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Sample Term Paper on Exemplification of the Social Work Purpose in an Agency Program

Exemplification of the Social Work Purpose in an Agency Program

Introduction

Social work is a practice-based profession that aims to promote positive social change, development, and the empowerment of communities and their members to solve their problems. As a profession, social work aims to promote community and human wellbeing based on the principles of a person-in-environment framework, a global perspective, knowledge from scientific inquiry, and respect for human diversity. These principles support and guide the purpose of social work through the quest for socioeconomic justice and efforts to prevent conditions that undermine or limit human rights, eliminate poverty, and enhance the quality of life for all human beings, locally and globally (CSWE, 2015). This paper aims to assess whether and how the agency of my field placement exemplifies this purpose of social work. The agency of my field placement is SUN Behavioral Health Delaware, which is a treatment facility for mental health and substance use problems for people of all ages. The analysis in this paper focuses particularly on SUN’s outpatient treatment program for adults aged 18 and above with psychiatric and co-occurring disorders. The paper critically evaluates the agency’s activities and their impact in this program to achieve this objective.

The following analysis shows that SUN’s outpatient treatment program for adults with psychiatric and co-occurring disorders exemplifies the purpose of social work through the program’s emphasis on placing clients’ needs first and valuing his/her input in decision-making on the plan of care. This emphasis is an important foundation for the program’s fulfillment of the perspectives and principles that underlie the purpose of social work, including the person-in-environment framework, respect for human diversity, effective use of resources in clients’ systems, solution approaches that empower clients, and employment of an evidence-based approach.

Agency Demographics

SUN Behavioral Delaware is a 90-bed facility located in Sussex County in Delaware. It specializes in the provision of treatment and care for people of all ages suffering from substance use disorders and mental health illnesses. Its services include specialized programs for adults, seniors (the elderly), children, and adolescents. These services include a full continuum of specialized care on both outpatient day and inpatient service bases (SBH Website/Our Facility). The hospital's mission is to be an effective partner in collaborations with communities that it serves to solve the unmet needs of substance use and mental illness patients effectively. The facility lists its values in these services, like safety, compassion, teamwork, and integrity.

The specific agency activities that are the focus of this paper’s analysis are outpatient services for adults aged at least 18 years with psychiatric and co-occurring disorders. This program targets patients in the middle of crisis situations but do not meet inpatient criteria and those recently discharged from inpatient treatment. This program focuses on the provision of quality treatment for chemical dependency and mental health difficulties as an alternative to inpatient services (SBH, 2020). It involves evidence-based treatment for these patients to help them transition effectively towards a self-sufficient life and healthy living skills while simultaneously promoting their understanding of substance use and mental disorders. This focus in the program serves to empower patients to acquire strong proactive capacities to confront their problems and cope positively with their effects. The activities that SUN offers to clients in this program include comprehensive assessment and evaluation of treatment needs, medication management, process/psycho-educational group therapy, recreational therapy, chemical dependency group therapy, and discharge planning. Others include family therapy and education, 24/7 emergency care services, coping skills training, and referrals to community-based support groups.

SUN supports a wide community in this program and its activities. While the facility's location in Sussex County, Delaware, implies that this county is the primarily supported community in SUN’s services, the facility’s services are available for the broader community in other counties within Delaware, across the U.S., and internationally.

Underpinnings of the MSW Program

The Master of Social Work Program rests on certain underpinning perspectives and constructs relating to the purpose and core values of the social work profession, along with the program’s context. These perspectives are supportive of the need for social work practitioners to be culturally competent and adhere to professional ethics and values and evidence-based practice to promote the lives of individuals, families, groups, and communities. The perspectives are especially significant due to the responsibility to implement intervention and prevention services, advocacy work, and leadership services for diverse client groups in a global society. These perspectives concern the obligations of social work practitioners to demonstrate a high level of social consciousness and adhere to the core values of social justice, service, ethics, and dignity in their work. The following are the five perspectives that underpin the MSW program (DSU, n.d.):

The Strengths Perspective

This perspective emphasizes the need to utilize features and resources or assets present in the client’s environment or “system” to achieve positive change in the client’s life. These features and resources may be internal or external in the environment of the client. The perspective insists on the need for the social work practitioner to identify, mobilize, enhance, and utilize these resources efficiently to promote a strong capacity to address the client’s problem effectively.

The Empowerment Perspective

This perspective focuses on the need for the social work practitioner to apply an approach in work to help the client (individual, family, group, organization, or community) acquire power and greater control over personal wellbeing both presently and towards the future. It essentially insists on the need for the solution approach that the social worker adopts to have an effect of empowerment on the client, such that the client can have a proactive role in addressing his/her/its own problem. Such a solution is effective and sustainable because it vests the power and ability of control on the client to confront and address the problem proactively.

