Critical Incident Analysis Essay Example for Free

Critical Incident Analysis Essay Throughout this assessment I will analyse a critical incident of an interaction between a worker and a service user or carer during my statutory observation experience. I will conclude my own assessment of the situation and demonstrate my understanding of the use of self, context in which social work takes place and the knowledge and methods of practice. I will not use any of the service users, carers or agencies names in this essay due to the data protection act 1998. I will also adhere to the GSCC codes of conduct that respect and relate to the service users confidentiality and safety. This include respecting confidential information and clearly explaining agency policies about confidentiality to service users and carers, being reliable and dependable, declaring issues that might create conflicts of interest and making sure that they do not influence your judgement or practice; and adhering to policies and procedures about accepting gifts and money from service users and carers. (GSCC, codes of practice for social care workers. ) My statutory observation placement is at a clinic for substance misuse, mainly being heroin, crack cocaine and alcohol. During one of my days there I was given the opportunity to shadow one of the clinics general practitioners for the day. The general practitioners main role is to work alongside the service user in order to help the break the cycle of drug or alcohol dependency and also to live a healthier lifestyle and offer them a better standard of living. The general practitioner meets with the service users on a monthly basis in which gives him the opportunity to gain as much information about the service user as he can in order for him to work with them as effectively and efficiently as possible. The general practitioner greeted the service user in the service room, and he also asked the service user’s permission for me to be present in the room, which then he further explained me being a student social worker. The service user agreed to this. Before actually meeting the service user I had the chance to read through their notes with the doctor so I could get a better understanding of what the meeting would entail, Furthermore to gain a better understanding of the service user’s background and their main reasons for being there. I introduced myself to the service user as a student social worker. We all sat down and the GP went through the notes with the service user and asked them about any other incidents that may have occurred since the last meeting. Prior to the meeting with the service user the GP had revived the service users latest drug test results which were indicating that the service user still had very high traces of heroin in his system even though he was on a methadone script. Furthermore the drug test did not correspond with the amount of methadone that should have been visible in the service users system. Therefore the GP explained what the test results indicated and queried the service user of why the test results have come back with these conclusions. The service user then went on to explain that these indications are showing on the results because the service user has been selling his methadone prescriptions to feed his heroin addiction as he is unemployed and was not receiving the same feeling off the methadone that he would get when he would take heroin. The GP then called one of the clinics social workers as he could only advise the service user on the effects that it will have on their health, but could not help them with the mental and social strain that comes with drug addiction which a social worker could. A social worker then come in and spoke to the service user, to find out about his social background and other emotional issues that are present in the service user’s life that may influence the taking of heroin. ‘A critical incident analysis is a solution, either positive or negative that made a particular impression on a student (Clamp 1984 cited in Reed and Procter 1993) (p. 69). Richard and Parker (1995) argue that reflecting and analysing the incident the practitioner is able to consider how the incident may have been managed differently by applying other knowledge and consequently enable the practitioner to move forward and consider a future situation differently. For the purposes of this piece of work I will be analysing an observation of a meeting between a male and a GP. When I learnt that I was going to be shadowing at a clinic for service users with drug and alcohol problems I was quite worried and intrigued as to what would take place. Then I realised I had to be holistic and also realistic, and although I am not close to anyone that has a heroin, crack cocaine or even an alcohol addiction I have been surrounded by people that have used certain drugs such as cannabis or cocaine. I also feel that I will not always know that this is the case as not everyone demonstrates through their behaviour that this is an issue for them, also some individuals feel ashamed as drug and alcohol use is frowned upon and individuals will deny using drugs. Some individuals explain that they use drugs as a way of numbing their problems or to gain confidence and self esteem. Beliefs about oneself and about the role of drugs or alcohol in ones life are sometimes called existential models (Greaves, 1980). Khantzian (1985) has proposed that addicts use drugs to offset or address specific problems they believe they have, such as a lack of confidence in social-sexual dealings, a view sometimes referred to as the adaptive model of addiction. According