Skills of Thye Manager

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					SS4115 integrated
Social Work
Practice
Outline
  Definition
 Historical and rationale of integration
 Model of integration
 - profession oriented integration
  - method oriented integration
  - agencies oriented integration
  - locality oriented integration
  - client oriented integration
 Difficulties and solution of integration
 Discussion
 Others
What is integration?
   It is to change the different parts into a new
    whole.
   During the integrating process, each of the
    different parts will have to have some
    adjustments in order to cope with the change.
   The quality of the new whole is totally different
    from the quality of the original parts.
(譯自: 阮曾媛琪, 1992; 社會服務整合化的意義及展望.香港社會工
    作學報,第二十六卷第一期)
Why do we Integrate?
 Respond to the changing needs of clients
  and society.
 Repair the difficulty in Service Centre, e.g.
  overloaded and overstretched.
 Solve the problem on service delivery.
 Prevent duplication on service.
 Allow centre to allocate the recourse
  flexibly.
 Reduce the high expenses in social
  welfare agencies, e.g. the salary of senior
  worker.
 Social Workers are suggested to be
  generalist in all fields.
The development of integration
   Social welfare in the 1990s & beyond, the social welfare
    Department purposed on integrated approach. (See
    White paper Description 1991)
   It aims at solving the difficulties brought by fragmented
    services provided by various department or agencies.
   By adopting the integrated approach, service users can
    more easily get access to the service, and related
    departments.
   Agencies can provide service with existing resources
    more vividly and economically.
The rationale of Integration
approach:
1. Coordination and Integration of the Service
  Delivery:
 Provide clients with more convenient access to a
  wide range of services (e.g. One-stop service)
  and enable more flexible and cost-effective use
  of available resources. Different service units
  join together to work for the betterment of the
  clients.
2. Holistic and Person-oriented approach
 The coverage of the service should include all
  groups in society and no group is being left out.
  (Comprehensive coverage)The services
  provided by agencies should base on the needs
  of clients and society. Clients can get
  comprehensive care. It allows the worker uses
  multi-content and multi-level approach to meet
  the needs of clients.
Profession-oriented
integration

Definition: different
professions joint together
Advantages
1. Multi-context intervention and assessment
 Since social workers may not be competent
  enough to cope with different problems of the
  service users, profession-integration helps to
  gather professional knowledge from different
  fields to provide comprehensive service to
  service users and assess clients‟ needs in
  broader and diverse context.
   Example: school social workers can obtain
    information from teachers about the student’s
    behaviour problem in classroom in order to provide
    in-depth assessments. Teachers may also assist
    social workers to monitor the change of client in
    classroom.
2. Convenient to service users
 Service users do not need to go to other
    agencies to obtain service, but can
    obtain different services in an integrated
    centre, so it is more convenient and less
    time-consuming to seek for services.
   Example: parents can obtain family service in I.T.
    centre, the PHAB Association.
3. Able to access resources quickly
 Profession-integration enhances the
    communication and co-operation among
    different professions, so social workers
    may help to identify these professions
    and related resources quickly.
4. Support different professions
 With communication and discussion between
  professions, it helps to support different
  professions in providing service or designing
  intervention plan.
   Example: School social workers support teachers in
    handling students’ emotional problem so that teachers
    can teach the class effectively.
Disadvantages
1. Time consuming
  Takes more time to communicate and
  cooperate with different departments and
  centres, so more time is consumed in
  administrative procedures.
2. Difference in vision, mission and work
   practice among different professions
 With co-operation, the workers may have
   to meet the demands and expectation of
   other professions, which service users
   may sacrifice in obtaining some of the
   services. It is also difficult for different
   professions to come up with a consensus.
   Example: The police of Yuen Long adopted the social
    work notion of “zero tolerance to family violence” and co-
    operated with Yuen Long IFSC, they arrest abusers
    without trying to remedy the situation and keep them
    over night, so as to protect the victims and other family
    members. Yet police may not understand the rationale
    behind, they may mislead or deprive clients during
    execution.
3. Higher the cost of service
 Having more professions to deal with a
    case, it accelerates the cost of service.
    The agency may need to employ
    different professionals, so the service
    users may not be able to afford the cost.
