DO NO HARM

Reflections on Chronic and Terminal Illnesses, and the role of the Community Social Worker

 

For me, a social worker working from a community based setting; assessment is an essential aspect of social work. Assessment guides our intervention, and is also an important step in identifying how different members of a family system are affected by the problem. Within the realms of palliative care, there is that additional step to explore further how the patient is emotionally and physically affected by the terminal illness. There is also a need to understand the experiences and need of the caregivers in the family who are inextricably linked to the patient.

Client Positions

Discussed by Insoo Kim Berg (1994), social workers frequently come across different client positions which would affect how they would go about in terms of engaging their clients towards collaborated goal setting. Especially in settings where clients are referred by a third party, it is easy for the social worker to dismiss a client as unmotivated, or uncooperative. However thinking about the different positions our clients approach us in would assist in developing more empathy as to why clients may be reluctant to see us, and also provides some ideas about the focus of our interventions. 

1st Session Structure

 

The following 5 stage model reflects a general guideline I use when meeting clients for the first session. Like all checklists, they are not meant to be followed strictly but just as a rough guide when trying to engage our clients. 

Our Singapore Conversation

 

I happened to have had the opportunity to facilitate a group discussion during a recent Singapore Conversation under the Singapore Association of Social Workers, where my group moved to talk about whether we as a Singaporean society were caring enough for disadvantaged groups in the community. 

Was a bit disappointed with the outcome of the conversation, as no clear outcomes or directions were delineated. It developed into the usual discussion of whether one should depend on the government to set directions, or whether the community (of Singaporeans, social workers, etc) can be empowered to better support disadvantaged persons in the community. But of course, realistically speaking, one might not have much expectations when partaking in a time limited endeavour where topics such as "Whether the disadvantaged were being cared enough Singapore" could only spark general conversations. 

On Altruism (again)

 

I am always fascinated about the idea of altruism, and whether in essence there is any pure attainment of the idea of being selfless in the service of others. In reality it is difficult to expect nothing in return when you do good.

I guess the nobler position we should strive for is to perform acts of service, and be content by the fuzzy feeling we get when we observe positive change in the people we help. This is where the experience of personal gain is subjective to the beholder, and hence we do not set ourselves for disappointment when we expect reciprocal actions from those we help. Even the expectation of gratitude would set ourselves at a higher possibility for interpersonal dissonance.

I am not saying that basing this reciprocity on subjective experiences would not lead us into this experience of distress and disappointment, but instead this position gives us some measure of control over how we gain happiness from performing acts of service. 

Surely this would be a position to strive for.