In this essay, I will define and discuss values and ethics in relation to social work practice, by referring to the work with a service user (V) during my 40days placement with an agency that provides advocacy services to adults with learning disabilities. I will then look at the anti-oppressive practice and analyse the opportunities and dilemmas raised. Finally, I will reflect on my own learning from this intervention. Cynthia (2004p116) states that values are: “generalised, emotionally charged conceptions of what is desirable; historically created and derived from experience; shared by a population/ group within it and they provide the means for organizing and structuring patterns of behaviour”.
Therefore, values are socially constructed moral codes that guide and control our actions within the social world; as social work practice recognises the complexity of interactions between human beings and their environment, it has drawn some of its knowledge from anti-oppressive practise and values in order to facilitate individual change. This knowledge helps the social worker to make informed judgements in addressing the barriers, inequalities and injustices that exist in society (Stanford 2005). Values are at the heart of Social work practice and Banks (2001p6) defines them as “a set of fundamental moral or ethical principles, which social workers are or should be committed”. A good social worker needs to be aware of the societal and professional values underlying his or her work so as to empower individuals, families and communities. Both Anti-oppressive practice and values are embodied in the BASW code of ethics.
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The Case. An initial referral form was sent to the agency on behalf of V, requesting advocating services. An initial visit called the 2nd part assessment was arranged and I accompanied my Practice Teacher to meet the support worker and V so as to gather more information. V is in his late 40s with no verbal communication and deaf but uses a lot of gestures and lives in supported accommodation. He drags himself on the floor while moving around in the house and uses a wheelchair to access the community. The support worker explained that V was an outgoing person who enjoyed going to the pub, gym, swimming, bowling, and eating out and so on. However, the Physiotherapist had stopped him from going swimming as V was seen as posing risk to other people who were using the pool; although there had been no incidents to support this decision.
Also, the Physiotherapist had stopped him from going to the gym because it was considered a risk that V had to shuffle on his bottom through 4 steps to access the gym. The staff were in a dilemma as they could not argue on behalf of V because what they said was seen as their views, not the service users; they needed an independent person to speak out for V because he wanted to be able to do things he enjoyed doing without being stopped by professionals. I found this very disheartening and questioned the physiotherapist’s decision; had she thought about what V enjoyed doing, was this helping V to lead a fulfilling life like any other citizen and had she thought of any other way to support V to go swimming and attend the gym without stopping him completely?
I wondered whether the buzzwords “anti-discriminatory practise”, “choice” and “empowerment” meant anything at all to the Physiotherapist. I thought that the Physiotherapist was purely basing her decisions on a medical model, “an approach which, although quite a dominant discourse in terms of influencing health and social welfare practice, can be seen to be quite destructive as a result of the disempowerment it engenders” (Adams et al 1998 p301). This decision denied V to experience enjoyment by participating in social activities because of his complex needs which were not being met as noted by the Valuing People Document (2001p11) that “people with severe learning disabilities and complex needs are more likely to receive poor quality services”. On the other hand, if V was able to say what he wanted the physiotherapist might have been challenged to consider what was said and probably change the decision.
I imagined how frustrating it must be for V to wake up one morning and find out your daily routine has changed, without really knowing the reason and felt that his difficult behaviour was justified. I drew on Biestek’s social work values of “acceptance and empathy, non-judgemental, individualisation and respect for persons…” (Shardlow in Adams 1998 p26) and referred to the Base Code of Ethics, which states that social work practice “should both promote respect for human dignity and pursue social justice, through service to humanity, integrity and competence”. (Stanford 2005). Society is diverse and social workers should endeavour to work in a way that respects all individuals’ uniqueness, their choices, beliefs, and culture, observe basic human rights, promote their dignity as well as fostering autonomy, irrespective of nationality, age, gender, ability and so on.
Banks (2001p7) contends that in so doing the social worker has to take into account the rights of significant others. I realised that in this instance these values had been thrown out of the window and endeavoured to employ them so as to make V feel a worthwhile individual. I was also aware that Part III of The Disability Discrimination Act 1995 makes it illegal to discriminate against disabled people in terms of gaining “access to and use of any place which members of the public are permitted to enter”. V was being discriminated against because of his disability and I felt it was imperative to apply the social model of intervention, which is “rights-based” and looks at removing barriers so as to enable people to lead fulfilling lives. (Lindow (2000) in Davies p322).
An advocacy plan was set up concentrating on what V wanted and how these were to be implemented, in order to meet personal and social needs. A Person-Centred Planning meeting was held enabling us to work in partnership with support workers in order to draw on everyone’s expertise so as to foster humanity and open processes to enable V to lead a fulfilling life. I wanted to understand his world and felt awkward speaking about him whilst he sat there like a little child, probably wondering what we were talking about as Neil (in Adams 1998 p300) points out “…adults with learning disabilities can face infantilisation”. It was not easy to engage V in conversation as he is deaf with no verbal communication. I had to observe his non-verbal communication which “includes observations about what people are wearing, how they are sitting, what they are doing with their hands, the expressions on the face, eye contact and the physical distance separating them” (O’Connor et al 1998 cited by Osmond 2005p 886)
I found it difficult to interpret his non-verbal communication because I was seeing him for the first time. However, I noticed that V seemed uneasy and kept going out of the lounge where we were sitting, he took a while to settle down. I felt his behaviour was understandable, he did not know us and obviously felt edgy as most people do on meeting somebody for the first time. When he settled down, he sat there glancing at us from time to time. I must admit that during that first visit, I found it difficult to listen to the support worker and became more engrossed in V’s body language and facial expressions. I was aware of an ethical dilemma, whose views were being expressed here, the staff had the potential of saying their views as if they were V’s because of his inability to verbalise his thoughts.
