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This essay provides a critical analysis of a 10-minute AV recording transcript (appendix 1) of an interview with a service user in a simulated role play. This is not a real interview, but part of a student assignment. All names used in this recording transcript are fictitious and thus there are no issues concerning confidentiality.
The essay comprises two parts. In Part 1, Kolb’s Learning Cycle (Kolb, 1984) will be utilised to reflect upon the interview. In Part 2, the ASPIRE Model (Parker and Bradley, 2003) will be utilised to outline how further work with this service user would be approached. Kolb’s Learning Cycle and the ASPIRE Model will both be briefly outlined within the appropriate section.
Part 1: Reflection and Critical Analysis
Kolb’s Learning Cycle, which will be used to reflect upon and critically analyse the interview, comprises four stages of learning from experience: Concrete Experience (i.e. active involvement in an experience); Reflective Observation (i.e. reviewing and reflecting on the experience); Abstract Conceptualisation (i.e. concluding and learning from the experience); and, Active Experimentation (i.e. planning and trying what has been learned). Each of these stages will be used in this reflection and critique.
A simulated role play interview was conducted with ‘Paul Jones,’ a 60-year old who contacted the adult social work team to discuss the possibility of some assistance. Paul is the sole carer of his 92-year old father, James. Paul has been finding it increasingly difficult to care for James, who spends all day on the sofa and does not even go upstairs to his bed at night. James became this way soon after the death of his daughter 1-month previously. She died of cancer not long after Paul and James lost Paul’s mother and James’ wife to a heart attack, 6-months previously. Their only relative is Paul’s son, who lives up North and is unable to visit regularly. The full case study can be found in appendix 2.
The purpose of the interview was to work collaboratively with Paul in establishing his current needs. With the exception of the beginning of the interview when I was nervous and finding background noise distracting, I communicated in a clear and courteous manner. These skills are important when establishing rapport with a service user, laying the foundations to develop mutual respect and trust (Koprowska, 2005). After some introductions and the setting of boundaries regarding confidentiality, I placed the interview agenda into Paul’s control with the appropriate use of the open-ended question, “What has bought you here today?” By recognising the power imbalance present between social workers and service users, I was mindful to reduce the oppressive impact of hierarchy (Dalrymple and Burke, 2000). The question did, however, seem to unnerve Paul and he passed the question back by asking “Well, I’m not sure how much you know?” I informed him that “I do know a little bit. . .” and then gently encouraged him to provide me with some more information. On reflection, I should have clarified with Paul why needed the information again (i.e. to confirm accuracy of details). He was clearly uncomfortable with repeating the information, possibly due to a previous resistance to seeking outside help. I was focused on eliciting information from Paul first-hand to prevent any assumptions being made, but should have adapted my approach based on Paul’s needs.
A key strength within the interview was the effective use of empathic understanding, which appeared to put Paul at ease. Statements such as, “This must have been a very difficult time for you” and appropriate use of eye contact and body language conveyed empathy, congruence (genuineness), and unconditional positive regard. These are three core conditions required in person-centred counselling (Rogers, 1980). I feel that by utilising these skills within the interview, Paul was able to speak openly about his concerns. Indeed, evidence suggests that congruence supports anti-oppressive practice by facilitating the development of a partnership (Miller, 2006).
Paul sought help under the premise that it was for James, but with the appropriate use of open-ended and closed questions it was established that he needed help too. The needs of the carer are far too often overlooked within social care (Herring, 2006), but I ensured I gained a balanced accumulation of information on both Paul and James in order to establish both of their needs. Systems Theory (Bronfenbrenner, 1977) purports that in order to understand an individual, they need to be assessed in terms of their interactions with their environment and within their relationships.
By the end of the interview, a shared understanding had been reached, as well as a plan of action in terms of arranging a home visit and contacting Citizen’s Advice to discuss financial concerns. Thus, the initial aim of the interview was met.
