1, basic information
Zhang was 25 years old. On March 20 10, due to mental health problems, his family sent him to the seventh people's hospital of Hangzhou for treatment. After a period of treatment, he went home. Because of mental illness, Zhang lost his job and lost contact with his friends. His family is afraid of his accident, and out of concern, they often keep him alone at home and don't allow him to go out. The hospital doctor learned about Zhang's situation during the return visit and found that Zhang's mood was not stable. Zhang said that he was lonely, everyone was afraid of him and he was abandoned by everyone.
2. Background information
As a special group in society, the disabled are vulnerable groups in society, and their problems are intertwined with many social problems, which are extremely complicated. Social workers advocate that according to the characteristics, advantages and different backgrounds and abilities of the disabled, they should use the theories, concepts and skills of social work intervention from the perspective of advantages, and provide psychological assistance, disability rehabilitation and employment support for the disabled by psychological interview, consultation, evaluation and diagnosis. In order to restore it to a normal life and psychological state and achieve a good state of adapting to society. Specifically, in this case, because of mental health problems, Zhang was basically identified as mentally disabled by the professional appraisal of doctors in the Seventh People's Hospital of Hangzhou. Social work for the disabled is a professional activity to help individuals, families, groups, relevant social organizations and people around the community. In the whole service intervention process, Zhang himself, Zhang's family, colleagues, friends, peer relations, doctors and hospitals, community civil affairs commissioners, neighbors and other related systems interact and influence each other, and integrate all community resources to provide help and support for Zhang.
Second, the main problems faced by the case owner
In this case, the main problems that Zhang faces are as follows:
1, Zhang's inferiority, insecurity and loneliness need to be improved, and social workers should focus on enhancing their self-confidence and enthusiasm for life.
2. Improve the relationship between Zhang and his parents, change the simple way that parents don't let them go out, and enhance the support of the family system.
3. Improve Zhang's interpersonal relationship with friends and colleagues and establish communication channels with the outside world.
Third, the problem analysis
Compared with social work of other groups, social work for the disabled has its particularity, which is manifested in the following two aspects:
1, the particularity of disabled people and their groups. In addition to being limited by social or natural conditions, it is difficult for disabled people and their groups to live like normal people because of physical and mental defects or injuries. Their pain and misfortune are twofold. For example, the case said that a person lost his job because of mental illness, lost the care of relatives and friends, and even his freedom of movement was restricted.
2. The particularity of social work process for the disabled. In most cases, social workers with disabilities are usually physically and mentally sound, and it is difficult to have similar life experiences or traumatic experiences with disabled people. Empathy? Compared with providing social work services for other groups, it is much more difficult to express and consider the appropriateness of service needs. If it is not handled properly at work, the harm to the disabled will be more serious. It is precisely because of the above particularity that the disabled need the help of the government and society and various services provided by professionals. For social workers, it is also necessary for social workers to clearly understand the importance and arduousness of social work for the disabled.
Fourth, the service plan
The methods of social work for the disabled include psychological consultation, case work, resource search, referral and other specific ways. Under the guidance of social model, it is very important to choose appropriate actions to provide services for the disabled. These actions include four levels, which constitute a series of interventions from micro to macro. Specifically, these actions and methods are:
1. Let disabled people make full use of their available resources and abilities. Staff should try their best to understand the existing capabilities and available resources of customers from disabled people and their surroundings, and help disabled people change their attitudes or learn some problem-solving skills and methods. The specific working method is:
(1) Counseling, that is, staff explain some viewpoints, teach disabled people to build their own will and give play to their potential problem-solving ability. Social workers strengthen the counseling work for Zhang, so that he can fully realize his own value, strive to overcome his inferiority complex and rebuild his self-confidence.
