For the sake of this unit, I must undertake an activity which will be to the benefit to one of our service participants. I must discuss the processes of this activity at every stage with this individual. Throughout this paper I shall also refer to our service participant as Dan and our service as “the Group”. This is not the real name of our client or our group. By doing this I am complying with our organisations policy of confidentiality. This policy was designed to conform to the (ref 1) Data Protection Act of 1998. This Act ensures client confidentiality and any information written about a client is accurate, truthful and any opinions are objective, substantiated by factual evidence. The Act also allows the individual to make a formal application to see the information held on them by the Group. To identify a task which would benefit one of our service participants I had numerous thorough discussions with the manager of the Group. This was to ensure that any task undertaken complied with our organisations constitution which concentrates on social inclusion of adults with learning disabilities and the activity is risk assessed. We then went on to identify an individual who would enjoy and benefit from this activity.
The activity I have decided upon is to support Dan to make a piece of African art that can be exhibited at our Malawi Awareness fund raising evening with others from the art group. I will give him choice in deciding what type of art he would like to make, through supplying a choice of materials and source materials. Giving Dan choices and the right to free expression complies with the (Ref A) Human Rights Act 1998.
There is no widely accepted definition of a learning disability and there is an ongoing debate of the definition. However, there are certain factors that are agreed upon.
- Those with a learning disability have difficulties with educational success and growth.
- An uneven pattern of their human development is noticeable i.e. physical, perceptual, educational and language developments.(Ref 2)[i]
The NHS and Community Care Act of 1990(Ref B), implemented in 1993 saw the closure of institutions. This saw the movement of adults with learning disabilities to being cared for in the community, either by their own families or in small supported housing being cared for by the voluntary sector or social work department. (Ref 3)[ii] “The Same as You” strategy of 2000 by the Scottish executive is committed to providing fairness, equality and social inclusion for adults with learning disabilities. As a result of this strategy the local community set up the “Group” to provide socialisation to help with social inclusion of adults with learning disabilities through one to one befriending and group activities.
Dan lived within a nuclear family unit where he was given the basic human requirements of food, shelter, clothing, love and socialisation to live until the age of 6. He then moved into a local institution until 1995. With the help of his family, until the age of 6 he was able to meet the bottom three stages as seen in Maslow`s hierarchy of needs pyramid.(Ref4) Abraham Maslow (1908-1970) was a humanist psychologist who developed this model between the 1940s and 1950`s in the USA.
This model consisted of five stages. He stated that we are all motivated by need. He stated that we must satisfy these needs in turn, starting with the first. The first stage is the biological and,the second need is that of security, the third need is belonging and love, the fourth need is esteem and the fifth need is self actualisation which is realising personal potential. Within his family unit Dan, as sociologist Talcott Parsons(1923-1979) as cited in (Ref5[iii]) will have gained his primary socialisation and emotional stability. After the death of his elderly mother Dan relied totally on his elderly father for any continued socialisation out with the institution. Dan`s development was affected by being institutionalised he now has no social skills, no road work skills and has had no form of education. After 1995, when the government strategies of closing large institutions were implemented, Dan was given a home within supported accommodation as his father had become disabled.
These strategies of closing large institutions came about as a result of the implementation of the NHS and Community Care Act of 1990 and the Human Rights Act of 1998.
After being institutionalised Dan did not like to go out unless his father was with him and tended not to interact with anyone when introduced. He suffers from anxiety attacks and gets agitated when his routine changes and when in a large group situation. When with more than two people he must be able to sit on his own or at the end of a row. He does not like feeling hemmed in. He is unable to read or write and has difficulty making a decision; therefore, he can only be given limited choices.
Dan`s behaviour may be explained by the theories of (Ref 6) J.B. Watson (1878-1958) who created the term behaviourism and believed that all behaviour is learned, that it happened by association and is also determined by the surroundings. Watson showed this in the Little Albert experiment. His anxiety attacks, behaviourists claim, is a consequence of negative reinforcement, when Dan comes across a situation which makes him anxious, Dan is liable to become nervous and steer clear of the particular circumstances. The avoidance behavior is negatively reinforced and the anxiety is maintained. Suddenly having his environment changed from a loving home to an impersonal institution may well have contributed to his current behavioural problems. Lev Vygotsky and Russian cognitive psychologist believed that development was guided by culture and interpersonal communication with significant adults. Being institutionalised will have reduced Dan`s chances of having regular important communication with a significant adult. Vygotsky stated that to learn a range of tasks that are too difficult on their own, a child must be shown or guided by someone who is more knowledgeable. This became known as the “Zone of proximal development”. In the care setting where Dan spent his life, the chances of a child being challenged to learn new skills would have been diminished or non-existent. Vygotsky was the first to observe that social isolation caused a delay in both social and cognitive development. While(Ref 7) Martin E.P. Seligman an American psychologist in 1965 accidentally discovered learned helplessness, a behaviour resulting from an person`s apparent hopelessness over life events. Learned helplessness is common amongst those who have been institutionalised and behaviourists believe that it can also be unlearned.