When discussing his problems, Paul was very open and forthcoming, as was facilitated by the use of non-verbal encouragers such as nodding and leaning slightly forward to show interest (Seden, 1999). He was, however, resistant to further outside help such as from his GP or a counsellor. I was careful not to judge Paul on this and to remind myself that there are a number of reasons why he might be resistant (e.g. previous negative experiences with health professionals; family belief systems, etc.). Interestingly Paul did share that James would also be resistant to outside help, indicating the possibility that seeking help is not part of the family belief system. It was important that I did not oppress Paul or James by “undermining their responsibilities for the choices they make” (Dominelli, 2002, p.47).
On reflection, I should have been more understanding of Paul’s difficulties accepting help and adjusted my approach accordingly. In particular, if I was to conduct this interview again, I would change the way I responded to Paul’s concerns that, “I am just worried that I am going to lose it with my dad” and “I often find things closing in on me. . .” I should have probed these concerns further, as has been highlighted in my feedback, in order to establish whether Paul was a danger to himself or James. One of the key roles within the National Occupational Standards for Social Work is to “Manage risk to individuals, families, carers, groups, communities, self and colleagues” (GSCC, 2002, p.12). Paul’s feelings of despair were mentioned on more than one occasion and, on reflection, I should have detected this as a potential risk factor.
I feel I was effective in my use of paraphrasing, as used to clarify issues and demonstrate active listening. However, greater use of summarising might have facilitated communication and ensured that information provided by Paul was being interpreted according to his own subjective experiences (Seden, 1999). I will endeavour to develop these skills throughout my training.
Bronfenbrenner, U., 1977. Toward an experimental ecology of human development. American Psychologist, 32, pp.513-530.
Dalrymple, J. and Burke, B., 1995. Anti-oppressive Practice: Social Care and the Law. Buckingham: Open University Press.
Dominelli, L., 2002. Anti-Oppressive Social Work Theory and Practice. Palgrave Macmillan.
General Social Care Council, 2002. The National Occupational Standards for Social Work. Topss England, April 2004.
Herring, J., 2006. Where are the carers in healthcare law and ethics? Legal Studies, 27(1), pp. 51-73.
Kolb, D.A., 1984. ‘Experiential Learning experience as a source of learning and development’. New Jersey: Prentice Hall
Koprowska, J., 2005. Communication and interpersonal skills in social work. Exeter: Learning Matters
Miller, L., 2006. Counselling Skills for Social Work. London: Sage Publications.
Parker, J. and Bradley, G., 2003. Social Work Practice: Assessment, Planning, Intervention, and Review. Exeter: Learning Matters.
Rogers, C.R., 1980. A way of being. Boston: Houghton Mifflin.
Seden, J., 1999. Counseling skills in social work practice. Buckingham: Open University Press.
Part 2 – Further Work with the Jones Family
The acronym ASPIRE represents the social work process of Assess, Plan, Intervene, Review, and Evaluate, which enables the exploration of successfully operationalising a plan made with a service user (Parker and Bradley, 2003). Adopting this framework also encapsulates the fourth stage of Kolb’s Learning Cycle: Active Experimentation. Importantly, supervision would be required in any interviews since I am a newly qualified Social Worker. Furthermore, the contribution of regular and high quality supervision in the social work profession has been emphasised (Laming, 2009).
If the case of the Jones family was allocated to me after this initial assessment, I would take an eclectic approach, using the ASPIRE framework to guide intervention delivery. An eclectic approach would be adopted in order to ensure that Paul and James’ individual needs were taken into consideration. I would be unable to identify the most appropriate approach to use without first meeting with James, thus an eclectic approach would facilitate flexibility between service user needs.
