to the agency by schools which are worried about poor academic performance and substance abuse.
Personal, Family, Medical History
The biopsychosocial framework recognizes the need for practitioners to consider the impact of medical and environmental factors on the health of clients. As part of the psychosocial assessment, an examination of the personal, family and medical histories of the clients that the agency serves was conducted. This examination revealed that there are historical problems that are responsible for the current issues with which the children and adolescents present. Regarding personal and family history, it was observed that a majority of the children and adolescents are from troubled families. For example, there are those who stay with single parents. There are others who are from dysfunctional families where sexual and physical abuse is common. Other clients complained that their families do not provide the support that they need. The results of this assessment are consistent with research findings. Such researchers as Green et al. (2012) have observed that an unstable home is among the primary causes of the problems that children and adolescents face. Most of the clients have a history of medical conditions and illnesses. For example, there was a 13 year old girl who had been hospitalized for deep wounds inflicted by her abusive father. The case of this girl is not isolated as there are many other children and adolescents who presented with poor physical health outcomes.
Legal and Educational History
Research shows that there is a link between foster care placement and criminal behavior in adulthood (Lindquist & Santavirta, 2014). This research insight has prompted the agency to prioritize crime prevention programs. A worryingly high number of the agency’s clients have criminal histories. There are some who have been arrested for drug possession, burglary and violence. It is important to note that some of the adolescents have had encounters with the police as they seek help and treatment. Regarding their educational history, a number of the adolescents are truant and there are some who have abandoned their studies altogether. Moreover, most of the adolescents reported poor academic performance and have been in trouble with their school’s administrations for violating rules and guidelines. Given the complex and worrying educational histories of the adolescents, the agency strives to link them with services that motivate them to stay committed to their studies.
Social Service Treatment History, Current Level of Functioning
When assessing a client, it is important to examine such questions as whether they have received social service treatment and their current level of functioning. Most of the adolescents that we attend to have not sought or received treatment from social service organizations. Inadequate access, mistrust of social service workers and lack of knowledge regarding the social services are some of the reasons that they cite for their reluctant to seek social services. However, there are some adolescents who shared that they have indeed sought these services. The services that they sought included treatment for wounds, counseling and support with academic endeavors. A review of the current level of functioning of the adolescents showed that most of them are capable of independent functioning and only need minimal help to reclaim their lives. However, some of the adolescents are simply incapable of functioning without constant monitoring and support. For example, there is a 16 year old Latino boy who has struggled with substance addiction for three years and has been living with his ailing grandmother. During our interactions, he confesses that he feels unable to live independently and that he is in desperate need of intervention. He feels that his grandmother is unable to offer him the support he requires and that he feels vulnerable. The agency is in talks with the grandmother about the possibility of placing this youth with a family that is better equipped to attend to his needs.
Diagnostic Impressions and Prognosis
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is one of the tools that we rely on heavily to identify the conditions with which clients present. This tool outlines the symptoms that the clients should exhibit so as to be diagnosed with particular disorders. While the clients fit the diagnostic criteria for a number of conditions, substance abuse disorder is the most common. According to the DSM, some of the symptoms that accompany this disorder include an uncontrollable desire to consume a particular substance and numerous failed attempts to abandon the substance (APA, 2013). I have personally worked with adolescents who exhibited these symptoms. By understanding the symptoms and the disorders that they represent, I have been able to develop interventions that work and are in line with practice guidelines. It is true that most of our clients grapple with serious challenges. However, I am confident that with continued treatment and constant support from the agency, they will be able to overcome the conditions and hardships that they face.
