The Meandering Social Worker

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Archive for the tag “behaviour”

A Life Lost in Thought

The Man Who Couldn’t Stop: OCD, and the true story of a life lost in thought by David Adam, 2014, published by Picador

David Adam is not an ‘academic’ writer.  However he is an established British writer, mainly on the subjects of science and nature, which make him well placed to write this well researched book even without the autobiographical element.  The book is written for the lay reader – anyone interested in the subject, perhaps because they think they or a friend or a relative might be ‘a bit OCD’ – but is just as valuable to the social care professional whether working with the young or the old, with or without recognised mental health problems.

Adam explains the difference between an obsession (thought) and compulsion (action), looks at the history of OCD, how the DSM classification has changed in recent years, the role of the brain in OCD, and the eccentric behaviours of people who if they were still alive today may well find themselves diagnosed with OCD.

One of the things that comes out Adam’s writing is the emerging recognition that OCD is another spectrum disorder and that rather than each disorder being distinct in its own right there is some overlapping: some of the behaviours linked to autism may be seen in OCD; whilst there is no known cause for OCD it is often triggered by a single traumatic event that might result in PTSD in someone else; intrusive thoughts, that lead to the compulsive behaviours, can be compared to schizophrenia, although the reactions might be different.

A key point Adam makes clear is OCD is not just about repetitive hand washing or checking ovens are turned off or doors are locked.  There are many other behaviours symptomatic of OCD that are not so visible: some may attract attention such as skin-picking (causing damage and scarring) while others might be almost un-noticable to most people, such as maladaptive daydreaming and endless counting.

Woven through the factual information is Adam’s own story, giving the reader a real insight in to what it is like to live with OCD.



Good parenting?

An Australian mum, angry of the attitude and lies of her teenage daughter and her daughter’s friends, auctioned the ‘One Direction’ tickets she had bought them for her daughter’s birthday present.

Business Insider (US based online news) refers to the ‘blistering and shaming message’ and said this could ‘scar her daughter for life’

Mirror (US based online news) described the mum as ‘wonderfully unforgiving’

John Boone on ‘E’ picks up on the mum’s use of the word ‘trollope’ to describe the girls’ behaviour

Perezitos uses the terms ‘highly unusual’ and ‘strange’ ‘form of punishment’ to describe this mum’s actions

Uproxx said “I’m not sure whether to applaud, or call the authorities” because of this punishment for being ‘lippy’

Gigwise refers to the mum’s ‘blistering and angered rant’ picking up in the title the use of the mum’s word ‘trollope’

International Business Times took the cautious route and made no judgement in their report

So what’s it all about?  Well, here’s the eBay entry for the ticket sale:

“THIS AUCTION IS FOR ALL 4 ONE DIRECTION TICKETS IN SYDNEY OCTOBER 25th. You  can thank my daughters self righteous and lippy attitude for their sale. See  sweety? And you thought I was bluffing. I hope the scowl on your bitchy little  friends faces when you tell them that your dad and i revoked the gift we were  giving you all reminds you that your PARENTS are the ones that deserve love and  respect more than anyone. And your silly little pack mentality of taking your  parents for fools is one sadly mistaken. Anyhow. Your loss someone else’s gain  who deserves them! THE TICKETS ARE SEATED IN ROW O section 57. REMEMBER AUCTION  IS FOR ALL 4 TICKETS and will be sent registered post.

…OH YOUR FRIENDS THOUGHT THAT A FEW PRANKS CALLS WOULD PUT ME OFF SELLING  THE GIFT WE BOUGHT FOR THEM for YOUR BIRTHDAY because YOU all LIED to us about  sleep overs so you could hang like little trollops at an older guys HOUSE?????  Pffft!! I find it HIGHLY amusing that you girls think you invented this stuff.  Tricks like this on OUR parents is how HALF of you were conceived …..And why a  lot of your friends DONT have an address to send that Fathers day card  to!!! I’m not your friend. I’m your MOTHER. And I am here to give you the  boundaries that YOU NEED to become a functional responsible adult. You may hate  me now….. But I don’t care. Its my job to raise a responsible adult..not  nuture bad habits in my teen age child.”