The Rural Perspective

This perspective insists on the need for social work practitioners to consider the unique mores and folkways of people in the effort to find solutions for their problems. It promotes the understanding that people who have grown and live in rural communities have unique mores and folkways that shape their behaviors, knowledge, understanding, and expectations differently relative to those in other backgrounds. This understanding is essential in the practitioner’s effort to individualize interventions by developing solutions that fit individuals and their environments for maximum practical value in solving the target problems.

The Global Perspective

This perspective insists on the need for the social work practitioner to consider the diversity of people’s backgrounds and cultures in solutions for clients. It requires the practitioner to be conscious of and embrace both the commonalities and differences that exist on the levels of religions, individual persons, communities, and cultures among the world’s citizens. This recognition is essential to promote respect for differences among people and cultures in social work interventions.

A Black Perspective for Social Work Practice

This is a prototype (model) perspective for social work practitioners to understand and consider the unique experiences and concerns of individual communities relative to others in the society in social work interventions. It insists on the need for the social work practitioner to understand the unique worldviews and experiences associated with the African genetic identity and origin within the U.S., especially in the context of oppression based on race and ethnicity, and to consider these worldviews and experiences in social work interventions. Considerations of the unique worldviews and experiences of minority communities are important to understand their problems and difficulties effectively and develop solutions with practical value in improving their lives.

The outpatient program for adults with psychiatric and co-occurring disorders at SUN incorporates these perspectives fairly effectively through the design of the treatment process. The design of the program is highly individualized and focuses on empowering the client to have an active role in his/her care and treatment. The highly individualized nature of the treatment and care process in the program orients the applied intervention heavily towards the client’s individual needs, environment, preferences, values, culture, and experiences. The outpatient program focuses on customized treatment plans and sessions for clients. It features adherence to certain rights for clients in the provision of its services. These include (SBH, 2020):

§  Having impartial access to treatment irrespective of differences in race, sex, religion, age, handicap, ethnicity, or legal status

§  Having the right to recognition, consideration, and respect for personal dignity, spiritual beliefs, and cultural, racial, or ethnic beliefs in the provision of care and treatment, as long as such efforts do not harm others or interfere with the planned course of treatment.

§  Having the right to information about received training and treatment

§  Having a right to an opportunity for consultations with private providers

§  Having a right to the confidentiality of medical records and the treatment process

The outpatient program focuses on individualized treatment plans designed specifically for individual clients with their active input. The attending provider and his/her team also review the treatment plan with the client weekly. The process of treatment features a heavy reliance on, and encouragement of, the client's active participation by voicing any concerns, questions, and experiences that he/she may have in the treatment process or its progress. As part of the treatment program, the provider bears a responsibility to incorporate special considerations and arrange specialized family sessions, group sessions, or individual therapy according to individual needs. The provider has an obligation to evaluate each patient’s emotional and physical needs and prepare interventions that meet the client’s needs (SBH, 2020). The key point from this assessment of the program is that its process places the client and his/her needs, input, experience, environment, and preferences first in decision-making on the plan of care and its implementation.

The focus of the program on placing the client’s needs first and valuing his/her input in decision-making on the plan of care and its implementation is an essential foundation of the effectiveness of the program in incorporating the five perspectives that underpin the MSW program, and hence in exemplifying the purpose of social work. Prioritization of the client’s needs, input, experience, and environment in the plan of care is an important common and basic element in the requirements of the five perspectives. It underlies the need to utilize features and resources in the client’s environment or “system” to achieve positive change in the client’s life because of the opportunity it provides for the practitioner to understand the client’s environment and its features. In this way, it is possible to orient the care or intervention plan to the efficient use of these resources. The prioritization of clients’ needs underlies the effectiveness of applying an approach in work to help the client acquire power and greater control over personal wellbeing, both presently and towards the future, because of the opportunity that it offers for the practitioner to understand the client’s deeper concerns, desires, worldviews, and preferences. Based on this understanding, the practitioner can understand how to build the client’s active power and control over his/her problem. When the provider prioritizes the client’s needs, concerns, and preferences and values the client’s input in decision-making on the plan of care and its implementation, he/she can understand effectively the client’s unique cultural background and differences from others on a religious, worldview, experiential, personal, communal, and other levels effectively. This understanding clears the way for the provider to be highly socially conscious of the client’s needs, experiences, and preferences, and hence devise an intervention that can address the client’s problem effectively and fulfill the core values of social justice, service, ethics, and dignity.