Role of Culture, Race, Religion, Class and Gender
Culture, race, religion, class and gender are some of the factors that I have observed to influence the experiences of our clients. While some of these factors facilitate recovery, others erode the progress that we make. I have observed that culture, race, class and gender tend to have detrimental effects. Most of the clients are from cultures that place little emphasis on education. Furthermore, they grapple with poverty and engage in practices which compromise their health. For example, among the clients whose case I have handled is a 17 year old African American boy who was pressured to join a street gang and to abandon his studies. The fact that nearly all of the clients are from minority communities further compounds the hardships that they face. For example, the African American clients lack adequate access to social services. Such organizations as the one for which I work strive to enhance access for African Americans. We ensure that all children who require social services receive them or are directed to institutions that can offer the services. However, I think that our agency’s efforts do not go far enough and that more needs to be done. Their class is defined by poverty, vulnerability and powerlessness. It is not surprising that these clients are struggling in school and others are homeless. Gender is also a critical factor. Girls were at greater risk of such problems as sexual and physical violence. On the other hand, issues like poor academic performance, truancy and criminal behavior were more common among the male adolescents. I found that religion plays a helpful role. It is a source of comfort and resilience. For most of the African American adolescents, churches serve as centers of refuge and support.
Review of Client Contact
At the foster care agency, I continue to work with dozens of children and adolescents. Each of my clients had a unique narrative that captured the complex hardships that they face. I observed a number of common themes and patterns that defined the experiences of each client. Resilience and a desperate desire to reform are the main themes. Nearly all the clients expressed a desire to commit to the treatment process until they recover. They would present themselves for sessions with enthusiasm and infectious hope. The clients were also remarkably resilient. Despite coming from backgrounds characterized by poverty, unhealthy cultural practices and lack of support, the clients were positive that with continued commitment, they would eventually find healing.
It is true that I find the experiences of all my clients to be equally important. However, I feel that there are certain clients who are more remarkable and their narratives offer a reflection of the cases that social workers receive. He was an 18 year old African American boy who had been placed in a foster home. His placement in the home was necessitated by his mother’s failure to offer appropriate care. For example, during one of our numerous sessions, he complained that his first foster mother failed to provide him with the medication for his Diabetes. As a result, he often developed complications that would require hospitalization. Following the intervention of the child protection bureau, it was determined that placement in a new foster home would serve him better. In his new home, this young adult receives the love and care that his mother was unable to provide. He stays with a retired nurse who understands the vital role that affection and support plays in promoting the healthy development of young adults. This client has confirmed that he is satisfied with the condition of his new home and the fact that he now stays together with his sibling at the foster home has only served to enhance his experience. However, while reviewing his case, I observed behaviors and patterns that caused concern. In an effort to ensure a thorough assessment, I made a visit to his school where my fears and concerns were confirmed. His teachers shared that his performance has been on the decline for months and that he often misses classes. Furthermore, this client appears to lack an understanding of the importance of his studies. Another issue that was revealed is that the client has been using marijuana and I have reason to believe that his poor academic performance is linked to his marijuana use. Research findings show that substance abuse has a detrimental impact on school attendance and academic performance (Akanbi et al., 2015). While I am worried about his substance abuse and failure to perform well in school, I remain confident that his new foster home offers an ideal environment for healing and healthy development.
The discussion on my contact with the client whose case has been detailed about would not be complete without an examination of countertransference. Essentially, countertransference is concerned with the emotional interactions between a practitioner and their client (Wiener, 2009). I found my interactions with him to be generally healthy and satisfying. I was pleased with his willingness to abandon his destructive habits and the remarkable progress that he was making. However, there were moments when I felt frustrated and disappointed. For example, despite the progress that we had made, he continued to struggle with substance abuse problems.
Treatment Plan and Interventions
The ultimate goal of social work is to deliver healing to clients. This goal is achieved through the adoption of well-designed and evidence based interventions that have been proven to be effective. I attribute to the progress that I made with the client discussed above to the robust and carefully selected treatment plans and interventions that I administered. The main components of the treatment plan that I adopted involved an evaluation of the severity of the client’s presenting problem, an examination of the impact of such factors as criminality, race, social support structures and poverty, and an analysis of the client’s preparedness to change. Through this plan, I was able to determine that the client had a severe substance abuse problem that was affecting his performance at school. Moreover, I established that while he has no criminal history, his previous home environment exposed him to such hazards as poor health and peer pressure. My examination also revealed that the client was eager and fully committed to change. The treatment plan set the stage for the administration of interventions. Intense counseling and linking him to community support services are the primary interventions that I adopted. Counseling was determined to be an appropriate intervention as it allowed the client to understand the adverse outcomes of his behavior and the need for reform. For example, I challenged the client to understand that unless he renewed his dedication to his studies, he faced an uncertain future. The counseling proved effective as the client promised to return to school and commit more effort to his studies. I understand that this client is far from full recovery. This is why I have identified other interventions that I think will help him to maintain the momentum. Challenging him to take up such extracurricular activities as sports is one of these interventions. I believe that by engaging in these activities, the youth will eventually abandon his marijuana use and that his academic performance will improve further.