Certainly she didn’t pull any punches.  Her daughter and her daughter’s friends can be in little doubt as to the cause of the loss of their privilege.  The overall impression I get from the other commentators above is one of shock and a degree of disapproval.  But was this mum right?  Or, was the punishment excessive?

On the basis of the eBay listing I applaud this mum.  She’s right when she says she’s not her daughter’s friend, she’s her mother, and it’s her job to raise a responsible adult.

One often recommended form of discipline is withdrawal of privileges.  It has to be something that is valuable to the child/young person in order for the withdrawal to be effective. It also needs to be reasonable and of a scope to fit the misdemeanor.  Clearly this mum is very angry at being lied to and upset that her daughter is putting herself in vulnerable situations.

Unlike grounding or removing TVs from bedrooms, this is a short, sharp withdrawal of privilege, but one of sufficient magnitude to be effective.  Her daughter won’t forget this lesson in a hurry.  It won’t have done her any long term harm, she is unlikely to need therapy to overcome it (as suggested by Business Insider).  It will have demonstrated to her, and her friends, that her parents have authority and that they love her enough to have the courage to use that authority.  She will know that you cannot lie to and disrespect someone, including your parents, and not get some kind of consequence.

I believe parents have a job to do.  A difficult job.  Too often parents want their children to like them and let them do things that are not in their long term best interests.  It takes courage and determination to guide a child through the turbulent waters of adolescence, to be their parent, not their friend.

Hopefully this girl will grow up to appreciate that.

Watching your back

As social workers we regularly visit families alone – most teams don’t have enough staff for regular joint working – and that makes us vulnerable.  Often we think of that vulnerability as the direct risk of violence but that’s not the only risk.

Many years ago I had a male colleague whose female client suddenly and unexpedly exposed her breasts to him in order to show him some bruises.  He was clearly shaken.  In the office we covered our concerns with humour on that occasion but we all recognised this had been a high risk situation for him – long before there was the GSCC/HCPC to answer to.

Parents wanting to stop investigations or proceedings may be uncooperative or claim they cannot work with a particular social workers, knowing that each time there is a change in allocated worker there is a delay as the new person gets to know them and their history, with the possibility that the new social worker might be more easily manipulated (at least at first).

However very occasionally clients/service users take more extreme action in attempting to delay or prevent social workers from doing their jobs, by making allegations amounting to malpractice against the social worker.   Of course in the long term it’s only successful as a delaying tactic as making false allegations will only have a negative effect on the courts’ view.  However, at times like this the social worker can find themselves experiencing what many of our clients feel as they undergo an investigation.  And that can be a terrifying process as one social worker experienced when she was falsley accused, as reported via Community Care.

Knowing we have maintained our professionalism in practice, keeping our integrity and values intact, is our first defence of our own mental and emotional health when faced with malicious allegations.  But we get so used to working with distressed people who, under investigation, respond with strong emotions, often anger, that too often we push to one side threatening experiences, when we should be diligently recording even veiled threats.  In today’s open sharing of information, when we (ideally) get parents to sign and confirm the notes we put on their children’s files we have to consider how we record our observations and how the parent(s) will view what we have said.   However, putting our observations of threats in file notes, review or court reports, serves three key purposes.

Firstly, it’s good practice as sharing our observations with the client (at a later date perhaps when everyone has calmed down a bit) can provide opportunities to open up a conversation about how their words and actions are perceived by others and gives the client the opportunity to reflect on that; and it gives the worker the opportunity to check out different meanings of language used.  In particular the words used to describe anger can be very misleading: try asking a group of people to come up with 10 words to describe different levels of anger and then put them in order of extremity – they will usually come up with some very different choices for the most and least extreme words to describe anger.  Doing that exercise might help the client could be very informative and give the client the opportunity to correct our own impressions and interpretations.  It also gives them the opportunity to have their view recorded on file.