Assessment would take place within the home, thus adopting a person-in-environment perspective (Kemp et al., 1997). Importantly, supervision would be required in any interviews since I am a newly qualified Social Worker. Systems Theory posits that in order to understand a service user, their ecological system needs to be taken into consideration (Bronfenbrenner, 1977). This includes their microsystem (i.e. immediate relationships), mesosystem (i.e. different parts of the microsystem working together), exosystem (i.e. systems that the individual is not directly part of but that affects them), macrosystem (i.e. the larger social world, such as government and culture), and their chronosystem (i.e. a system of change). The rationale for utilising this theory is that the current problems experienced by Paul and James appear to be related to recent changes within his microsystem. This includes the loss of two family members, changing health status (i.e. James has gained weight, has emphysema, and is becoming less mobile), changing roles (i.e. Paul is now sole carer to James), and a change in their relationship. Bell (2003) asserts that it is easier to understand an individual’s behaviour in the setting in which it occurs, which is the approach I feel most appropriate within this scenario. Family relationships are complex and aptly described by Dallos (1991) as, “The essence of family life is that it is complex and changing and that unique situations and combinations of needs continually arise” (p.7). Therefore, effective support for individual members requires the utilisation of theory and knowledge that assesses their needs within the family context.
An understanding of demands and resources is important when working from the systems perspective, an understanding which the theory itself lacks to emphasise (Coady and Lehman, 2008). For the Jones family, demands within their life include bereavement, deteriorating health, and financial concerns. In terms of resources, they are fairly isolated and, despite initiating this interview, they are both resistant to outside help, which also limits their resources. This provides the rationale for utilising a Task-Centered, problem solving approach in the intervening stage of the ASPIRE framework. The evidence suggests that such an approach is appropriate for dealing with family problems, new roles, and illness or bereavement (Reid, 1978). Paul mentioned a number of problems, both personally and in relation to James, and thus facilitating him to identify the cause of these problems would be a useful endeavour in helping him tackle them. By using a problem solving approach within a collaborative partnership with the family, I would anticipate that it would enhance their capacity to deal with future problems if they were to arise (Germain and Gitterman, 1996, p.139). In turn, educating Paul on the use of problem solving strategies would act to prevent further oppression by providing him with tools he can utilise in other areas of his life (Coulshed and Orne, 1998).
A problem I identified during the role play, but which would need to be confirmed via a shared interpretation with Paul and James, is that Paul could unintentionally be colluding with James’ disengagement. For example, by leaving his lunch next to the sofa so that he does not have to move, Paul is creating dependency. Thompson (2001) suggests that when working with carers, it is important not to encourage them in a role that could result in dependency and thus further oppress the person being cared for. This would need to be attended to sensitively and without causing offence to Paul. One such way of achieving this is via the problem solving approach to help Paul recognise this for himself. Indeed, “change is easier if the directions that professionals and users wish to follow coincide” (Dominelli, 2002, p.25).
In working with Paul and James, great consideration would be needed in terms of bereavement. It sounds like James might be experiencing depression associated with one of the purported stages of bereavement (Kubler-Ross, 1989). In addition, Paul might be in the anger stage or possibly unable to process his feelings due to the stress of taking care of his father and worrying about finances. Their current problems are likely to hinder them both reaching a period of ‘restoration orientation,’ where they can focus on building their future after their loss (Worden, 2003). In order to facilitate a move towards restoration orientation, I would work with the strengths possessed by Paul and James to ensure anti-oppressive focus is maintained (Parker and Bradley, 2003).
There has been some critique to Systems Theory, including that it lacks theoretical and empirical support in practice situations (Healy, 2005). Overall, however, the purpose of the theory is to work with service users in a way that enhances and strengthens their abilities to adapt and solve problems, which ultimately provides long-term outcomes rather than short-term solutions. The key role of social work, as agreed internationally, is the promotion of “social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being” (GSCC, 2002, p.12), and I anticipate that the theories and approaches outlined above would facilitate the empowerment and liberation of the Jones family.
In order to effectively meet the needs of the Jones family, it will be essential to conduct the review and evaluation stage of the ASPIRE model in order to provide closure, implement any additional interventions, and develop my own skills and abilities through reflection and critical analysis.
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