Population Knowledge Base
A social worker’s knowledge base and their skill set are some of the resources that determine success in working with clients from diverse populations. I have conducted an evaluation of my personal strengths and competencies and have determined that I am adequately equipped to serve clients. My competence became evident during my interactions with the client discussed above. I found that I demonstrated sensitivity, kindness, understanding and professionalism. The fact that I am a young adult who understands the challenges of youth helped me to relate with the client. I recognized that many young people are facing pressure from their peers to experiment with substances and engage in other destructive behaviors. This understanding enabled me to sympathize with the client and maintain sobriety during our interactions. I also find that my previous experiences working with adolescents provided me with the knowledge and perspective that I needed to help the client. Other skills that served important functions include cultural competence, emotional intelligence, empathy and communication. Communication and cultural competence were particularly impactful. Leveraging these skills, I was able to establish boundaries, consider the client’s culture and to convey the need for action.
In conclusion, social workers serve different communities to whom they deliver interventions that enhance the quality of life. As a social worker, I can confirm that the members of our profession work tirelessly to impact communities. Working for the foster care agency, I have been exposed to fresh perspectives and new challenges. My experience at the agency has allowed me to recognize that there are thousands of young adults and adolescence who desperately need help. These people have suffered abuse and have been forced to turn to crime and dangerous substances. My overall assessment of social work is that it is a necessary profession that is central to the health of vulnerable communities. We need to strive to ensure that these communities are provided with all the resources and support that they require to thrive.
References
Akanbi, M. I., Augustina, G., Theophilus, A. B., Muritala, M., & Ajiboye, A. S. (2015). Impact of substance abuse on academic performance among adolescent students of colleges of education in Kwara State, Nigeria. Journal of Education and Practice, 6 (28), 108-112.
American Psychological Association (APA). (2013). Diagnostic and statistical manual of mental disorders. 5 th Edition. Washington, DC: American Psychiatric Publishing.
Beckett, C., Maynard, A., & Jordan, P. (2017). Values and ethics in social work. Thousand Oaks, CA: SAGE.
Davies, R. (2018). Private foster care agencies increasing cost of finding children homes. The Guardian. November 5, 2018 from https://www.theguardian.com/society/2018/jan/30/private-foster-care-agencies-increasing-cost-of-finding-children-homes
Dziegielewski, S. F. (2013). The changing face of health care social work: opportunities and challenges for professional practice. New York: Springer.
Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E., & Stall, R. (2011). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101 (8), 1481-94.
Green, H. D., Tucker, J., Wenzel, S. L., Golinelli, D., Kennedy, D. P., Ryan, G. W., & Zhou, A. (2012). Association of childhood emotional, physical, and sexual abuse with the structure and content of homeless women’s social networks. Child Abuse & Negligence, 36 (1), 21-31.
Lindquist, M. J., & Santavirta, T. (2014). Does placing children in foster care increase their adult criminality? Labour Economics, 31, 72-83.
Perron, B. E., Taylor, H. O., Glass, J. E., & Margerum-Leys, J. (2010). Information and communication technologies in social work. Advances in Social Work, 11 (2), 67-81.
Silverman, E. (2015). Organizational awareness: a missing generalist social work competency. Social Work, 60 (1), 93-5.
Wiener, J. (2009). The therapeutic relationship: transference, countertransference and the making of meaning. College Station, TX: Texas A&M University Press.
