Abuse can be defined as "to treat wrongfully or harmfully". There are different categories of abuse that have been recognized and within our case study there appears to be two distinct forms of abuse, domestic abuse and child abuse. These can be sub divided into terms of physical abuse, emotional /psychological abuse, and non-organic failure to thrive. Physical abuse is the intentional inflicting of physical injury or harm or deliberately not preventing harm occurring.
The minimum physical signs seen in our study to both Mrs Black and James are bruising with suspect excuses for their appearance. Emotional abuse is the continual failure to meet basic emotional needs. Emotional development is stunted and well- being impaired. The emotional signs in our case study can be seen in James by his actions of being withdrawn and non-communicative. The behavioural sign to abuse taking place to James is his aggressive behaviour.
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The short term effects of physical abuse to James are bruising and pain. In the long term recurring injuries can result in secondary illness and complications, permanent scarring and disfigurement. His emotional effects in the short term are a fear of adults or others, withdrawal, poor relationship with his peers. The long term emotional effects for James could be low self esteem, depression, inability to form relationships.
Abuse can arise for many reasons and there are a number of theoretical perspectives which may be useful in clarifying why the abuse has taken place. The Feminist perspective believes that gender and family roles gives approval to a culture of abuse. Consider the historical and stereotypical ideas of the family, with men, women and children having definite roles. With the men having power and control in the perspective of abuse. In James case he lives in a reconstituted family with the father figure being dominant and a heavy drinker. From a psychological perspective, alcohol misuse can bring mental health problems which may increase aggression in the person and so James is more at risk from abuse by his step father. The family dysfunction theory suggests that the family is not functioning due to family dynamics. The dysfunctioning family attempts to find alternative ways of coping. The relationship between the mother and James, involves a dependency of James on his mother. With other problems in James mothers life, this leads to increasing stress and the inability of his mother to cope and manage the situation within the relationship. The attachment theory state that significant separations of a child from the carer in the early years can have an effect on their emotional development and can lead to psychological and social difficulties in later life. With the loss of both his father and his sisters` father with whom he was close, may have contributed to his deterioration of his behaviour
If a client begins to make a disclosure of abuse it is important to ensure privacy and confidentiality. It is necessary to show that listening skills are employed and that I remain calm and receptive. I must listen without interruption and make it clear that I am taking their disclosure seriously. I must only ask questions of clarification if I am unclear as to what the vulnerable adult is saying. It is important that I acknowledge their courage in coming forward and tell them that they are not responsible for the abuse. I must let it be known to them what I will do to help them and where possible get their consent to inform my line manager. I must speak to my client in comfortable and quiet surroundings. I would ask my client to sit down where I shall use SOLER techniques to aid in communication. Using the SOLER theory I would use the five basic components used in communication. I would sit squarely on at the table turned towards one another. I would adopt an open posture. I would sit so that we have regular but varied eye contact and that my client could see my facial expressions and gestures to aid in communication. This would also let him know that I am involved in the situation. I would lean forward slightly to convey to him that I am interested and committed to actively listen to him. This adhered to our organizations policy on Confidentiality and the Data Protection Act of 1998 allowing my client to voice his concerns without worry and protected his privacy. I would inform him that they are not responsible for the abuse. I must let it be known to him what I will do to help him and where possible get his consent to inform my line manager. It is important that I make an immediate record of what the vulnerable adult has said, using only their own words. This should be recorded in the Incident Book, clearly, accurately and legibly, and then reported to the Line Manager who is responsible for any further action.
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As we do not supply a care service, we are not required to register with the Care Commission, but we ensure all our policies and procedures meet their standards. As all clients under these standards are legally allowed an individualized care plan, we instead have an activity plan. The policy and procedures on abuse of our organisation are underpinned by the National Care Standards which were set up under the Regulation of Care (Scotland) Act 2001. This Act came about to regulate the care and social work force and set out the principals of good care practice. The Care Commission was set up under this Act to register, regulate and inspect all care services listed in the Act. It also established The Scottish Social Services Council (SSSC). (ref1)The SSSC has aims and objectives to protect the service users, raise standards, strengthen and support workforce professionalism. An example of the code of practice on abuse, of the SSSC is `to protect the rights and promote the interests of the service users and carers. Strive to establish and maintain trust and confidence of service users and carers. Promote the independence of service users while protecting them as far as possible from danger or harm. Respect the rights of service users and ensure that their behaviour does not harm themselves or others.` The policy for protecting vulnerable people within our organisation is achieved through the careful selection, screening, training and supervision of staff and volunteers. Under The Protection of Vulnerable Groups (Scotland) Act 2007 a code of good practice for vulnerable adults within our organisation has been developed which expects staff or volunteers suspecting or have had abuse disclosed must immediately report the concerns to their line manager and write up an incident report. The line manager will discuss the concerns with the person reporting the abuse; she will clarify the concerns and obtain all known relevant information. This will then be forwarded to the appropriate local Social Work Department stating that it concerns vulnerable adult protection. In the absence of a line manager the concerns should be reported directly to the local Social work department and then inform the line manager as soon as possible. The social work department after investigation may have to inform the police to investigate further.(ref2)" the primary role of Registered Social Workers is the protection and promotion of the welfare of children, vulnerable adults and the promotion of the welfare of communities in accordance with the Scottish Social Services Council's Code of Practice for Social Service Workers." (ref3)"The social work department will work with the police to carry out joint enquires if necessary and organise case reviews and protection conferences. The police will keep safe from harm the individual who has been subjected to abuse and may call for a medical examination. They will examine and collect evidence, interview suspects, identify offenders and arrange cases for prosecution." The GP or hospital Doctor maybe involved giving medical evidence of abuse and treating the individual.