to Peele (1985), the individual becomes addicted to a substance because it fulfils essential intrapsychic, interpersonal, and environmental needs. I have always been swayed, and my views have always been clouded by what is written in the media. Substance misuse is always given a negative image and the people that use drugs or alcohol are looked upon in a very negative way, and seen as less important and problematic in society. When looking in on various conversations at this placement I have noticed the band wagon effect- Brown and Rutter (2009) come into play, as it seems to me that family members were scared to be disowned or frowned upon if they were to help the drug user, or even offer advice and support. Throughout my upbringing I have always been warned about the effects of drugs and alcohol misuse, however I feel that my parents didn’t really carry a lot of knowledge about the subject. The misuse of drugs act 1971 intends to prevent the use of non medical use of certain drugs for this reason it controls not just medicinal drugs (which will also be in the Medicines Act) but also drugs with no current medical uses. Offences under this Act overwhelmingly involve the general public, and even when the same drug and a similar offence are involved, penalties are far tougher. Drugs subject to this Act are known as controlled drugs. The law defines a series of offences, including unlawful supply, intent to supply, import or export (all these are collectively known as trafficking offences), and unlawful production. I was able to relate the misuse of drugs act 1971 to the conversation in which I shadowed as the service user was selling drugs that were only supposed to be taken as a controlled medicine that is prescribed. Therefore the service user is committing an offence. The medicines act 1968 clearly states that Prescription only medicines are the most restricted. They can only be sold or supplied by a pharmacist if supplied by a doctor. Pharmacy medicines can be sold without a prescription but only by a pharmacist. General Sales List medicines can be sold by any shop, not just a pharmacy. However, even here advertising, labelling and production restrictions apply. drugscope. org. uk Interviews were carried out with 68 people who were involved in selling in the four markets. Three-quarters of them were men. Their average age at the time of interview was 31, and just under a third had lived in the areas all their lives. Many had experienced unsettled early lives: over half had lived with a foster family, in a childrens home or in secure accommodation. Interviewees had typically used alcohol and illicit drugs from an early age. Many had had a disrupted education, over half being excluded from school or leaving with no educational qualifications. Nearly all had been in contact with the criminal justice system, and over two-thirds had served a prison sentence. Throughout the interaction between the GP the social worker and the service user, and also having conjured up these images of substance miss use I was worried I was going to find it extremely hard to relate to the service user, and also find it difficult to hold in my emotions. I felt as though the individual did not value his own life and other around him, this then made me reconsider my own values and belief systems. I believe that my â€Å"use of self came into context as I strived for genuineness with the service user and I truly wanted to believe that they were on the road to recovery. However I still honoured the values and ethics I strongly value in social work. I could not imagine myself, what it must be like to be addicted to a drug or alcohol, and I have had this stereotypical image of what it would be like and how a person would live their life. I imagined them to be without a lot of money, and living in very poor housing conditions. But also imagined them to hang around with the wrong crowd which may be a big influence on how they go about things. Some of these perceived ideas were backed up by research or what I have seen in the media. It is also very much a stereotypical image. Rogers (cited in Thompson 1988) says that making a judgement about people can be a barrier to effectiveness and is something I need to be aware of if I am to become a reflective and reflexive practitioner. When I first met the service user, I was surprised as to how well he looked considering the circumstances, He seemed very outgoing, friendly and generally happy. I order to gain the facts around the service user’s current situation this meeting had been arranged between the GP and the service user. The conversation began with open questions from the GP to the service user in an effort to gather information about his behaviour and addiction to heroin. He asked the service user about any events that had happened since the last meeting, he explained that he had used heroin since even though he has been assigned to a methadone script, and the way he has been fuelling his heroin addiction is by selling his methadone to other users that can not get any substances top feed their addiction. According to Lawson (cited in Davies 2008) even if their is a key worker system in place the whole team still need to be aware of the intervention and support that the service user is getting. I felt that this was not happening as their should of been a closer supervision in place for the service user to take his methadone script which would therefore prevent the service user being able to sell the drug for money and other purposes. This to me proved that there was a lack in communication; therefore I would be worried that this could