Method orientated
integration
Models of integration
   Use all three social work practice methods
    to deal with the different levels of client‟s
    problem. E.g. Case, Group, Community
    Work. The rationale of the integration is to
    provide preventive, supportive and
    remedial services to the clients.
   For example: IFSC is integrated as family
    resources unit (preventive and
    educational), family support unit
    (supportive and empowerment) and family
    counseling unit (intensive counseling).
    Within these service units, it includes the
    practice of case, group and community
    work to intervene with client’s needs.
Advantages
1. Actively respond to clients‟ needs
 The model could provide initiative to client‟s needs. For
   example: FSC used to specialize in doing the case. The
   case was received passively. The center could not put
   the first aid and assess potential risk of the family. The
   support network is rather weak for those families in need.
   After integration, more preventive and supportive work
   would be done as to response to the needs of the client.
   Worker would go outreaching to identify potential clients.
2. Easy to assessable
   Before the integration, client needed to face
    geographic inconvenient. Different government
    departments would respond to their work individually.
    Case department and group department were different
    units that located in different areas. Client needed to
    refer to different departments when they undertook
    case or group intervention. Method integration which
    provides all three levels of practice would be
    undertaken in one single unit. Client no longer needed
    to refer to different departments to undertake different
    services.
3. Person-centered
 Person centered approach is likely
    applied as client could get
    comprehensive case within three aspects
    of intervention. Clients can obtain
    different intervention methods according
    to their needs.
4. Simpler administration
 One case file is used within the agency
    for each client when getting different
    services.
Disadvantages
1. The quality of work
 Dealing with all different methods may introduce
  much more workload and pressure to workers.
  Different methods may require skills to handle
  the tasks; the worker may not familiar with all the
  methods and thus have pressure when they are
  requested to provide services that they are not
  good at.
2. Use of the resources
   The resources may be reduced after method integration.
    One service center is used to capture the work of case,
    group and community work. However, the resources may
    not be enough to provide all three aspects. Center has to
    balance the resources and provide a fixed amount of group
    work and community work project. The resources may not
    be flexible enough in response to client‟s needs.
   For example: some of the family service centers such as single
    parent center would be incorporated in the IFSC. The original
    resources to run those family centers would not be given to IFSC.
    There are insufficient resources to provide service to those clients
    and the quality of service would be lower.
3. The quality of worker
   The worker used to specialize in doing one
    field unit, however, after integration; worker
    would require being skillful in both group work,
    case work and community work. Workers may
    not be able to master the demands of all the
    methods .They would not handle the work
    properly as lack of skill training.
4. Complicated administrative procedures
   Different methods may associate with different
    administration procedures, providing all these
    methods by a single agency may make the
    overall administration complicated. Even
    though having the same case file, different
    services may still be provided by different
    workers
Agencies oriented
integration
Example:
   DECC (district elderly community center)
   Integration of Social Welfare Department, DECC,
    NEC, Non-Governmental Organization elderly
    centres, home services, care & attention home,
    nursing home, the leisure and cultural service
    department and Hospital Authority.
Advantages
1. Re-deploying existing resources:
  Different agencies join in the service can
  manipulate the resource more efficiency.
  The flexibility of the service can be
  increase due to the more resources in
  used. Service become more faultless
  which is benefit to our service users.
2. Injection of new resources:
  Different kind of service provided wide
  range of resource. It solved the problem
  which is lack of resources, knowledge and
  professional. It expand the function to
  provide a wide range services to the
  services users.
3. Increase agencies communication and
  cooperation:
   Agencies oriented integration highlight the issue
  about cooperating between different agencies.
  The information, knowledge were interchange
  within agencies. Due to the cooperation increase,
  service become diversely and gives more choice
  to service users. Resources saving with
  integration that reduce the repetition expenditure
  on the same resources.
4. Save some NGO‟s life and retain them in the community
  Resources, manpower supported by different agencies
   save some NGO‟s life. They can had more chance to
   provided service and maintain there competitiveness in
   the community.
5. Joining professional workers together:
   such as social worker, psychologist, elderly assessment
   workers, doctors…etc. therefore, they could provide one
   stop-service to service users.
Disadvantages
1. More complicated cooperation that may take a
  long time to work with other departments.
2. Takes more time to communicate and cooperate
  with all the departments and centres.
3. More difficult to allocate resources because
  there may lack of manpower to proceed the
  service render provided by the different
  departments.
