The Service User

The Service User (SU) Mrs S was referred to the Army Welfare Service (AWS) by the local Unit Welfare Officer (UWO). Mrs S is 28 years old and was born in the UK. When the SU arrived for her first visit to the AWS I noticed that she had turned up in a timely manner. This told me the SU was committed from the outset. I greeted Mrs S and told her to take a seat anywhere of her choosing. I wanted to subconsciously start to empower Mrs S in making decisions for herself and set the tone for the rest of the session. At the start of the session I engaged in problem free talk with Mrs S with subjects including the weather and her travel to the office and adopted a (SOLER) style of approach (John Shufeldt. Mastering the Art of Non-Verbal Communication- S.O.L.E.R.). I felt that this put Mrs S at ease and allowed ourselves to start building rapport. The SU was presented with the Armed Forces Code of Confidentiality (CoC) which we read through together. (The CoC states the five reasons why we as workers can break confidentiality and inform other agencies). This was in a nice relaxed manner and my aim was to instil in Mrs S the thought that she could indeed work with me as a Specialist Welfare Worker (SWW). I felt that by doing this I also covered Anti discriminatory Practice (ADP) and allowed for the SU’s learning and reading capability. We also covered during the start of the session a Permission to Share form. It was explained that any information that needed to be shared to other agencies would then need the SU to have this form signed. Upon reflection I felt that I had covered this area very well and felt the SU was fully onboard with the boundaries I had put in place.
The Session was then formally started using a ‘TED’ question “Tell me what has brought you here today?” My aim was to slowly start to explore the current situation and then pick out some key areas where the SU could then work on and set goals there by empowering the individual. (A Task Centred Approach, Ford and Postle, 2000) The SU presented that her husband had been using a dating application called Tinder and had been doing so for the last couple of months. The use of open questions was paramount to enabling conversation and allowed the SU to give a fuller more descriptive answer which then allowed further questioning on key points within the conversation. With the use of active listening skills, I could pick out key words and sentences which were then paraphrased and reflected to the SU, so those points could be further developed. I was then able to gain a deeper more meaningful understanding of what was truly being said. The SU’s body language tied in with what was being said at that time. This was one of crossed arms, leant forward and almost in despair of what was happening in her life. The SU was very forceful with her words and showed visible signs of disgust. During this period, I remained in a very neutral position. I felt by doing so allowed myself to remain calm but also to enable the SU not to fall into a deeper emotional state. Within the first fifteen minutes of the session the SU began to directly try to put me in a position of collusion. This felt quite oppressive to me, but it was clear what Mrs S was doing and I was able to deflect the the questions by refocusing her on her own opinions and why she was here at the office. This I felt worked and I believe I handled it very well. This would happen further throughout the session, but I was able to deflect such coercive tactics.
I started to explore Mrs S’s family dynamic at this point. It was clear to see for Mrs S’s facial expression that this is one area in her life that indeed makes her feel happy. There were visible smiles and laughter as Mrs S reminisced on past family outings when things were good. I explored risk at this point using probing but open questions focusing on the relationship between both parents and their child. From what was being said I was confident that everything was good however I was very mindful that this might not be the case. I had to put my own thoughts to one side and really focus on the engagement I was getting with Mrs S. I felt the session was going well and as we started to build rapport the conversation flowed far more easily. During the session I had to be very conscious of my own boundaries and that of Mrs S as it appeared to me that she could become quite attached to myself. My role is to be neutral and not play the part of the rescuer in this circumstance. This could present further issues down the line and potentially start to cloud my judgement when it came to form a non-judgemental assessment.
The SU was challenged during this conversation because it was clear in her mind that her husband could not change and wouldn’t change, Mrs S could see no way past this. Mrs S was very focused on the past and the here and now but wasn’t prepared to look forward to better things at this point. I challenged this by posing an open question of “tell me do you think that is true of everybody?” The SU’s response was again very negative at this point stating he had ‘changed for the worse’. It felt to me that the SU was refusing to look at anyway forward and was solely set on leaving her husband. I decided at this point I would refocus the SU onto a more positive path and adopt a Solution Focused Brief Therapy (SFBT) approach. This is a postmodern approach founded by (Steve de Shazer and Insoo Kim Berg) and was developed in the late 1970’s focusing on the future and recognises the client is the expert in their own life not the Worker. The SU was reminded of what she had as a family unit and asked what she wanted to achieve to make her life better. The SU and I using SMART principles came up with various goals that were achievable. It was my aim that the SU take control of this part of the session and really own it. These were her ideas and with a bit of guidance she was able to steer her own path on what she thought her priorities should be.
During this conversation the SU explained to me that her husband had a very serious injury to his leg and this was really affecting him. As a serving soldier he is now under the local physio but has been told that there is no fast fix available. It appears to me that Mr S is presenting possible issues surrounding depression and guilt because of the injury and not being able to now do the things he loves. Work life is severely being affected by this adding to the current pressures being put on the family. (John M Fischer’s Transition Curve, 2012) describes life and change as a curve constantly bounding through various stages where you might feel a mixture of emotions. This appears to me what is happening to Mr S however this can be further explored in future sessions.
It was during this part of the conversation that the SU made a startling and rather unexpected disclosure to myself. Whilst I remained composed on the outside, inside I was having conflicting views and opinions. The SU had disclosed that Mr S had been on various Pornography sites which looked at Teen and BDSM styles. During this part of the session I allowed my own values and beliefs to cloud my judgement of what was happening in that situation. My theory was based around the legal age of the actual Pornography actresses and not the impact of the word ‘teen’ and how that could relate to a family environment with a child. Upon having time to reflect after this I could see the error of my thinking and how my thought process could have directly and negatively had an affect on the Mrs S’s current mindset. I assessed the risk properly and decided I would indeed have to break confidentiality for the sake of safeguarding concerns with a child. I am glad that this happened as it has allowed me to evaluate not just the information but also my own thought process and values. I feel I have become a better person because of this and know that in the future if this was to happen again then risk would be explored properly, and the right decision made regarding the Code of Confidentiality and HCPC practise. At the end of the session I used ‘Scaling’ as a form of assessment to see how it had gone. I again empowered Mrs S to own this and she was surprised that she had achieved so much considering where she was at the start of the session.

To conclude this Reflective Critique, I think I did well during the session and was able to gain relevant information that was then used to empower the SU to make goals and look to the future instead of back in the past. I have found it difficult to put Theory into this critique as the I was unable to do a lot with the SU. What I did do though was listen by using effective communication skills, use a mix of approaches such as Task Centred and Solution Focused Brief Therapy over the course of one session to achieve the aim of my session.