Under our code of good practice in preventing abuse it is important that I avoid unobserved situations of one -to-one contact with a vulnerable adult. I must never invite a vulnerable adult to my home; I must never offer to take a vulnerable adult alone in my own vehicle, if it is necessary to do things of a "personal "nature e.g. toileting, I must have the consent and knowledge of the carers and my line manager, before doing any of the above. I must not engage or allow any sexually provocative games involving or observed by vulnerable adults. I must never make or allow suggestive remarks or discrimatory comments to be made to a vulnerable adult. I must not engage in or tolerate bullying, or inappropriate physical behaviour. I must respect all vulnerable adults regardless of age, gender, ethnicity, disability or sexual identity. I must avoid "favouritism" and singling out "troublemakers". I must never trivialise abuse and never let allegations of abuse go unreported, including any made against myself. The policy and procedures of our organisation adhere to the Protection of Vulnerable Groups Act (Scotland) 2007 by ensuring as a way of vetting and barring every volunteer and employee has undergone a Disclosure which shows any convictions. If any convictions suggest that abuse of our clients is a possibility then they would not be allowed to volunteer or be employed.
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Sources of support for workers in the field of preventing abuse can be provided by statutory, voluntary, and private or independent organisations. Statutory services have a distinct concern laid down by legislation e.g. social services and NHS. The voluntary sector is run on a non profit making basis and have arisen through a recognised need and reflect society`s feelings. E.g. Advocacy, Mencap. Private organisations make a profit but I am not aware of any private local organisation that supports vulnerable adults suffering abuse. Support can consist of Casework, by working on a one to one basis, by counselling again one to one, and by group work bring people together with shared issues to resolve problems together.
(Ref4) Cultural values play a part in defining what is considered abusive conduct .What we in the UK consider abuse may not be considered abuse in another culture. For example, domestic abuse has only recently become abhorrent in the UK. As up until the 1970s/80s, domestic abuse was considered a marital problem and to be accepted, but today we have little tolerance for domestic abuse. But, today, ethnic minority women still run the risk of long periods of abuse and find it difficult to report, families expect women to put up with it, as ethnic women are considered their husbands property. 'Honour killings` are not unknown amongst ethnic minorities using religious text as justification. (Ref5)Female circumcision is another culturally accepted form of abuse, still practised in 28 countries in Africa. It is seen to control female sexuality and sex outside marriage. This is done to girl's age range from 4 to 12. It usually takes place in un- hygienic conditions with potentially fatal consequences.
Sometimes, workers may have trouble accepting the motives of people who are involved in abuse. There may be the need to ask why and how can they have abused? Where they just bad or mad? Perhaps the workers values and beliefs make working with an abuser distasteful. However, a professional approach to working with an abuser must be taken. For those who work with abusers there is a need to understand why people abuse.
Abusive behaviour can sometimes be the result of mental health problems, empathy deficit, brain damage or being abused themselves. By becoming the abuser they believe they are taking control, some even believe that they are not doing anything wrong and cannot stop themselves. When working with individuals who have abused it is important to be aware that they may go on to abuse again and as well as trying to treat the underlying cause for abuse their is a need to protect the community from the abuser. So, the use of risk assessments are important to keep safe when working with an abuser. ( Ref7) It is important to be able to understand probable risks and take appropriate action to reduce them. Effective communication and personal skills are useful to understand and reduce potential conflicts. Reflection on my own values and how they may affect my practice and awareness and understanding of the abusers cultural values and background is required to ensure awareness and intervention is employed when required.
- SSSC. (2009). Codes of Practice. Available: http://www.arcuk.org.uk/silo/files/791.pdf. Last accessed 09/02/2010.
- Stephen Smellie. (2005). Role of the Social Worker: Protection of Title. Available: http://www.unison-scotland.org.uk/response/swrole2.html. Last accessed 09/02/2010
- Elizabeth Bingham +. (2009). Protection including safeguarding and management of risk.. In: HNC in Social Care. Edinburgh: Heinemann. 229.
- Mary Barnish. (2004). Domestic Violence: A Literature Review. Available: http://www.domestic-violence-and-abuse.co.uk/information/Cultural-Differences-in-the-UK.php. Last accessed 13/02/2010.
- Frances A. Althaus . (1997). Female Circumcision: Rite of Passage or Violation of Rights? Available: http://www.guttmacher.org/pubs/journals/2313097.html. Last accessed 13/02/2010.
- Kathryn Patricelli. (2005). Why do people abuse?. Available: http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=8482. Last accessed 13/02/2010.
- Elizabeth Bingham +. (2009). Issues involved in protection from abuse. In: HNC in Social Care. Edinburgh: Heinemann. 217.