Applying social work skills in practice
Applying social work skills in practice

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Applying social work skills in practice

2.5 Individuals in context

Social workers usually take account of the service user’s family group or close networks, and consider whether to stay focused on the individual or work with the whole family (or parts of the family network). However, there will be times when service users expressly state that they do not want their wider family or other kin involved. Care should be taken when soliciting carer’s views. However, there are caveats related to abuse and also capacity issues. This is particularly important when working with vulnerable adults and children, where it is important that their voice is heard and heeded in relation to the extent that they want wider family involved.

Legal guidance, such as that relating to community care assessments, specifies that assessments are needs-led, but also that carers and ‘relevant others’ have a right to be involved in assessment and planning. Child and family social workers will usually explore the possibility of placing children with relatives before looking at other options.

Family and close networks are often very knowledgeable about individuals, their preferences and views, and can prove a vital source of support and expertise. Nonetheless, if the service user doesn’t want their involvement, this sets up dilemmas for practitioners, where negotiation and case-management skills are needed to resolve differences of perspective. For some people, the family/network to which they relate is a negative and unhappy place to be, and social workers may be involved in providing alternative care. Families can criticise, abuse and use power to damage some members. In social work, such relationship issues/difficulties are a recurring part of the work with service users. As part of their advocacy role, social workers can support people who are gaining independence and moving away from such negative environments.

Often, however, the state – and therefore social workers – expect or leave family members to help each other, and this can have a profound impact on family roles and relationships. For example, the rights of young carers to a needs assessment were only introduced in England on 1 April 2015. In the next activity, you look at an example where the children’s relationship to their parents has been profoundly changed by their mother’s illness.

Activity 7 Young carers: Helen and Sean

Allow about 45 minutes

Steve is a community psychiatric nurse (CPN) who becomes concerned when Jennifer, a longstanding patient taking medication for depression, misses her clinic appointments with him. He makes a home visit and finds that 15-year-old Helen and 10-year-old Sean seem to be caring for themselves and their mother.

Watch Video 5 about Jennifer Edwards and her two children, then answer the questions below.

Download this video clip.Video player: Video 5 Young carers: Helen and Sean
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Transcript: Video 5 Young carers: Helen and Sean

STEVE
Sean? How’s your mum been?
SEAN
All right.
STEVE
Aren’t you going to be late for school?
HELEN
She doesn’t want to get up. You’ll have to come back later.
STEVE
How long has she been like this, in the mornings?
HELEN
I don’t know, about three weeks?
STEVE
And how are you coping when she’s like this?
HELEN
We’re fine.
STEVE
Are you all right for money?
HELEN
We could do with some money for shopping.
[TELEVISION BLARING]
STEVE
What about breakfast? Have you had any yet?
HELEN
No. We’re out of food.
STEVE
Does your mum cook for you?
HELEN
Why?
STEVE
I’m just asking to make sure that you get to eat properly.
HELEN
She cooks when she’s up.
STEVE
OK. What about your dad? Has he been to visit lately?
HELEN
No. Mum won’t let him. He sends us pocket money though.
STEVE
OK. Listen, can I give your mum a shout?
HELEN
If you want.
STEVE
Jennifer, it’s Steve! Can you come down please? I need to see that you’re OK.
[TELEVISION PROGRAM PLAYS]
[FOOTSTEPS]
Hi. How you doing? Things not been too good, then? OK. Let’s talk about how things are.
NARRATOR
Helen has been supporting her mum for the past 12 weeks. Helen does most of the work around the house, with Sean only helping out when he’s told to. She finds little time to do things with her friends, as Sean also becomes increasingly demanding.
HELEN
Mum’s all right, really. People shouldn’t get so worried about her. Because we can cope.
She just needs me to be here all the time. Hi. No, I’m stuck at home because mum’s got someone here to see her. No, you go on without me.
What, tonight? I thought it was Friday. Oh. OK, yeah, no problem. What you wearing? Mm, I think I might wear the black top with the straps. Can I get changed at yours?
SEAN
You’re not going out tonight, leaving me with mum.
HELEN
Oh, shut up.
SEAN
No way! What I do if something happens?
HELEN
You’ll be all right. Look, I can’t talk. I’ll see you later.
SEAN
If you go out tonight, I’m not coming back after school.
HELEN
Oh, for God’s sake, grow up, will you? Look, I’ll speak to you later, yeah? Bye. Oh, gosh.
STEVE
OK, see you later.
MAN
How did it go?
STEVE
Difficult. Really difficult.
MAN
Have you seen Jennifer like that before?
STEVE
No, no. She’s in a pretty bad way. I think she started drinking again. Also, I’m pretty concerned about the children and how they’re going to cope with this.
You know? I mean, there’s no food in the house. There’s no money to buy any either, by the looks of things.
And they really should be at school by now. Basically, they’re taking care of themselves. The thing is, underneath all of this, they’re having to cope with their mother’s illness. You know?
NARRATOR
Steve has arranged for Jennifer’s GP to call round after surgery at 4:30. His concern for Jennifer also extends to her children. And he’s agreed with Jennifer that he’ll discuss the situation on the phone with Helen’s head teacher.
STEVE
And she’s not been attending much? Yeah. Yeah, no, I can see that you’re also worried about her. Yeah. OK, well, I’m going to discuss it with Jennifer.
But I think I’d like to contact social services and discuss it with them. Yeah, we will, just explore options. For example, perhaps one of the family members might be able to help out.
End transcript: Video 5 Young carers: Helen and Sean
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Video 5 Young carers: Helen and Sean
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  • What are the concerns about the potential effects of Jennifer’s mental illness and drinking on Helen and Sean?
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  • What are the strengths in the situation?
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  • What further kinds of support might be provided for Jennifer, Helen and Sean from social workers, the community psychiatric nurse, the schools and other agencies?
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Comment

The concerns about Helen and Sean are:

  • the standard of care in the home – Jennifer’s inability to care for her children and provide them with enough food to eat
  • the impact of caring for their mother on their school attendance and attitude to school work
  • the absence of the leisure, social and other opportunities relevant to children of their age
  • the absence of their father’s input.

Sean’s behaviour appears to be an issue for Helen as he refuses to cooperate with her. Helen has taken on some key responsibilities. It would be a concern that the relationship between brother and sister is being adversely affected by Jennifer’s illness. There might be concern that the children’s worries about their mother could start to affect them and other behavioural issues might emerge. Also, the relationship between the children and Jennifer might deteriorate.

Some strengths in this situation are the children’s attachment to their mother, the fact there is a father living in the area who could be asked to offer more support, the school’s awareness of Helen’s situation and the CPN’s decision to involve other agencies. You might also have noted that both youngsters are showing some signs of resilience (the ability to continue to develop and to adapt to adverse conditions). For example, they have been managing to get to school and keep the home running.

Helen and Sean’s education and leisure opportunities are limited and they have become socially excluded through staying at home to care for themselves and their mother. Counselling support could be made available to Jennifer, and the children’s father could be involved in providing some recreational activities and assistance with shopping or lifts.

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