It is difficult for me to assess my developing understanding of practical approaches to social work practice with individuals, families, groups, and organizations. I find it difficult because I don’t feel that many of the approaches that we are being taught in class are being utilized in practice. I noticed in my internship that clients are seen as patients and diagnosis, rather than consumers of a service. Their strengths are not emphasized enough, in fact most of the time we continue to look at our clients from the diagnostic point of vie.
I see this as a major flaw in the system and I want to be a part of the system that changes this. I noticed how several of our clients’ strengths were overlooked because they were just seen as routine “frequent flyers” of the hospital. Instead of being able to offer these patients the sufficient care for their illness they were punished and received “777” from CBH denying them service for care. Families were rarely involved in helping the clients we served and if the were they too were seen as detriments to the system.
Family members weren’t treated with enough respect from the doctors or the social work staff. They were expected to give up their time to care for ill patients; however we didn’t do our job by offering them services to handle the additional stress that this would add to their life. We just expected them to pick up the slack of their relatives without question. Unfortunately, people need help. I don’t think this hospital and the CBH system realizes that families want to help but they become just as frustrated as those with the illness. If we expect family members to help their loved ones, we need to be able to offer them services they can turned to for assistance, such as groups for family members dealing with people who have mental illness, mental retardation, or drug ; alcohol dependency. There was several times when I sat in family meetings, listening to the social working telling adult parents of adult clients what they needed to do for their children to keep them out of the hospital.
I sat thinking to myself these were not the responsibilities of the parents, we are enabling the client from getting better and we aren’t even asking the client if this is what they want. I remember one of the Code of Ethics from the NASW, the client is entitled to be a part of their on treatment goals in making and determining what their goals should be, as long as they do not cause any harm to the consumer or anyone else. In the hospital, we don’t allow clients enough freedom to make their own choices and mistakes. As much as we “assume” we work from a strengths perspective, I would have to argue that we don’t. Clients are diagnosed, grouped, and when insurance says it is time for them to go, they go.
Although I paint a grim picture of the learning and teaching that went on at Episcopal Hospital, I would also argue that I learned a lot about what I value as a person and as a professional in the field. According to the Code of Ethics, a social workers primary goal is to help people in need and to address social problems. I believe it is my duty to help others and to but others before myself. I try and use my own personal experience as well as my book knowledge to encourage those I assist with there difficulties. I believe it is important to fight the good fight, even if the good fight seems hopeless. I have never come across an argument that I couldn’t talk my way around and I don’t intend to start now.
While I believe in fighting social injustice, poverty, and fighting for the vulnerable and the oppressed, I don’t feel that it can be done on the front lines. I feel this is fight that must start at the front and will eventually end up in the hands of the politicians and the lobbyists, or the ones who control the money to the programs necessary to solve the problems of the oppressed.
This is why I want to fight the fight at this level. I feel that I would best serve my clients, by expressing my opinions and where they can do some good; where money matters are of concern. I seek, as most social workers do to aid in the fight against injustice. However, I don’t want to sit by in sidelines and watch the system stay the same. I want to choose to make a difference. I want to ensure that all people have access to necessary resources regardless of race, age, sex, sexual orientation, and so on. Again as stated before I feel the only way to achieve this is by climbing the ladder to managerial status, and I intend to do this to improve the lives of the people I work with.
Several skills are used when interviewing clients and gathering information. I feel that throughout my internship I have utilized several key skills in interviewing clients and also in building rapport with clients and providers. For example it is important to treat clients in caring and respectful manners, while being mindful of individual differences, cultural and ethnic diversity. At Episcopal I had the opportunity to speak with clients of several different cultural and ethnic backgrounds. I was able to learn information about how their childhood differed from mine, their values differed, and even their family roles differed. I think this challenged me in several ways.
It helped to open my eyes to how other people less fortunate than I live, how they foster family values, mutual aid, and why they might continuously end up in the hospital, because they might lack the support and resources I had growing up to cope with their situations. This also allowed me to help clients see their strengths when others may not have been able to see any strength at all. I am adamant about working with clients from a strengths based perspective, whether it is at a direct level from an administrative level.
I feel it is imperative that as professionals we help clients to see the positive in themselves and stop pointing out the entire negative. Yes, clients need to know what it is they must work on in order to improve their status-quo. However, when they hear the same thing over and over again, day in and day out, from family, friends and professionals alike, we then become part of their problem instead of the solution to their recovery. I think another skill that I acquired at my internship that was very helpful to me and will continue to be helpful as I work towards my goals of administration is the beginning ability to refer clients to their proper services.
I think this is the only time when a client’s diagnosis should come into play so that they can be referred to the proper services. However, there were several times at the hospital that clients were being referred to D;A services when their predominant problem was mental health. I am aware that in order to treat patients who are dually diagnosed it is necessary to “clean” them up first and then treat the mental health. However, if as professional we intend to treat dual diagnosis we need to offer services that can treat those with such symptomatology. Unfortunately, there is too much of a concern about getting paid by insurance at times that I sometimes notice and see that the well-being of our clients is put to the side. I feel that this treatment represents the lack of respect our clients receive on a daily basis due to their illnesses
As a social worker not only is it my duty to treat my colleagues and those I serve with respect but, I feel it is my obligation. I try, at any cost, to avoid unwarranted, negative criticism of clients while in communication with my colleagues. There were many times at my facility that I heard professionals talking about consumers using derogatory and demeaning statements. While the clients we see may frequent our services, I feel they deserve the courtesy of knowing that we our there to help them in an unbiased fashion. I know that it is difficult to be without judgment 100% of my time however, it is an ethical responsibility that I cherish. My judgments fall into play when I see others judging people for there ailments and shortcomings. I start to wonder, “What makes you or me so perfect that we can sit and judge someone else”.
In the beginning of this paper I really thought I was going to write why I don’t want to be a social worker on the front lines. While part of that may be true, I have also learned some valuable lessons about myself this year; about what I want to do as a social worker, what I want to change, and how I hope to help people in the future. I have learned that it is important for me to be a part of my clients’ treatment as long as the treatment is appropriate to their needs. I have also learned that I feel strongly about using the strengths perspective in working with clients. I feel when I open clients up to their strengths and help them to see what they have accomplished; they are able to take the next step on their own. I also have learned that I feel it is important to be an advocate for our clients without being an enabler.
There is a point when I can do too much, it is important for me to know the difference between helping and doing for the client. Finally I still believe the best way I can serve my clients’ is at an administrative level. I truly believe if any change is going to occur in how services operate it has to come from the top down. I need to be a part of that system to make sure clients are receiving the services they deserve. It is important that someone be a voice for people who may not have a strong voice. I have always said I want to be that voice. I believe that being in administration, where changes occur I can make things happen, and hopefully change a life.