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Scenarios

This section of the learning object contains five case scenarios and a reflective exercise at the end.

Click on each of the five scenarios below. In each case a social worker is considering how to communicate sensitively and appropriately with someone who uses care services.

As you work through each scenario you will be invited to think about how you might respond and find out how the social worker responded and why. When you have completed all five scenarios, click 'next' to complete the reflective exercise.

Scenarios

in Translation

Lucy, a social worker in a mental health team, has just begun her first interview with Muna who has depression. Muna speaks little English and Farah an interpreter is present.

Lucy to Muna:
"What you say will be confidential."

Farah to Muna:
"What you say will be confidential."

Muna to Farah:
"What do you think? Can I trust her?"

Farah to Lucy:
"What do you think? Can I trust her?"

Muna to Farah:
"You shouldn't have said that!"

Farah to Lucy:
"Muna says I shouldn't have said that."

Click 'Next to continue.

Scenarios

in Translation

Our response to: 'I am sorry, Muna, I should have explained that it's Farah's job to interpret everything that is said. As I was saying, what you say is confidential.'

Here Lucy responds to Muna's confusion about Farah's role, before continuing to explain the purpose and ground rules of the interview. Although this explanation is essential, it is unlikely to be sufficient.

For people who use services, accessing help through an interpreter has many potential difficulties (Alexander et al., 2004). Clarifying and agreeing at the outset how the process of communicating through an interpreter will work is important if problems are to be avoided.

Click here to download checklist for working with an interpreter.

Scenarios

in Translation

Our response to: 'I am sorry. I should have explained Farah's role as our interpreter. Actually, we all need to be clear and confident about the process of communicating through Farah. So let's go back and look at that.'

This response acknowledges that work with Muna cannot progress until there is a shared understanding of the process of communication between them. As this will take time to negotiate, Lucy may not get as far as she hoped with the interview. However, next time she uses an interpreter she won't forget to spend time at the beginning clarifying roles and agreeing ground rules with everyone involved.


Click here to download checklist for working with an interpreter.

Scenarios

Shall I? Shan't I?

Aisha had always lived in an extended family where important decisions were not an individual but a family matter. So leaving her violent husband and moving to a refuge with her baby had been a particularly difficult step. Her social worker, Sinead, has worked hard to secure her the offer of a flat. After a lengthy discussion, Sinead is feeling frustrated that Aisha seems unable to make up her mind whether to accept the flat.

Eventually Aisha says: "I just don't know what I should do. I think I had better leave it. What do you think?"

Click 'Next' to see how Sinead might respond.

Scenarios

Shall I? Shan't I?

Our response to: 'Well, if you don't take this you won't get anything better!'

Aisha's question suggests that she expects advice that Sinead would not normally give. Professionals in Western cultures are trained to support people in making life decisions, but not to tell them what to do. Although this response makes an important point, which Aisha may receive as useful advice, it does not address the difficulties Aisha may have with the process of making a decision. If Aisha is to live successfully in her own home she will need to become more confident about decision making

Scenarios

Shall I? Shan't I?

Our response to: 'What do you really want?'

This acknowledges Aisha's right to self-determination. But it fails to take account of Aisha's life experience within an extended family group. She may not be used to thinking about her individual wishes or to making important decisions on her own.

Self-determination

This complex concept is a core value in Western cultures. Put simply, it is the idea that people "have not only the right, but also the capacity (under most circumstances), to exercise choice and make decisions about their own lives." (Wilson et al, 2008, pp. 81-2)

Scenarios

Shall I? Shan't I?

Our response to: 'It seems to be difficult to make this decision on your own. Is that how it feels?'

This signals Sinead's understanding of Aisha's difficulties in making a decision on her own and enables her to say what she is actually feeling. The next step, helping Aisha to make a decision will take time. Sinead might explain to Aisha that if she is to manage on her own, in this society, she will be expected to make decisions about everything. Making decisions is always risky and sometimes she may feel she has made the right decision and sometimes not. Sinead could remind Aisha that she has already made a brave decision to leave her husband. Sinead may then suggest that they make a list together of potential advantages and disadvantages of accepting the flat. This may reveal useful areas for discussion, as well as modelling an approach to decision making.

Scenarios

Crossing generations

Henry Green, aged 88, is a retired head teacher living alone. His health is deteriorating and his daughter has contacted adult services with her concerns. Mioko, a social worker aged 35, has written to Mr Green to arrange a visit.

At the appointed time, Mioko knocks firmly on the front door as Mr Green is hard of hearing. Some minutes later he opens it.

How should Mioko introduce herself to Mr. Green? Click 'Next' to see some options.

Scenarios

Crossing generations

Our response to: 'Mioko says nothing and waits for Mr Green to speak.'

When Mioko was new to the UK, she would have chosen this option. Mioko is from Japan which is a high-context culture. In Japan, it may be seen as disrespectful for a younger person to speak first when meeting an older person, especially someone who had professional status. However, she soon learned that in the UK, a low-context culture, a stranger calling at a private address would normally speak first to say who s/he is and why s/he is there, regardless of differences in age, status or role.

Scenarios

Crossing generations

Our response to: 'Good morning Mr Green. I'm Mioko, from Adult Services. I'm a social worker in the Older Persons Team. Did you get my letter? I understand you are having difficulties and I've come to find out if we can do something to help.''Mioko says nothing and waits for Mr Green to speak.'

