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In this paper, the author generally considered her past personal experience as well as reviewed relevant professional literature, addressed her weakness in serving as a social worker in cases with mentally handicapped persons.
After defining this special population and describing their contemporary situation, the author probed the root factors contributing to influence her perform in social work practice. Her experiences, perception and stereotype towards mentally disabled, affection when getting together with them are all taken into consideration in the context of her own environment. At last, she utilized professional knowledge and skills, aiming at solving her disadvantages in working with mentally handicapped population and improving into a qualified social worker, developed a feasible personal plan in the MSW program in the University of Hong Kong.
Keywords: social work, reflection, mentally handicapped, personal plan.
Social work is such profession that requires self-reflection from experiences to find deficiency or misuse of several factors, including knowledge, skills, values, stereotypes, and so on, so as to achieve social workers’ self-development. As far as I am concerned, I think I lack one of the fields I cannot perform satisfactory work is mentally handicapped. Why coming out this is based on my past experiences. I used to work as a volunteer in a care center of Huiling, which is a non-government organization mainly providing service for intellectually disable people below 16 years old. Though I thought I owned the talent to cope with children perfectly, I found I was unable to work with such mentally handicapped not only because I knew nothing about them, but also owing to stereotype of them. In short, I didn’t want to have any relationship with them by instinct while forcing myself to protect them, apparently excessively, by the perception that I was a kind-hearted person and a future social work. As a result, I left the care center two months later, feeling frustrated.
In this way, I want to present a reflection on my problems in working with mentally retarded people, as well as plan to overcome this weakness in the future two years, aiming to assist myself to become a qualified social worker when graduation from the University of Hong Kong.
Definition of mental handicap
To the simplest, mental handicap, or mental retardation, is referred to the individuals who have below ‘normal intellectual capacities’ (Walsh, 1986, p.16). But any academic and useful definition of this phrase should cover three components, including medical, social and educational. Thus, mental handicap is used to describe the condition of those individuals who, through impaired intellectual functioning (for whatever causes, but referring to a long-term, normally permanent, impairment), are unable to pass the test for citizenship (Brink-Budgen 1986). DSM-III-R condenses this definition as follows:
Significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behaviors and manifested during the developmental period (Davison & Neale, 1990).
Mental handicap has a wide range of coverage, ranging from slight to severe retardation, from totally depending on others for survival to living independently within a certain level. In this way, mental handicap has been classified into different levels according to IQ, with DSM-III-R (1987) divides it into four while Hong Kong Government adopted three levels classification.
50 – 79
35 – 49
20 – 34
50 – 69
25 – 49
The causes of mental handicap are multiple, as physiological, social, environmental factors should all be taken into consideration. According to a survey conducted by the Office of Health Economics (1976), genetic factors account for 35-40% of all severe handicap, including aberrant chromosomes and harmful genes such as autosomal dominant, autosomal recessive and X-linked abnormalities. Environmentally influenced biological factors, for instance, damage to the nervous system, contribute about two-thirds to causing severe mental handicap while about 30% for mild handicap. Among all, cultural of adverse material factors are the most significant one because they take 70% of the responsibility for mild mental handicap, where there is no apparent physical cause.
Contemporary situation of mental handicaps
Mental retardation is quite pervasive all over the world. In fact, about 2-3 percent of children are born to have that deficiency. 75 percent of those unfortunately children are mildly handicapped, while 16 percent of them will be companied with severe retardation.
Mentally handicapped people suffer from both internal and external disadvantages, on which we can refer to the World Health Organization’s model of disability, which covers capacity to function, ability to function, and opportunity to function (Reinders, 2002).
Capacity to function
Such as original impairment of low IQ, abnormal genetic makeup and associated health-related conditions
Ability to function
It means limitations of activity or difficulties in executing tasks or actions that stem from impaired capacity, among which the most significant ones for mentally retarded persons are cognitive skills and adaptive skills. These people are weak in concentrating, remembering and perceiving information. They also have difficulties in using strategies to solve problems, processing and controlling language. Additionally, their adaptive skills are deficiency as well, containing communication skills, interpersonal skills, academic skills, sensorimotor skills, self-help skills, vocational skills. As social skills are the means to social competence (Kellmer-pringle, 1965), those individuals who have intellectual disability will undoubtedly feel hard in this society.
Opportunity to function
It refers to restrictions on community and economic participation that stem from the impact of broader social forces and the availability or accessibility of resources, adaptations and supports. Actually, mentally handicapped encounter numerous hardships in social affairs. For example, they can hardly make friends outside their own circle, find schools to be enrolled, or be employed as “normal” people.
Mental handicaps and their relatives’ self-determination, as well as individual choice have an influence on their social participation. However, no one can deny that they are mostly vulnerable to stereotyping by the general public. Instead of getting to know that all levels of mentally retarded can be educated or trained to some extent, we are usually informed by the mass media that the mentally handicapped are dependent, annoying, violent, and dangerous (Hong Kong Standard 5 April 1992; HK Standard 4 March 1993; South China Morning Post 22 August 1993). For many people, retarded is linked to little control over lives, low expectation for performance on a lot of activities, including those not associated with intelligence(Gibbons 1981, Gibbons & Kassin 1982, Stabler et al. 1977, cited in Gibbons & Kassin 1987). What’s worse, only an extremely small number of schools support to integrate mentally retarded students (Stratford & Tse 1989). Handicapped men are even described as sexually menacing (Longmore 1985). As a result, those individuals have little guidance, support, or chances to learn how to make friends, establish relationships, express sexual wishes. Social isolation is always bound with mental retardation, which leads to financial hardship, low self-esteem for handicapped ones as well as their families.