potentially be dangerous and cause problems if the service user was able to get away and carry out these sorts of actions. As Seden (2005:2) states â€Å"whether a communication is good depends on how it is received in the situation and what is conveyed to the other person. GP prescribed the service user with a higher methadone dosage that he was on before. This was never noted to his key worker or discussed before hand which therefore allowed the service user to sell his extra methadone and be unnoticed for so long. As Seden (2005:2) states â€Å"whether a communication is good depends on how it is received in the situation and what is conveyed to the other person. Throughout the meeting I made sure I paid particular attention to the way in which I was positioned using the Egan (2007) theory of Soler. I also made sure that I put the focus on the ther person and on what they were offering as they spoke, rather than keep asking them for additional information or going on to talk about other things, this is called paraphrasing and summarising. Eye contact or looking at the user of services is important in this kind of situation and context as it conveys that we are attending to the other, it is a way of saying â€Å"I am interested in what you say and f eel†. The Soler theory is an effective theory to undertake whilst being in this position when listening to a service user one on one. As you need to make the service user feel that you are genuinely interested in what they have to say, then only will the service user actually open up and truly tell you what his problems are as then they are confident that I am here to honestly try to help them. Egan (2007) (p. 99) argues that attentive listening to these experiences and feelings of users of services is critical for further work: these experiences help us to understand where they are starting from and their frame of reference. Attentive listening is very effective in these sorts of situations with service users, as every service user is different and has different problems. Therefore listening intricately is very important as this will then help you navigate in which is the most effective and efficient route to take in trying to help rehabilitate each individual. As the meeting went on social worker began to question the service user’s motives for selling his methadone script and continuing to take heroin. The service user then went on to explain that it is because he does not have a strong support network as his family have disowned him and the only companions he has are the other heroin users. This is why he is struggling to break the chain of causation as the only people he is surrounded by are the other users and dealers. After hearing this I was impressed with his capacity to cope with the situation that he was in. This meeting reinforced Schulman’s (2006) resilience theory. Here was a man who had been disowned by his own family for being a heroin user for many years and is currently undergoing a methadone script and does not have much support around him at all and is experiencing a lot of disruption in his life. In reference to the Ecological model I can see that the service user is struggling to stop continuing taking heroin. This is because the environment that he is present in is surrounded my other drug takers and drug dealers which therefore triggers his new drug fuelled instinct to relapse and take heroin again. Whereas if the service user had a different environment that he could go to where it was drug exempt, this could encourage the service user to stay off heroin and act as a barrier in which would break the chain of causation for relapsing and taking drugs again. (Social service review 1998) Being able to read the case notes enabled me to be better informed. Schulman (2006) talks about how ‘tuning in’ and how it involves the workers effort to get in touch with the potential feelings and concerns that the client may bring to the encounter. The purpose is to help the worker become a more sensitive receiver of the client’s indirect communication in the first sessions. I tried to put myself in a similar where I had questioned someone that had authority over me, the only example I could think of was when I had been in detention at school as a child and I was questioned as to why I was there, and why I did the incident. I felt powerless and frightened as they had more authority over me, and seemed so much more important. I could not seem to get my point across and I did not feel that he was listening to my point of view and taking it into consideration. This has made me realise how important it is to make the service user feel at ease as you are asking them to open up and asking them to let you in and explore their troubles. They will only allow this if they feel comfortable and not undermined. However at the same time establishing clear boundaries with the service user is very important. Throughout the meeting I realised just how hard it would be discussing your problems and the use of drug addiction to two complete strangers, furthermore having to open up about your life and all the problems you have encountered on the way to lead you to this state of life. As a result I tried to keep a low profile during the meeting, by not making eye contact with the service user and trying to make myself inconspicuous. By avoiding eye contact I was merely reinforcing the awkwardness I felt. Schulman (2006) believes that it is better to tackle difficult subjects head on. Then I was worried that the service user may think that my lack of ability to maintain sufficient eye contact could lead him to think that I was merely not interested