I recall being asked to visit an unallocated client where the concerns were quite low key but the mum had threatened ‘to set the dog on’ the next social worker who visited.  At the time I was still practicing as an unqualified worker and a student and was instructed to take with me another unqualified worker on the basis of the threat.  Needless to say the woman asked why we had to visit in pairs.  So I explained about the threat.  By this time I had met the dog, was sitting at the kitchen table leaning to one side with my wrist being gently held in the mouth by a small friendly dog with an erection.  She laughed and said she didn’t mean it and I could see the dog was harmless.  I explained that we have to take threats seriously.  Ultimately I concluded there was no reason to continue joint visits and in future visited on my own.  Fortunately I like dogs, I feel sorry for social workers who are afraid of them!

In another example of the changing use of language, I recall working with a young teenage new mum who described her baby as ‘sexy’.  Alarm bells were going off all over the place as all sorts of people envisioned her lining her baby up for men to abuse.  But the girl was 15/16 and using the language of her generation.  ‘Sexy’ was for her the ultimate in expressing her love for her child – you could see it in her body language and hear it in her tone of voice.  She was using the word in a similar way as sexy might be used to describe a new smart/good looking phone.  The older generations sitting around the child protection conference were not convinced!

But I digress.

The second reason for diligent recording is that it provides potentially important information for future social workers involved with the family.  If threats are used to detract from underlying issues, meticulously recording them can help build the picture of how the family functions and prevent further delays and distractions.

Finally, sadly, it is part of the armour we have in protecting our own backs.  If a malicious allegation is made we should be able to use our recording to (a) support our own memories of events and (b) provide evidence to investigators.

Rider: Of course, if we are genuinely concerned for our safety, physical or professional, this should be possible to keep ‘confidential’ via supervision, but then we should also be raising those concerns with senior staff and management anyway.

(The above refers mainly to working within children’s services but the same applies just as much in working in adults’ services)

I came across this story by chance. I can’t improve on it, it stands as it is, as an amazing example of the sensitivity needed in dealing with children who have been neglected or abused in some way. It’s why we do the jobs we do – whether we are social workers, foster carers or adoptors or any number of the allied professions. Thank you to the original author for being happy for me to re-blog her post.

Raising 5 Kids With Disabilities and Remaining Sane Blog

Marie, who is profoundly deaf, came to live with us at the age of 7 years old.  At first she appeared to be your typical “tom boy”, but then she began to exhibit symptoms of being something more…symptoms of being an actual boy.  Quite simply, she TOLD me she was a boy.  She would only wear boy clothes, (including boy’s underwear.)  She refused to use the Ladies Rest Room so we found the family and unisex restrooms if she had to go to the bathroom in public.  She begged me to let her get her hair cut short, but her birth mother’s rights had not yet been terminated and she would not give permission for Marie to get a haircut, so Marie would pull it up in a pony tail on top of her head and wear a baseball cap everywhere.  She looked like a boy and she acted like…

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Turning Tides – maybe

Following the Conneticut massacre, and amidst the debates on gun law and gun controls in the US, a quote recently appeared on Facebook:

Reagan quoteAt first glance it might seem that Reagan has a good point, but is it that simple?  Certainly over the years there has been a move towards ‘rights’ rather than ‘responsibilities’ and a decline in the individual being held accountable for their actions, as excuses are made, “he had a bad childhood”, “she was drunk”.

Coming from a different angle, members of the Australian Social Workers’ Association produced a cartoon several years ago.  A small group of professionals: social workers, teachers, police, and medical professionals, were depicted with the caption, “We are responsible for the death of that child.”  The second image was of a large group of people representing society as a whole with the caption, “We are responsible for the death of that child.”  The final picture was of a stereotypical “bad man”, with the caption, “It was my hands that beat the life out of that child.  But I am not responsible for her death.”  If anyone still has a copy of that cartoon (with the accurate quotes), I would love to have a copy to post here.

