The report is based on an interview conducted at a medical social work agency. The primary purposes of this investigation were: to explore the organization and its delivery of services given to the society, and to understand and assess the function of the workers at the medical social work agency. This report attempts to provide a qualitative analysis of the organizational context of the services rendered, and the influences this has on agency practice, standards and functioning. In this study, we will begin with an overview of the agency, then we will look at the necessary avenues of a social worker in the healthcare sector; their roles and responsibilities to their firm and as a worker of the community, and finally the techniques used in the agency for working with the different parts of a community or society. Avenues such as practice and intervention, client population, ethical standards and professionality in dealing with issues arising within the firm, will be explored. The data was collected via a single interview and thus all data collected and analysed would be assumed as the standard for all social workers in the organization.
An Overview of the Agency
The name of the organization of focus was The Eastern Regional Health Authority (ERHA), located in Mayaro. It was founded in 1994 as an act of parliament and is one of five health authorities in the Republic of Trinidad and Tobago. ERHA is responsible for healthcare in Trinidad’s eastern area which consists of places accounting for approximately one-third of Trinidad’s land mass. The agency covers from Rio Claro in the south, to Valencia in the east (The Government of the Republic of Trinidad and Tobago, 2018). The organization works in line with the Ministry of Health in Trinidad and Tobago and it functions based on clusters which separate the different areas. The number of health facilities in the different areas will account for the varying of cluster numbers. According to the social worker, the area of research is split into two clusters and this is done throughout the different branches of the organization for easier management. Also, social work in ERHA is divided into two professional groups, psychiatric social workers and medical social workers.
Vision Statement, Mission Statement and Values of the Agency
The vision and aims of the agency are to continuously improve the quality of life for clients by delivering quality health care that is accessible to all. The mission statement and intended actions of the agency are to promote social welfare while collaborating with the community and by focusing on the needs of the population, the agency provides help for members of the community. It allows members of society to obtain several healthcare services that they may not be able to obtain, within the guidelines of national social policy.
The core values of the agency that define their identity and actions are as follows: 1) Respect for Human Dignity, 2) Integrity, 3) Shared Ownership, 4) Commitment to excellence, 5) Partnership, 6) Universal access, 7) affordability and equity and, 8) Quality Care.
The Role of the Social Worker in the Agency
The role of the social worker interviewed was that of a medical social worker. His role in the agency and to the community is to improve and maintain quality healthcare. An integral part of social work in healthcare management and service delivery is to provide support advice and sometimes advocate on behalf of clients and members in society.
The social worker is highly qualified for the job as in the Republic of Trinidad and Tobago, social workers must at least obtain a social work degree before gaining employment. The worker must obtain a full understanding of the theoretical aspect and principles of social work discipline to promote positive development and empowerment for those in society. They must also be mindful of social work policy and keep themselves up to date on all ethical standards and guidelines of both the National Association of Social Workers (NASW) and the agency.
The Qualities, Competencies and Skills of the Worker
Specific skills and competencies are highly required in the medical social work settings. One the worker considers is of great importance is the quality of self-awareness. The medical social worker utilizes this skill in dealing with client situations to allow for maximum service quality. By paying attention to his biases and other impeding qualities, along with personal understanding of his capabilities in managing a client’s situation, self-awareness helps the worker to determine the best route of action for his clients.
The worker highlighted that the field of social work is never entirely manageable or comprehensive, and by engaging in continuous practical field work he can and has built on his skills and capacities. Through human interaction, the worker was able to see how interpersonal skills are necessary; and how things such as journaling were important for understanding himself as it allows for reflectivity and re-evaluations of oneself to take place.
Ethical Standards, Professionality of the Agency
Ethical values of the NASW are upheld and maintained by the firm and as stated by the worker, the quality of service and ethics in the agency is not lost based on the continuous urgency of protocol and guidelines of policy administration. Workers are kept up to date on social policy, and, to maintain the standard that the organization holds, workers must sustain these ethical standards by the board to meet the responsibility of their clients. It’s important to be mindful of the ethics and other vital areas to ensure that there isn’t a breach in policy or standards. Example, rules of the organization include no conducting of business and not giving out money to clients but, seeking the relevant avenues for them to receive the financial assistance and help they need. The worker however disclosed that although it is shunned, sometimes they do help clients financially, but it is not to be exposed to the public because it will question worker’s integrity, and only occurs in urgent situations. It’s important to note that because the firm looks at empowerment, they try to provide discussions and forum for persons in need of financial assistance, to explore their strengths so that they aren’t dependent on government assistance so cases of physically giving clients financial assistance are few. Although it is a thoughtful sentiment, it can also be counterproductive in leading clients to believe that the system cannot fulfil their needs.
At all times, workers in the firm are to practice an anti-oppressive and anti-discriminatory intervention approach even in cases where their values, beliefs etc. lay elsewhere. This is an obligation of the social worker as it ensures that the client’s rights are upheld and that they are comfortable in the environment.
Description of Client Population
Approximately 450 clients are seen for a given year at the firm with the more significant numbers seen in female clients as opposed to males. This was assumed to be the cause of the psychological and emotional aspect that is focused on in the firm. As the worker believed that women may be more comfortable than men in discussing their feelings. Men are likely to be referral cases whereas women tend to seek and access the services of the organization more frequently.