Strengths

One key strength in the outpatient program for adults with psychiatric and co-occurring disorders at the SUN is its incorporation of intervention methods that support and enhance the SUN's adherence to the social work profession's purpose. These methods place the client’s needs first and place fundamental value on clients’ input in decision-making on the plan of care, as discussed in the previous section, and adopt an evidence-based model in the treatment of clients' problems. The approaches that the program applies in the treatment of clients' problems demonstrate a global perspective, basis on scientific evidence, respect for human diversity, and emphasis on the conception of the person in his/her environment in interventions to address clients’ problems. These elements are essential in SUN’s programs for outpatients, such as Cognitive Behavioral Therapy (CBT) and Coping Skills Training.

The nature of CBT as a form of therapy is highly illustrative of the principles of social work, particularly those of a person-in-environment framework and respect for human diversity, along with the empowerment perspective’s requirement of interventions to empower clients to have a proactive role in addressing their problems. CBT is a psycho-social, talk therapy that aims to improve the mental health and wellbeing of individuals by challenging and altering the cognitive distortions (attitudes, thoughts, beliefs, etc.) that underlie behavior and adverse experiences of life. It further aims at achieving improvements in the abilities of individuals to regulate their emotions and the development of effective strategies of coping with solving current problems. It employs the approach of helping the patient to identify and challenge dysfunctional attitudes, beliefs, perceptions, and thoughts that underlie adverse feelings, behaviors, outlooks, and experiences of the world (Nehra et al., 2013). CBT focuses strongly on the individual by transforming the lens or eyes through which he/she views life and the world. This focus on the individual in the intervention illustrates a key strength of SUN’s processes in responding to and treating clients’ problems. It aligns strongly with the purpose of social work to promote community and human wellbeing based on the principles of a person-in-environment framework, a global perspective, knowledge from scientific inquiry, and respect for human diversity.

Another strength concerns the combination of experienced and highly knowledgeable staff with industrial best practices in SUN’s operations and treatment programs, including the outpatient program for adults with psychiatric and co-occurring disorders. This combination provides clients with huge opportunities to recover from their problems and attain wellness (SBH Website). It strengthens the quality and effectiveness of SUN’s programs and their potential value for clients.

Limitations

A key limitation in the agency’s operations concerns a high staff-patient ratio, which yields congestion and system inefficiencies in the delivery of services. As a for-profit organization, SUN has adopted a model of leadership and management that aims to improve revenue and profits from its operations and services. The attention to profitability and revenue in SUN’s operations influences some managerial approaches with a potentially adverse effect on patients' experiences and the effectiveness of care, such as a high staff-patient ratio.

A shortage of staff relative to the demand for services at the organization has significant implications on the efficiency of service delivery and the experiences of patients because it influences work overload, work stress, low motivation, low job satisfaction, and turnover among staff. These problems also promote significant risks for the safety of care and the quality of nurses' and counselors' relationships with patients. They undermine the efficiency of the performance of health workers to fulfill the requirements of principles of social work, particularly the need to individualize treatment through critical evaluations and understanding of resources in patients' environments and consider personal, cultural, and community differences in care decision-making.

Opportunities to enhance Strengths

A key opportunity that SUN could utilize to enhance its strengths concerns the growing demand for mental health and substance abuse counseling services. The U.S. Bureau of Labor Statistics (2020) observes projections that the employment of behavioral disorder, substance abuse, and mental health counselors shall grow by 25% in a decade between 2019 and 2029 (US BLS, 2020). This growth represents a rate that is much faster than the average for all occupations. The projected growth in employment in the counseling fields is the outcome of expected growth in demand for mental health and addiction counseling services. Closely related to and contributing to this growth is the trend of substitution of jail time for drug offenders with counseling and treatment services (US BLS, 2020). Stakeholders in the criminal justice system have increasingly realized a lower rate of recidivism among substance abuse and drug addicts who enroll in counseling and treatment programs. The growth in demand for counseling and treatment programs represents a key opportunity for SUN to improve its strengths through the recruitment of highly qualified counseling professionals and improvements in technical expertise in the field of counseling. SUN’s operations and programs are likely to benefit enormously from an increasing abundance of skills and expertise in the fields of mental health and substance abuse counseling. The organization needs to exploit these advantages competently to improve the skills of its staff and the effectiveness of its programs.

Another key opportunity for SUN to improve its strengths concerns the improving uptake of evidence-based practices in the counseling field. Evidence-based practice concerns the incorporation of considerations of patients' values, input, preferences, and desires, besides best current evidence from research and the education, skills, and experience of practitioners in care and treatment decision-making. The incorporation of evidence-based practice in counseling is essential to improve patients’ experiences of care and the effectiveness of treatment in addressing patients’ problems (Louie et al., 2020). The increasing uptake of EBP in counseling promises improvements in the work and productivity of staff at SUN because of a lower prevalence of stress and challenges relating to the ineffectiveness of care and patients’ experiences of treatment. SUN’s continued commitment to EBP models in its treatment programs promises to improve the motivation, performances, and productivity of its staff, and hence the success of its operations, owing to its promotion of improved experiences of care among customers and higher effectiveness of treatment in meeting clients’ needs.