in what he had to say or that I disapproved with some of the explanations that he was presenting. When it was just to do with me being uncomfortable. Lloyd (cited in Davies 2008) talks about the need for social workers to work on there own issues. This should involve self awareness and being comfortable around others. This will help me challenge my views but also help me become more self aware and, in turn, more open to others who are struggling to express their difficulties. While my own life was not trouble free neither was it associated with the emotional turmoil and psychic disturbance which Hall Stanley G (cited in Davies 2008) research showed. I have always had the support of a loving family and friends. I have always been influenced to do well at school, go on to university and make something of my life. I have also been lucky enough to always live in nice areas that have very low crime rates, however this was not the case for the service user. He has always grew up and lived in very run down, deprived areas and has mixed with the wrong social circles. He has also not have had the family and friend support network which I think a person strongly needs in their life. The service user also left school with no GCSE’S and went straight into work, which was bar work which lead him to a wrong crowd. Giddens, A (2001) refers to gender as the psychological, social and cultural differences between makes and females. Essentially sex is determined biologically and gender is culturally learnt. The functionalist sociologist would argue that boys and girls learn sex roles through socialisation while the feminist perspective would be that women do not share the same status as men in society. It can be argued that male socialisation infers that they are the stronger sex and not able to express their emotional feelings as females are able to. The service user’s lack of permanence and consistency with his own parents and friends will, according to Rushton (2000) impact on his emotional development. It is therefore important that the professionals in his life are not seen to perpetuate these feelings. The holistic approach builds on the social model of disability which is the theory of there being blocks such as environment disabling systems and social attitudes that are getting in the way of the service users independence. Therefore in this case going by the holistic approach, the service user that I was able to shadow, his environment acts like a block to his independence as the social attitudes to the people within his environment are drug related which is leading the service user to carry on using drugs. The holistic approach builds on the social model of disability that sees blocks to independence arising from social attitudes, disabling systems and environments. (Campbell and Oliver 1996; Oliver 1993). Further more this pproach stresses the need for attention to the service users ethnicity, culture and history because together they form their identity and influence life options open to them, and the attitudes of some people towards them and their abilities. Throughout this experience I have been able to learn about the importance of drawing on theoretical frameworks to understand a person’s current behaviour and the effects of his life experiences. According to Freud behaviours driven by th e id are largely unconscious and describe impulsive behaviours that can lead to all kind of difficulties. What this critical incident analysis has highlighted to me is that social workers and other professionals have a responsibility to reach decisions about intervention, protection and safeguarding in a series of situations where evidence may be unclear or contested. Baldwin, N. and Walker, L in Adams et al (2005) say that it is important to recognise that risk can be assessed through a process, which is a collaborative and undertaken within a legislative and organisational framework. From my experience at this particular placement I can draw upon a number of different things that have made me question my own learning and development. It had made me wonder weather I see things differently to others, and also whether my views and opinions would be appreciated. From this shadowing experience I have most definitely changed my views on substance misuse and the kind of stereotypes I had around it. I feel that it has made me value my life more however value the people that are in my life even greater. This experience enabled me to see the importance of ‘critical thinking’ to find a workable solution (Brown, K, pg 12). Throughout the conversation the GP and the social Worker ‘reached for feeling’ and put feeling into words. I feel that I was very judgemental before actually meeting the service user, and I realise that this is a very bad habit as a Social Worker, however this helped me in my development and learning. This also made me think about other factors that may affect how people ‘label’ others such as; discrimination and oppression. I was also able to observe how different agencies work together in order to provide better care for the service user. In this case the GP worked alongside the job centre, the pharmacy, the social worker and the key worker. ‘They can offer service users a more flexible approach and share expertise in order to give them a better outcome’. (Tennyson,1998). When the service user had left the GP had a ‘de briefing session’. This was also a time for me to ask any questions, this is something that I have practiced through reflection time and feedback time with my peers and tutors. The importance of ‘tuning in’ was explained to me. ‘Research informs practice’.