As a new student social worker in the UK, Mioko would have chosen this option. However, in a social work context, she learned to be cautious about disclosing her role and purpose on the doorstep. Mr Green may not see himself as needing help or want others to know who his visitor is. In a society which values independence, contact with social care services may be associated with dependency and failure. Also, as Mioko has not yet established that Mr Green can hear her voice, or if he can lip read, the information given may be wasted.

Scenarios

Crossing generations

Our response to:'Good morning. I'm Mioko Knight. Are you Mr Green?'

This is the option Mioko chooses. She gives her full name, to correspond with the letter she sent, and she checks that it is Mr Green she is speaking to. By asking a question, Mioko hopes to find out if he can hear her voice.

Most importantly, it gives Mr Green space to introduce his agenda. He is likely to have questions for Mioko before he invites her into his home.

Scenarios

A Question of Faith

Eva, aged 65 has been referred to a palliative care team. She is talking to Mel, the social worker, about her family. Eva is worried about what her granddaughter should be told:

"When I was her age my grandpa passed away and they told me he was with Jesus in heaven. Now it's my turn and I don't know what they'll say to her. I haven't been to church for years and now it's too late."

How do you think Mel should respond? Click 'Next' to see some options

Scenarios

A Question of Faith

Our response to:'Would you like me to refer you to the chaplain so you can discuss this with her?'

This response recognises that what Eva is saying has a spiritual or faith dimension. But it is impossible to predict at this point whether Eva will welcome a referral to the Chaplain. If this is not what she wants, Eva may find it difficult to continue talking about an issue that is clearly worrying her. She may also get the message that Mel is unwilling or afraid to engage with these concerns (Moss, 2005).

Scenarios

A Question of Faith

Our response to:'Have you talked this over with your son and daughter in law? Are they concerned about this too?'

This response seems a sensible starting point for addressing Eva's explicit concerns about her granddaughter. However it ignores an underlying message, which hints at existential anxiety in the face of death, and perhaps a wish to reconnect in some way with the faith she was raised in. Again, Eva may be left feeling that Mel is unable or unwilling to engage with these concerns.

Scenarios

A Question of Faith

Our response to: It may be difficult to explain but can you say a bit more about what you mean when you say, "It's too late"?'

This is the option Mel chooses. It invites Eva to say more. The way in which the question is posed signals that many people have difficulties finding an appropriate language to discuss meaning in the face of death (Holloway, 2007). In responding, Eva can choose whether to focus on what is happening to her, or on the question of what approach would be helpful for her granddaughter.

Scenarios

Coming out?

Dan aged 15 has lived with foster carers Rob and Julie for five years. His social worker Rhys has called round after a phone call from Julie who is worried that Dan is being bullied at school. Normally, Rhys relates well to Dan but, today, Dan avoids his gaze and launches into a rambling account delivered in a monotone. Rhys is struggling to keep his attention focused when Dan hesitates and, in a different tone, adds:

'They were shouting "you poofter".' Dan is now silent and looking at the floor.

How do you think Rhys might respond? Click 'Next' to see some options.

Scenarios

Coming out?

Our response to: Your school has a bullying policy.Let's find out about how it applies to your situation so we can get some help for you at school.'

This makes clear that Rhys understands that Dan is being bullied and that he is keen to help him tackle the problem. However, ignoring the homophobic content of the bullying may increase Dan's discomfort and isolation. Research evidence indicates that homophobic bullying is common in schools and has significant and harmful effects on LGBT (lesbian, gay, bisexual, and transgender/transsexual) young people (Freed-Kernis, 2008).

Scenarios

Coming out?

Our response to: 'What? Oh that's just mouthing off. It's a wind-up. Don't let it get to you. All that sort of offensive behaviour will be covered by your school's bullying policy.'

It had not occurred to Rhys that Dan might be gay. So his first thought was to reassure Dan by implying that what had been said was nonsense. Denying the possibility that Dan could be gay, an example of heterosexism, is likely to make it difficult for Dan to be open about his sexuality and to increase his feelings of isolation.

Scenarios

Coming out?

Our response to: 'That must be really hard to have that sort of offensive homophobic stuff said about you.'

By acknowledging that Dan is experiencing homophobic bullying, and making clear that it is unacceptable, Rhys validates Dan's feelings and communicates respect for him as an individual.

Giving Dan an opening to 'come out', if he chooses, enables Rhys to mobilise appropriate support. For example, Dan could be put in touch with Educational Action Challenging Homophobia (EACH), which provides a national freephone helpline for young people affected by homophobic bullying.

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Reflective exercise

After working through the case scenarios you may find it helpful to spend a few minutes on the following exercise.

A stranger enters the room you are in now.

A) What does he/she see?

B) How might this person describe you?

Use a pad to jot down your thoughts and when you have finished click 'check'.

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Reflective exercise

Check

Perhaps the person entering the room has noticed your skin colour, the way you dress or sit, or maybe a picture on the wall, and then made all kinds of assumptions about you which may or may not be right.

So read through what you have written and consider:

A) is what the stranger sees helpful or unhelpful for understanding you and your cultural assumptions? Why is this the case?

B) How does the stranger's description of you relate to how you normally see yourself? How and why is it different?