Opportunities to Address Agency Limitations

The following opportunities are suitable for SUN to address the limitations of system inefficiencies relating to a high staff-patient ratio in its operations and programs:

§  Greater involvement of employees in decision-making: The involvement of employees in decision-making is an important way of empowering them to utilize their knowledge, skills, and experiences in work to contribute to decision-making. This process exploits the unique and strategic positioning of employees in work processes in an organization to improve the efficiency of these processes and the experiences of employees in performance. The involvement of employees in decision-making offers them opportunities to shape the processes of work according to their experiences and needs. At SUN, the management’s allowance for staff to participate more actively and effectively in decision-making promises great value in terms of innovative solutions to improve the work experiences and performances of staff, and hence to alleviate adverse effects, such as work overload, work stress, low motivation, low job satisfaction, and high turnover. As part of the effort to facilitate greater employee participation in decision-making, the management at SUN could adopt a more structured participative model of leadership.

§  Greater focus on work-life balance: The management at SUN could focus more on strategies to promote employees’ abilities to achieve a balance between their work and personal lives. It could make the work of employees more flexible to fit their personal responsibilities and needs. This effort requires the active involvement of employees in work scheduling decisions to be effective. These efforts are important to make work at SUN more meaningful and satisfying among staff. Efforts to make work more flexible to fit employees’ needs and personal lives would reduce work fatigue and stress among them, and hence promote their productivity and help to reduce inefficiencies relating to high staff-patient ratios.

§  Employment of more staff: The employment of more staff at SUN could help to alleviate the workload on current staff and improve the efficiency of work performance.

Conclusion

This paper has evaluated critically how the outpatient program for adults with psychiatric and co-occurring disorders at SUN Behavioral Healthcare Delaware exemplifies the purpose of social work. This purpose of social work is to employ the principles of the person-in-environment framework, a global perspective, knowledge from scientific inquiry, and respect for human diversity in the promotion of community and human wellbeing. The analysis illustrates that the outpatient program at SUN embodies this purpose through its emphasis on prioritizing the client’s needs and input in decision-making on plans of care. This emphasis represents a critical foundation for the program’s alignment with the underlying principles and perspectives for the purpose of social work. The prioritization of clients’ input and needs in the program facilitates the incorporation of a person-in-environment framework, respect for human diversity, effective use of resources in clients’ systems, the use of solution approaches that empower clients, and employment of an evidence-based approach in solutions. While this is a key strength in SUN’s programs, the organization faces the problem of system inefficiencies in the delivery of services owing to a high staff-patient ratio. Some suitable opportunities that the organization could utilize to address this problem are the employment of more staff to lower the ratio, promotion of greater involvement of staff in decision-making to yield innovative solutions in staff performances and work experience, and the adoption of strategies to make work more flexible and promote work-life balance among staff. These strategies could enhance the efficiency of work processes at SUN, and hence strengthen the alignment of its programs with the purpose of social work.

References

Council on Social Work Education (CSWE) (2015). Educational policy and accreditation standards for Baccalaureate and Master’s Social Work programs. CSWE.

Delaware State University (DSU) (n.d.). Socially conscious: Department of Social Work - mission statement. Retrieved from: https://chbs.desu.edu/departments/social-work

Louie, E., Barrett, E., Baillie, A., Haber, P., & Morley, K. (2020). Implementation of evidence-based practice for alcohol and substance use disorders: Protocol for systematic review. BMC Systematic Reviews 9(25): 1-6.

Nehra, D., Sharma, N., Kumar, P., & Nehra, S. (2013). Cognitive behavior therapy: An overview. In Hooda, D., & Sharma, N. (Ed.s) (2013). Mental Health: Risks and Resources (pp.271-312). New Delhi, India: Global Vision Publishing.

SUN Behavioral Health (SBH) (2020). Organizational performance improvement plan. SBH.

Sun Behavioral Health (SBH) (2020). Sun Behavioral Health Delaware website. Retrieved from: https://sunbehavioral.com/delaware/

U.S. Bureau of Labor Statistics (US BLS) (2020). Substance abuse, behavioral disorder, and mental health counselors: Job outlook. US BLS. Retrieved from: https://www.bls.gov/ooh/community-and-social-service/substance-abuse-behavioral-disorder-and-mental-health-counselors.htm#tab-

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