The age group of the client population varies from elderly, middle age and persons from the younger population. Elderly client population deal with mainly care and management and non-compliance i.e. elderly persons who do not have someone to ensure that they take their medications etc. The middle age population is generally focused on situations like domestic abuse with intimate partner violence. The younger population consists of youths with learning disabilities or those of child abuse.
The Organization’s Relationship to the Client Group
The organization is a medical organization and as such it deals with all individuals in the community that require health care services and can’t afford it. The phrase ‘all individuals’, relates to the diversity of individuals in the community. The client group will pay attention to most individuals in the community seeking assistance within the health facility but is open to members of the community that have no reference in the facility.
Intervention Methods Used by the Agency and Ways in Which the Groups of Society are Handled in the Firm
In the firm, the focus is on all levels of society, including macro, mezzo and micro levels and it was noted that the worker does this to bring about communal change in society. The medical social worker stated that he works with all the agents of society in the following scenarios: 1) casework which deals with one-on-one sessions with individuals utilizing methods of interviewing, home visits and play therapy; 2) groupwork in the form of support and providing knowledge to persons on a basis of need; and 3) community work dealing with outreach programs like lecturing the public about the services of social workers and informing them of the social work calendar, person’s rights, contacts for seeking help etc. The workers also act as brokers and advocators to link required resources to all of their clients. For example, advocating for clients and persons in different forums like a children’s authority seminar, where the worker(s) will utilize it as an avenue to speak about child-related issues.
The worker uses different techniques in different work environments. In casework, he encourages self-mediation to help persons deal with stressors. In group or community settings he may involve persons in mediation exercises to promote the interdependence of the group but, in the community, mediation is done as the promotion of services so that people have a sense of direction as to where to go for whatever requirements they have. The worker also highlighted that in dealing with family situations, he first speaks to each member of the family to get their ideas of commitment towards the family unit and, lays specific ground rules to avoid conflicts arising. The family members engage in discussions and are free to disagree; their interactions are valuable towards the family settings because social workers aren’t to advise persons on actions but to guide or provide suggestions. In extreme cases towards the law, however, the worker does give advice and may sometimes need to take matters into his own hands.
The organization’s most famous theory followed is the Ecological systems theory, because of the community setting that they work in. The theory allows for all areas of society to be addressed or looked at such as individuals, families and communities. The worker conveyed that the reasons for using this theory were that it speaks to all the facets that filter into an individual being who they are and how the individual reacts to their environment. Cognitive behavioural therapy is another method used in the firm because it looks at persons with personal issues such as self-esteem. He inferred that there may be other models used but in the intervention approach to social work at the firm, these are the most appropriate and functional methods.
Usually, persons are needed and recommended to go through referrals by the health facility instead of walk-ins. In severe cases, however, like suicide, the person may be allowed, if they do not wish to enter or disclose their issues with the health facility. Clients are informed of alternative services in cases that the firm cannot address their needs and are told when these services are not available. Example if there is a lack of funding for equipment or persons may not be able to obtain them, they should know because it is their right.
Lastly, the medical social worker works as a part of multi-disciplinary teams with other professions such as education, health and probation services, to ensure that all aspects of clients’ lives are taken into consideration when help is being discussed. The worker also aims to foster empowerment in society by looking at the psychological aspect of his client’s strengths and by working alongside the medical team, he can enhance the quality of health care for them and ensure that they can cope with stressful or traumatic events that occur.
Issues Occurring in the Medical Social Worker’s Practice
The worker inferred that transport difficulties and lack of finance are some of the significant challenges that clients face when seeking his services. He claimed that members of the firm are readily available and accessible to the public for these reasons. In the cases of home visits, they require persons to show a level of willingness and voluntariness by first reaching out to the organization, because they try to not make clients complacent about their services.
There is not much, if any, of social obstructions or hindrances on the worker from the society. The worker believes that if he trusts that the person(s) being helped can do well through the services, he can utilize this skill in supporting the intervention methods that are used.
How the Worker Responds to Values in Practice
The worker claims to be tolerant of all religious and cultural beliefs, and associations of his clients. It was stated that he is open and inquisitive to other religious beliefs which allows him to function in-line with the standards of a multi-diverse community. He believes that learning about other religions, cultures etc. is an integral and essential requirement of a social worker. In the medical field, a social worker encounters many persons with varying beliefs which sometimes may impede proper or necessary services being accepted by clients and if the worker is not able to deal with the client(s), he refers them to someone else or a different agency.
The worker mentioned that there are not any significant situations that have occurred regarding cultural or religious differences to impede his practice. He believes that this is because he prepared himself to deal with the varying gender issues in society by enrolling in gender studies that facilitated his understanding of the vast gender differences in the society today.
In a nutshell, the medical social worker is to be knowledgeable of all aspects of social work including standards, methods of practice and their self-awareness. It was found that the necessary and vital methods, theories and other avenues were like those learnt in the units. Besides healthcare, the organization also shows responsibility and commitment to the community by providing other services when needed.
Challenges occurred in summarising and digesting the crucial areas of the interview and placing each piece of information in their right category. However, conducting the actual interview was quite easy as the social worker was readily forthcoming with the answers.
- Government of the Republic of Trinidad and Tobago. (2013). Eastern Regional Health Authority. Retrieved November 10, 2018, from http://www.erha.co.tt/Home.aspx
- Government of the Republic of Trinidad and Tobago. (2018). Ministry of Health. Eastern Regional Health Authority (ERHA). Retrieved November 4, 2018, from http://www.health.gov.tt/sitepages/default.aspx?id=90
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