Locality-oriented
Integration
Definition
   Within one locality, different agencies or
    workers join together. e.g. agencies join
    together to respond to hot issues like
    indecent assault. (Lo, 2006)
Examples of locality-
oriented integration:
Example 1:
   The anti-family-violence road-show of
    Thye Hua Kwan Moral Society, Family
    Service Centre (Bedok North) in
    Singapore.
Background:
 Family Service Centre (Bedok North) located in old, poor district
  where a lot of women suffer from family violence.
 Family violence doesn‟t only happen to those low-educated women,
  but also to the high-education one.
 Victims often did not like to disclose themselves.
 “Reporting family violence is the only way to stop violence.” Fidzah
  (The Social worker) told us.
 The goal of the road show is to arouse the awareness of local
  people about the issue and encourage them to report it to The FSC.
 Therefore, different centre cooperated to achieve these goals.
Details of the road-show:
 Road show titled “Break the Silence, Seek
  Help to End Family Violence” held on
  Sunday (July, 2006).
 The road combined a myriad of elements
  of music, drama, games, pictures to
  convert anti-violent message.
Example 2:
 朗日計劃 of Yuen Long (West) Integrated
  Family Service Centre
Programme Details:
 This is a programme jointly held by an
  Integrated Family Service Centre of Social
  Welfare Department, an Integrated Family
  Service Centre of a NGO and a Youth
  Centre of a NGO.
Objective:
 The programme aimed at building
  community and social network between
  CSSA recipients and single-parent families
  in two targeted public housing estates.
  The programme made use of the client
  data from the Social Security Field Unit to
  screen out targeting clients.
Example 3:
   元朗區福利辦事處—元朗西「服務區域為本」協作網絡會議

   Programme Details:
   This cooperate-network meeting is organized by the Social Welfare
    Department. Members of the meeting included staff from Social
    Welfare Department, Social Security Field Unit, Family and Child
    Protective Service Unit, Integrated Family Service Centres of Social
    Welfare Department, Integrated Family Service Centres of Non-
    governmental Organizations, children and youth centres, secondary
    schools, primary schools, kindergartens. The rationale of the
    meeting is to create a communication platform to enhance the
    cooperation between various agencies and departments within the
    district. The meeting also served provided a platform for promotion
    of services. The meeting is held every half year.
   The meeting focused on monitoring and
    improving the welfare services of the Yuen
    Long District. Some foci of the meeting
    were prevention of family violence,
    enhance residents‟ sense of belonging,
    improve communication platform between
    agencies and between agencies and
    residents.
Advantages
To clients:
 As different types of welfare organizations will join and
  hold function together to target the hot issue, citizens
  could know more about hot issue and types of services
  they needed at the same time.
 Locality-oriented integration responds to the hot issues
  which usually reflect the needs of people.
 Easier to access as there are more than one agency
  involved.
 It enhances local people‟s sense of belonging to the
  community.
To Social Worker:
 Multi-level intervention
 Bring in more views and alternatives in tackling the
  issues
 Enhance workers‟ sense of belonging to the locality
 Enhance the cooperation of workers in different agencies.
 Self improvement by learning from other social worker
  on handling the case, group, or community work.
To centre:
 It facilitates the mutual cooperation process
    among agencies within the locality
   Different agencies may have different
    network and user groups, they can greatly
    increase the work effectiveness and
    efficiency by working together.
   Agencies can assess clients‟ needs in
    broader and diverse context.
   It may simplify administration and communication
    procedures after discussion and compromises over
    communication platform like meetings
   It allows multi-context intervention.
   It prevents service duplication.
   Better use of resources through centralized
    management
   For the more public advertisement of welfare
    organizations to the citizens.
   Provide different service creatively and flexibly .
To community:
 By involving many agencies within the locality, it is easier to
  create an atmosphere in the locality concerning the issue,
  which lead to better effect
 Better use of resources through centralized management
 Prevents crime
 Division of work depends on the characteristics of the agency,
  result in higher efficiency in responding to local issue
 The community work shows compassion to the citizens and it
  enhance the social cohesion in long term.
 it broadens the social network of the residents in the same
  locality
Disadvantages
To clients:
 Clients may not know clearly about the
  detail work division between the agencies,
  and may get confused of which agencies
  provide the service
To worker:
 The cooperation involved a lot of shared resource (time, material,
   manpower, money...), it may result in conflict when there is unfair
   events.