Perceive own problems
There are mainly three disadvantages oversetting me in working with mentally handicapped, which will be presented below.
Perception and attitude toward mentally handicapped people
It is unexpected that social work students’ attitudes towards the retarded are not significantly more positive than those who are in other professions (Prothero & Ehlers 1974 cited in Hagen et al. 1983). I have to admit that I am among those unfortunate social work students. Deeply in my heart, there are still great many stereotypes, such as “they are living in other world. There is no way for me to know what they are thinking about”, or “I know you don’t want to attack me, but maybe you think heating is as the same as showing friendly”. All in all, when believing intellectually handicapped people are extremely vulnerable and a little dangerous as well, I have much sympathy on them, but also being afraid of them at the same time.
There are some events to make me to reveal my shortages below. Once in the organization, I witnessed a nine-year-old boy, who was severely handicapped, screaming sharply, and hurting himself with a pencil. Rather than come up to help, I just stood there and even tended to get out of the classroom by initiation.
From the day I stepped into social work profession, it has been taught that the basic assumption of social work practice is that every individual can be helped to grow and change so as to achieve his or her greatest potential as a human being. The main concern of social work is to help people learn to contribute to, make use of, and develop through their interactions and interdependencies with others in the society. However, it seems that I cannot practice this principle well on mentally disabled. Calling to mind of the past experiences in care center of Huiling, I have to admit that I own a sessile perception that disable individuals, especially such children, are tremendously susceptible. In addition, most parents or relatives there just desire to seek health care and adult supervision for their junior family members. I falsely dealt with all of these and beard fruit of over-protecting the handicapped children. I simply and crabbily made them to take activities which I thought “safe”, to stay where I could watch out them every minute; I also showed my appreciation on their work but never encouraged them to do anything other than which the center had taken into schedule. All in all, I forced the children to act like lambs, not to mention any self-empowerment or self-dependence.
Lacking specific knowledge and practical skills
Supporting people with mental retardation is a challenge for social workers as it requires us to gain specific knowledge and practical skills. There is apparently a long way for me to be well equipment in this field.
For knowledge, since mental illness is commonly associated with behavioral disorders (Sovner, Beasley and Hurley 1995), I used to set the priority on correcting those children’s behavioral excesses (such as physical aggression, property destruction and self-violence) and behavioral deficits (such as refusing to engaging in activities or responding to requests). In fact, mentally retardation usually occurs with many more biopsychosocial issues, which the narrow perspective made me to miss, not to mention gaining relevant knowledge.
The resources mentally handicapped people need are usually not all available in a single organization, especially for those with challenging behaviors. In this way, when dealing with such cases, social workers need to focus on more than one service-related issue, such as education, medicine, occupational therapy, physical therapy, psychiatry and psychology. It is of paramount importance for me to develop a thorough understanding of all related practical skills.
Strategies & plan
As attitude is primarily in terms of affective, behavioral, and cognitive components (Olson & Zanna 1993; Rajecki 1990), it should be considered as the main factor contributing to my difficulty in working with mentally handicapped, and undoubtedly the paramount one to deal with.
Lau (1994:20) pointed out that “both knowledge about and contact with the attitudinal person or object are the most prominent factors that affect an individual’s attitudes toward this particular person or object”. In this way, I plan to correct my emotion, thoughts, and behavior towards intellectually disabled by gaining relative professional knowledge and skills, as well as intimately contacting with them.
Knowledge and skills achievement
First of all, formal education in MSW program of the University of Hong Kong has been offering me a good chance to gain various general professional knowledge and skills, such as self-determination, family, social network and so on.
Otherwise, there is also an imperative need to study by myself. The exceptional situation of special populations which includes mentally retarded ones should be understood. For example, I should know about the hardship of their families or caregivers, their financial, educational and employing status, their welfare and citizen rights, relevant organization, as well as possible dilemmas in coping with their cases.
Actually, I have gotten in touch with some relatives of mental patients in the Orientation Activities. By listening to their life, feelings, thought, and asking about their needs and situation, I don’t think the patients are as “strange” as before. Such contact with mentally handicapped people should be conducted. Only by this way will I reverse my stereotype of them, feeling that they are normal persons rather than something to be perfectly protected or to be afraid of. What’s more, in interaction with them, I will have the opportunity to apply what I have learned in school, to deepen professional knowledge, to gain new practical skills, to introspect and develop myself in dual role of not only an assistance provider, but also a source of emotional support for disadvantageous groups.
In details, I hope that I can work in an organization serving for mentally deficiency people. By listening to them, play and work with them, and what’s more important, listen and share feelings with them, I believe the intimate interpersonal activities will surely make a mutually positive influence.
Always keep their real needs in mind
As mentioned in last part, the families of the mentally ill children only seek a simple, crisis-solved service without recognizing the long-term settlement of the problems. So, there comes a conflict between “what they want” and “what they really need”. On the other hand, social work may be the best prepared profession to assist people with mental retardation to face and operate with life-long concerns brought by their disability.
Having setting objective of being an outstanding social worker, I am required to clarify my clients’ factual needs as early as possible, keep those needs in mind all the time, help my clients understand the necessities, and to target the best suitable resources and services to meet those needs. For mentally retarded clients, what I need to do includes offering them lifetime financial support and educational, employing opportunities, helping them to build social network with other people in the society. Concentration on my handicapped clients’ real need is one of the determinant factors whether I can competently work with them towards their well-being.
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