That cartoon was a reflection on how social workers experienced society’s reaction via the media following a serious incident, usually leading to the death of a vulnerable person.  It wasn’t an unrealistic depiction.  In the UK, when a child dies, enquiries are held, files are analysed, professionals are interviewed and individuals, in this case the professionals, are held accountable for their role and actions.  Often though, it is only the front line social workers who are subjected to castigation in the press.  Maybe it’s because health professionals and the police are seen as the “good guys” they are permitted a little failing occasionally.  Nobody wants a social worker calling at their door.  When the mother of one of the 10 year old boys who shockingly murdered Jamie Bulger in Liverpool back in 1993 said, “I told the (education) welfare (my son) wasn’t in school”, her words were reported but little comment was added as to her role in her son’s generally poor school attendance.  Society, as presented through the media, is selective about the individuals who are called accountable for their actions.

The tide may be turning a little.  Following the death of Baby P in England in London, England, in 2007, the enquiries were still held, the role of the professionals still investigated, but with a tone of shock there was recognition in the media that the parents of Baby P committed the actual neglect and abuse against their son and did their utmost to lie to and conceal the truth from the professionals who were engaged in trying to ensure their son’s safety and welfare.

The individual should be accountable for his actions[1].  But what of the role of society?  In the words of John Donne, “No man is an island.”  Individuals are members of society, together they make up society.  Society makes the laws that enable society to function as a whole.  Perpetrators of crimes are members of society.  Relatives, friends and neighbours of perpetrators of crime are members of society.  Among them will be some who recognise laws are being broken, criminal acts are being committed, that the human rights of other individuals are being violated.  Society as a whole has a role to play in the prevention of transgressions against society, not least because unless they do the “professionals” may not know there is a problem until it is too late.

Shortly after the Connecticut shootings, my heart went out to the woman who wrote her blog entitled “I am Adam Lanza’s mother”[2].  Not literally, but metaphorically.  Her own child has serious behaviour problems.  At times he is a sweet natured child.  At other times he becomes a monster.  She knows, as his mother, that her soon to be adolescent son will be a risk to society when he is an adult.  He could be the next Adam Lanza.  She has sought the help of professionals and has received and accepted the help given.  But under existing US legislation no-one, including her, can prevent her son from refusing to take his medication (which regularly happens) or one day going out and legally buying guns that are readily available in supermarkets, shopping malls and downtown stores, and using those guns to maim and destroy.

Professionals, whether front line workers, managers, employers, are society’s representatives, doing the work of society, to protect the vulnerable members of society on behalf of society.  They are also members of society themselves.  They have the responsibility to do their jobs to the best of their ability within the guidelines of their profession and the laws of their country.  They have the responsibility to make proper use of supervision to discuss cases and work related issues, to recognise and understand their strengths and weaknesses, and to identify new or refresher training to help them in their work.  Their employers have the responsibility to ensure that supervision and training are properly provided and that workers are not exposed to unrealistic work expectations and caseloads.  They are society at work.

Society as a whole may not be guilty when individuals choose to break individual laws.  But modern society is a fluid entity, impacted on by outside forces beyond its control, a changing thing that as a whole has a duty to protect its own welfare, for the sake of future society.  When it becomes obvious that society’s norms and laws are not protecting society in some way, and society chooses not to respond, leaving more laws to be broken, more crimes to be committed, more individuals to be harmed, more lives to be lost, then society is guilty of not protecting itself or its members.

This is the challenge facing the US today.  Each time innocent children get killed in a school shooting, society has to ask itself if that shooting could have been prevented and how.  Restrictions on gun ownership; more security in schools; more guns in schools to prevent shootings in schools (as proposed by the NRA); better recognition of mental health problems and better mental health care, particularly for the poor and uninsured: just some of the options up for discussion.

If society as a whole does not succeed in coming to some kind of resolution that works when problems such as this arise, then society as a whole may be considered guilty by default of not taking action to prevent the law being broken, and harm being done, in the future.

[1] There may be exceptions, such as victims of certain crimes.  For example, someone who is exposed to the drug scopolamine loses all power of individual thought and can be easily persuaded to carry out crimes on behalf of another person.  Like the date rape drug Rohypnol it may be given to the victim without their knowledge.

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