 Communication between workers from different agencies may not
   be as feasible and effective from workers in the same agency; this
   may lower the work efficiency
 As it involves many agencies and professionals, it is not easy to
   communicate all the information accurately if not over a
   communication platform like meetings
 It is time consuming to create the platform as it involves many
   agencies and professionals within the locality
To centre:
 Different centre have different missions,
  vision and work practices, these may
  result in misunderstanding and conflicts
 Agencies have different work focus; it is
  difficult to gather different agencies and
  departments to focus on one specific issue
  of the locality
To community
 Locality is very large and complex; target
  at all hot issues may not be possible
Client-oriented
Integration
Definition
   It provides the service in order to meet the
    individual or family needs, it is different
    from placing the clients into the existing
    services, thus, the planning of integration
    services develop in community and clients‟
    needs. Clients obtain the services which
    they need in the same agency, even the
    same worker.
 Two styles of client-oriented integration:
1. Same clients but different needs.
2. Different clients but same needs.
Examples:
1. The Jockey Club Centre for Positive Ageing
 It is specially designed for the care of elderly with
   dementia, and for training carers working in the field as
   well as informal carers, (e.g. family members, domestic
   helpers). Quality services are assured with the
   professional involvement, a team of specialists
   comprising a medical doctor, nurses, occupational
   therapist, physiotherapist, social workers and personal
   care workers operate the Centre. It provides one-stop
   services to the elderly with dementia.
2. Integrated Family Service Centre
 IFSC as a whole, it includes Family
  Counseling Unit, Family Support Unit and
  Family Resources Unit. People come from
  different needs, for instance: financial
  needs, housing needs, needs for job and
  emotional needs, etc.
Advantages
   The services were not divided into different departments,
    we can understand the individual, family and community
    needs in all-round, therefore we can provide appropriate
    service for their needs.
   Multi-level assessment of different clients: different
    perspectives from different professions to assess the
    same case. Effective - comprehensive care to satisfy the
    client‟s need.
   Clients can obtain different services in the same agency,
    it can save their time and it is convenient to them. they
    can also obtain different services from different workers
   Person-centered: clients get comprehensive care, it
    respects individual and start from client‟s needs.
   Make a good use of allocation of manpower, places,
    facilities and other resources with good flexibility. Clients
    may have a larger space in centre for activities.
   Apply diversification and multi-level of social work
    intervention with good flexibility.
   Simpler administration: one case file within the agency
    for each client while getting diverse services
       In IFSC, every client just has one case file, no matter what
        services they got. (financial and counseling service )
Disadvantages
   Cooperation with different workers
   The quality of service depends on the
    cooperation of different workers and their
    communication style.
   Different methods may associate with different
    administration procedures, providing all these
    methods by a single agency may make the
    overall administration complicated.
   Different methods require different skills,
    knowledge and experiences from workers,
    workers may not be able to master the demands
    of different professional knowledge and
    intervention methods.
     In the JCCPA, they run a case management
      intervention method to deal with every client, however,
      their case managers are come form nurses,
      occupational therapist, physiotherapist and social
      workers, so they may not acquire professional
      knowledge from other fields.
   Different professionals work together, but different
    people have different style to deal with the same case.
    We can not control their treatment method and style.
   Dealing with all different methods may introduce much
    more workload and pressure to workers, as they may not
    have the knowledge in different professionals and
    perspectives.
   Even though having the same case file, different
    services may still be provided by different workers
Positive comments on the practices
and Client-oriented Integration
 We can understand more about the client
  and did not divide into different parts and
  needs, it is easy for us to have a well
  recognition of the client.
 It is good for us to work with different
  professionals and workers, we can learn
  from their experiences.
Negative comments on the practices
and Client-oriented Integration
 We need to spend more time to have
  some discussion, for example, different
  professionals share their professional
  views and opinions on the same case in
  the case conference.
 It is easy to argue with different workers
  through discussing and sharing different
  points of views.
Difficulties in
implementing
integrated practice
Difficulties 1:
Misunderstand the concept of integration
 Different professions are only joining
  together to provide different services
  without recognizing the concept of
  integration. They may have some
  misunderstanding and did not know the
  rationale or meaning of the integration.