(2) Support, that is, helping the disabled to know the resources available in their own environment and their ways. Then, in view of the difficulties of the disabled, the staff arranged to provide assistance services, such as domestic helpers and short-term care for disabled patients, to help them tide over the difficulties. During this period, the staff should continue to give encouragement and support, so that the disabled can gain experience and face difficulties. The support system in this case is mainly the mutual support and care between family members, which makes Zhang feel warm and safe in the family. Feel the acceptance and respect of your family.
(3) Protection is a kind of strengthened support to prevent the disabled from being hurt. There are many ways to protect the disabled, and staff should take different prohibition and safety measures according to the situation of the disabled to avoid injury, such as sending the disabled to an institution for care when forced to do so, and arranging relatives and friends, domestic helpers and health nurses to take care of the sick disabled under normal circumstances. Specifically, in this case, it is reflected in letting Zhang move freely, better contact with the outside world, and restore all social functions more quickly.
2. Reduce the environmental resistance and contradiction of disabled people using resources. In the process of seeking help, disabled people will not get enough support because of many obstacles and misunderstandings of people and environment around them. For example, the families of the disabled have different opinions on what kind of services they should receive, and the staff of the institution do not understand the situation of the disabled. The intervention of the staff is to mediate these contradictions, clarify misunderstandings, and let the disabled get the support and help they deserve. The specific working method is:
(1) Mediation means that the staff can eliminate or reduce disharmony and conflict among the disabled, their families and service personnel, promote communication and cooperation among all parties, and provide beneficial help to the disabled.
(2) Consultation, consulting and coordinating for the disabled according to their needs, so as to obtain more social resources and services.
3. Develop and effectively use community resources. In most cases, disabled people need more help than social service agencies can provide. Therefore, staff should explore and mobilize more service resources to take care of their needs for the disabled. In order to achieve these goals, the service methods adopted by the staff are:
(1) To mobilize resources, the specific steps are as follows:
A Help the disabled identify some potential and helpful interpersonal networks and service resources in the community, such as family members, neighbors and volunteers.
B. encourage and motivate these interpersonal networks to play a role;
C. mobilize different available resources and support networks to help recipients. For example, for disabled elderly people who live alone and have difficulty in moving, the staff can weave a suitable assistance system for the recipients according to the resources that can be mobilized in the community, such as arranging domestic helpers to help with housework, mobilizing volunteers to make regular home visits and organize activities, and contacting neighbors to provide care for the recipients in times of crisis.
(2) To create new resources, the staff will help develop and set up some new mutual aid or support groups to strengthen the care and support for the disabled. These groups can take the following different forms:
Mutual assistance or support groups formed by disabled people who encounter similar difficulties and problems, such as pairing groups of jingwei patients and volunteers, mutual assistance groups for disabled elderly people, self-improvement groups for disabled women, etc.;
B. Caregiver groups, such as support groups for the disabled and parents' groups for the mentally handicapped;
C. service volunteer organizations;
D. Advocacy groups, such as associations for promoting the rights and interests of the disabled, caring groups for the disabled, etc.
(3) Community liaison refers to establishing and maintaining cooperative networks and relationships with different organizations and people in the community, so as to create a good resource and personnel environment for solving the problems of the disabled. There are two forms of communication and cooperation:
A. Short-term contact and cooperation for solving some disabled people, events or problems;
B. Long-term and continuous contact and establishment of working relationship, such as regular contact and meeting, referral, joint service plan for the disabled, etc. No matter what form of communication and cooperation, employees should have a full understanding and understanding of the community.
4. Promote the rights and interests of the disabled. Many times, due to the lack of social resources and the neglect of social people, the difficulties and needs of the disabled may not always attract the attention of the society and can be fully solved. In this regard, social workers can adopt two methods:
(1) Advocacy is to strive for reasonable care and welfare for some neglected disabled people, which includes staff striving for better service provision for disabled people in institutions and communities, proposing reasonable policy revisions to the society, and improving the plight of disabled people.