I wanted to know how they facilitated his communication and understood what he meant leading them to draw conclusions such as; V’s dream was to swim with dolphins. The support worker explained that when they took V to shop for ornaments to decorate his room he picked those with dolphins and also when he saw them on TV he got excited and started pointing at them. To communicate with him before a meeting or activity, they showed V pictures, photographs or symbols to explain what was happening. V was able to choose a picture of where he wanted to go or what he wanted; for example, he chose the colour to decorate his room, the furniture and accessories using the Argos catalogue book. The staff were thinking of the best possible way of addressing V’s needs; by getting advocacy involved to represent his views they were adopting the person-centred approach.
Adams (1998 p314) sees advocacy as a form of empowerment which, “involves representing a person’s interests in circumstances where they are not able to do so themselves”. It strives to promote social inclusion by empowering marginalised people and therefore, has a direct relationship to anti-oppressive practice in social work. The ethical principles underlying advocacy reinforce working in partnership with users and carers, a key concept in social work practice and community care. Furthermore, the skills required for successful advocacy reflect core skills of social work practice (Bateman, 2000p17). Professionals get involved in people’s lives most of the times to help, but then oppress them by making decisions for them. Oppression is: “Inhuman/degrading treatment of individuals/groups; hardship And injustice brought about by the dominance of one group over another; the negative and demeaning exercise of power. Oppression often involves disregarding the rights of an individual/ group and is thus the denial of citizenship” (Thompson 1997p31).
In V’s situation, the Physiotherapist made decisions without consulting him, his needs and interests were not considered. As Adams (1998p301) affirms “remedies to problems encountered lie primarily with experts and thus undermines self-determination and authenticity”. Most professionals take it upon themselves to make decisions for people as they assume that they cannot make choices for themselves, yet the Mental Capacity Act 2005 (to be effected in 2007) argues that almost all including the most severely disabled are capable of making choices and expressing their views and preferences. Therefore it is the social worker’s role to “challenge the abuse of power for suppression and for excluding people from decisions which affect them” as stated by Stanford (accessed 5/01/2005) in the code of ethics. People requiring access to services should not feel that they are beggars, their welfare needs should be met as a right and dignity and respect should be maintained all the times.
I was aware of the power dimensions between the service user and myself as I was in a position where I knew what was going on in his life, but he knew nothing about me, not even my name. Horner (2005 p97) says that social workers are to “engage holistically with both the person and their circumstances whilst at the same time recognizing the processes of power dynamics at the play in the helping relationship”. As such, I employed empathy in order to view the world from his reference and worked in a way that was not intimidating in order to understand the situation by asking and clarifying things with the support worker. Looking back, I became emotionally involved; my mind was all over trying to find solutions in the subject area of Risk Assessment that I knew nothing about. Talking to my Practice Teacher helped me to focus and keep on track with the advocacy plan. Although, there were a lot of things that were new to me I researched and read about inclusive risk assessment, the Mental Capacity Act, Person Centred Planning to equip myself as a student.
Being involved in V’s circumstances taught me a lot, not only about people with learning disabilities and services available for them but also about oppression, discrimination and social exclusion. It made me realise the importance of consulting with the Practice Teacher, admitting my limitations in the application of knowledge in terms of risk assessment and theories and stepping aside to reflect, as it is easy to get emotionally involved and overlook important things. I learnt that advocacy is very important for people like V who do not have a voice and that working with different agencies poses ethical dilemmas as each organisation has different shared cultural values. For example, in terms of “promoting independence and quality of life, whilst protecting service users from harm” (Placement Handbook 2005/2006 p90), which outweighs the other -independence or protection?
What if the organisation gets sued? For some professionals decisions are affected by risks to self that is, back covering which makes it difficult to think objectively about each person’s needs. It became clear to me that social workers dealt with complex and conflicting issues almost daily leading to misinformed judgements and therefore, supervision was a very important activity to thrash out any difficulties. In conclusion, social workers as agents of change attempt to alleviate inequalities and oppression within societies and need to be aware of the values underlying their work by referring to the code of ethics. By adopting values and anti-oppressive practice such as advocacy; social workers will be able to make informed decisions in addressing aspects, which relate to the provision of services to individuals who may have differing needs. Although I have explored the inherent conflicts that can arise when working with individuals who have complex issues, it is important to recognise these and discuss them during supervision.
- Adams, R., Dominelli, L. and Payne, M. (eds) (1998) Social Work: Themes
- Issues and Critical Debates. Basingstoke, Macmillan.
- Banks, S. (2001) Ethics and Values in Social Work. Palgrave, Basingstoke
- Bateman, N. (2000) Advocacy Skills for Health and Social Care Professionals. London, Jessica Kingsley Publishers.
- Cynthia, B. (2004) Social Work Values: The Moral Core. The British Journal of Social Work, 35 (6) October, pp109-123.
- Department of Health. (2001) Valuing People: A new strategy for Learning Disability for the 21st Century. London, HMSO.
- Disability Discrimination Act 1995, London, HSMO.
- Horner, N. (2005) What is Social Work? Context and Perspectives. Exeter, Learning Matters
- Lindow, V. (2000) “The Social Model of Disability”. In: Davies, M (ed) The Blackwell Encyclopaedia of Social Work. Oxford, Blackwell.pp321-322.
- Mental Capacity Act 2005,London,HMSO.
- Osmond, J. (2005) The knowledge Spectrum: A framework for teaching knowledge and its use in social work practice. The British Journal of Social Work, 35 (6) September, pp881-900.
- Stanford, P. BASW code of ethics [Internet], available from<http: www.btinternet.com> [ Accessed 5/01/2005].
- Thompson, N. (1997) Anti-Discriminatory Practice. Basingstoke, Macmillan.