Method to face or solve the difficulties:
 Provide training to worker in
  understanding the concept of integration.
 To train staff such as case manager who
  responsible for coordination between
  different professions.
Difficulties 2:
Difference in vision and practice between
  professions and agencies.
 Not all the professions obtain the training
  know about integration and there is a
  difference between every profession. Such
  as social worker, teacher, occupational
  therapist and physiotherapist etc.
Method to face or solve the difficulties
     Train up professional managerial personnel to
      monitor the integrated practice.
     Pursue further education is needed for different
      professionals or workers in order to fulfill the new
      trend of case management.
     Communication
   Different professions or departments should
    have a good communication channel to share
    their knowledge, views, and intervention method
    with others.
Difficulties 3:
Demand both specific and generic skills of
  workers.
 The balance of specialist and generalist,
  some workers are required to be skillful in
  group work, but some are good at case
  work. Except for special skill, different
  workers have different treatments or
  intervention methods.
Method to face or solve the difficulties
 Require social workers to attend
  continuous trainings.
Difficulties 4:

Worker’s may not have enough knowledge,
 acceptance and initiative to adopt
 integration in their practice
Method to face or solve the difficulties
   Providepractice guidelines and training to
   social worker.
Difficulties 5:
  Time Management
 In takes time to communication with other workers and
  agencies
Method to face and solve the difficulties
       Communication
   Case conference is a good chance for different
    professionals or workers to deal with the problems of the
    clients. They should make a good use of the case
    conference to exchange their opinions and intervention
    methods for professional development.
Difficulties 6:
  Funding from the government is limited
 How to distribute the funding to different
  departments and organization in a more
  appropriate way? How to face the demand
  of quantity of services provided. For
  example, not enough school social
  workers.
Discussion
   Integration offers one-stop services and service users
    could obtain the required services within one setting. To
    increase the range of services and relatively, more
    resources is needed for the administration fee and to
    hire more workers for the provision of services. But it is
    known that government did not raise any subsidy to the
    integrated setting after integration. Therefore, the
    workload of workers become heavier and the
    performance of workers is going to be questioned.
    Integration is rather ideal to offer comprehensive
    services to the service users but in reality, the resource
    is not directly proportional to the increasing of services
    and so it is value to think if service users could really
    gain any benefits from integration.
Discussion (Cont‟)
   The mission of integration is to combine wide range of services for
    the services users. Through the interview with some social workers
    in the I.T. setting of The PHAB Association, they expressed that
    workers were responsible for the youth service in the C&Y centre in
    the past. But after integration, workers needed to cope with the
    family and outreaching services and actually they were not
    competent enough to handle those problems. The purpose of
    integration is to offer clients with better services but in the reality,
    worker‟s ability or coping skills might not adapt to this sudden
    changes. Therefore, the mission of integration is going to be
    questioned as clients might not obtain „Good services‟ after
    integration.
Others
   The integration of different culture‟s worker in Singapore
   As the Social workers in Singapore come from different
    culture background (India, Malaysia, Chinese…), some
    of them were educated in their own country (Malaysia).
    However, they worked together to function well as a unit,
    because their clients may also come from different
    culture (to meet the needs of clients). They respect each
    other and they learn other‟s language to achieve cultural
    Integration.
Reference:
   何潔雲, <<資源重整---香港青少年綜合服務本地經驗反思>>,
    “社會福利與社會工作本土化---理念與實踐”學術研討會,1997, 台北
   阮曾媛琪, 1992; 社會服務整合化的意義及展望.香港社會工作學報,第
    二十六卷第一期
   Web site:
   Lai Chi Fung. The budget cut of family service center. Retrieved
    http://www.hkbu.edu.hk/journewsnet/news/news420.htm from
    31/10/2006.
   home4u.hongkong.com/education/training/skh/milestone.html
   http://home4u.hongkong.com/education/training/skh/model.html
   http://home.netvigator.com/~yipsir/newpage5D-278.htm
   http://swforum.socialnet.org.hk/article/001112.htm
   http://www.emb.gov.hk/index.aspx?nodeID=1974&langno=2
Member list
   Annie Chan 50486570
   Cindy Chan 50584341
   Jess Cheung 50552091
   Esther Ho 50510653
   Susanna 50585097
   Philip Won 50588180
   Hazel Tong 50535440
   Chole 50726925

				
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