(2) Community education. The purpose of community education is to educate people in the community to understand and appreciate the plight of some disabled people in distress, so as to eliminate their prejudice and discrimination against disabled people and win more community support and participate in the work of helping the disabled. Community education includes staff's direct explanation and lobbying, as well as organizing publicity activities of community education to enhance the atmosphere of mutual assistance and tolerance in the community.
Verb (abbreviation of verb) service process and effect evaluation
Case work is that social workers use professional knowledge and skills to help individuals and families with problems solve problems, prevent problems from happening, obtain better social resources and develop better through face-to-face communication. In the process of rescue, caseworkers maintain face-to-face or one-to-one professional relationship with case owners, and use professional knowledge, theories, methods and skills to help disabled individuals improve their environment and enhance their adaptability to life; Coordinate social relations and establish a benign interactive network; Adjust self-function and promote personality development; Understand and face problems with a healthy and mature attitude, give full play to one's potential, and make good use of social resources and opportunities to solve problems, thus improving one's self-confidence and quality of life.
According to the theory of community rehabilitation, community rehabilitation for the disabled is a systematic project, which involves not only the physical rehabilitation and functional recovery of the disabled themselves, but also the integration of the disabled into the community and the change of the views and attitudes of the community towards the disabled. This concept includes the physical, mental, life, social and environmental aspects of the disabled. Community rehabilitation consists of two parts: first, rehabilitation activities for disabled groups, mainly to change the original closed state of disabled people and strengthen their communication and contact with the outside world, including the contact between disabled people and disabled people, the contact between disabled people and ordinary people, the contact between disabled people and rehabilitation resources, and the contact between disabled people and family members; The second is community rehabilitation publicity for community residents. Mainly to publicize community rehabilitation knowledge to community villagers, help them understand and understand the disabled and community rehabilitation, respect and support the disabled, create a good community environment for the disabled, and build a complete? Care? 、? Support? With what? Do you understand? Community support network.
1. Establish a family support network. In view of the lack of communication between disabled families, especially between mother and child (female), such as the gap between children and disabled mothers and the concern of mothers for disabled children, social workers need to carry out education for the disabled? Parent-child group activities focus on improving the parent-child relationship of disabled families and actively building family support networks.
2. Establish a peer support network. Social workers found that Zhang was particularly fond of entertainment and was keen on line dancing before his illness. In order to realize the integration of disabled people with ordinary people and with the community, social workers plan to design and establish entertainment mutual aid groups, including disabled people, families of disabled people and ordinary people, so as to enhance communication and exchanges between disabled people and normal people and actively build peer support networks.
3. Establish a community support network. Community rehabilitation service refers to helping the disabled to reduce or eliminate physical and mental obstacles through community workers and their families who have received relevant training. Local community residents and even the disabled themselves have no basic understanding of community rehabilitation, such as the criteria for identifying the disabled, how to apply for a disabled card, and how the disabled and their families can help them with community rehabilitation. Therefore, social workers need to vigorously publicize the knowledge of community rehabilitation, so that more people in the community can understand and understand the disabled and community rehabilitation services, and actively build a community support network by enhancing the awareness of community rehabilitation of local residents. Only by strengthening the construction of the three-level network for the disabled can we help them better integrate into their families, groups and communities, let them feel the care and warmth from their families, peers and communities, and create a better, warmer and more comfortable community atmosphere for them.
1. Contact Zhang's doctor to learn more about Zhang's condition. I hope the doctor will pay more attention to Zhang's condition and keep in touch with social workers.
2. Help the Zhang family to change their misunderstanding of mental illness, improve their parents' handling methods, make the Zhang family understand the importance of communication with the outside world and enhance the supporting role of the family system.
3. Social workers give emotional guidance to Zhang, encourage him to affirm and identify himself, affirm his own value and enhance his self-confidence.
4. Social workers carry out a series of peer group counseling to encourage Zhang to get along with others, increase the possibility of making friends with Zhang, improve his social skills, and prepare him for getting along with others in society in the future. Social workers have achieved good results in the effect evaluation, process evaluation and satisfaction evaluation of case counseling.