Dan was introduced to join the “Group” by his father in an attempt to increase his social circle and confidence by one to one befriending. Dan would have been assessed at his initial assessment by a member of the Group staff. He would have been asked a number of questions using PIES to establish what his Physical, Intellectual, Emotional, and Social needs were. This information would have been put into his activity plan which we use instead of a Care Plan. As under the NHS and Community Care (Scotland) Act 1990 everyone is entitled to a care plan. Dan will have such a plan set up by the social work department. To increase his social circle as requested by his father, we included him in a number of activities which has expanded his scope of social activity and made him less isolated. Dan was rather introverted and shy but through one to one befriending I found that the activity he was most interested in was painting. I mentor at the art group which helps adults with learning disabilities gain new skills, gain confidence, improve self esteem, socialisation and self actualisation through creativity.
By doing the proposed activity I hope to help Dan improve the fourth stage of Maslow`s hierarchy of needs, of esteem.(Ref 8)Carl Rogers (1902-1987) the Humanist psychologiststressed the importance of creativity in making us able to attain our full potential. Creativity and producing art is healing, rehabilitating, life enhancing as well as satisfying.
Although this will be a group activity I shall be concentrating on Dan for this unit. I have used and will continue to use the task-centred model in planning this exercise; this is a short-term problem solving approach. This had five phases- Problem Identification (assessment), Agreement, Planning goals, Achieving Tasks and Evaluation. Here, the client takes concrete action to solve the problem. The Initial interview or phase allowed Dan to express his need to have more confidence when in a room with more people in order to be able to enjoy more activities. He wants to complete a painting and to be present at its exhibition. To achieve these goals, we will agree on the steps and tasks that will allow Dan to attain his goal. We will emphasise the tasks that will be required to be completed to allow Dan to exhibit his work of art and agree on timescales for the tasks. Other interviews will take place to ensure that we are on track and that Dan still feels safe and confident doing the agreed tasks, if not we will look at other options available to us.
After discussing and getting the agreement of my manager I spoke to Dan in comfortable and quiet surroundings, to discuss my proposals. I asked Dan to sit down where I used the SOLER techniques to aid in communication. Using the SOLER theory I used the five basic components used in communication. I sat squarely on at the table turned towards one another. I adopted an open posture. I sat so that we had regular but varied eye contact and that Dan could see my facial expressions and gestures to aid in communication. This also let him know that I was involved in the situation. I leaned forward slightly to convey to him that I was interested and committed to actively listen to him.
For this activity my aims and objectives are to:
- To ensure Dan is included in the process of planning this activity.
- To help Dan increase his confidence and show his creativity.
- To ensure that he feels safe, secure and comfortable during the production and exhibition of his art work.
- To have him exhibit a piece of art work, along with other art group participants, influenced by Africa and or Malawi. He has never exhibited his work before in an organised exhibition.
- Agree timescales for what we want to achieve.
- I will ensure that enough art materials, resource materials and paper are available for Dan to use. These will be available from the art cupboard.
- . Dan and I shall discuss how to mount his art work, which colour and type of mount board to use.
- We shall discuss where to position his art work on the selected wall.
- His art work will be completed within an art group setting over a 2hr period one week prior to our evening.
- I will ask staff members and volunteers to become part of art sessions with Dan and give each person a time and date to come along to the sessions prior to the exhibition as a slow introduction to an increase in group numbers.
All of these activities will take place at “the Group” premises where I am confident that I am able to keep Dan safe. He is familiar with this space and feels secure here. Under the (Ref 9) Regulation of care Act (Scotland) 2001Dan has a right to feel safe and secure. I will do Risk Assessments at all activities as this complies with the(Ref C) Health and Safety at Work Act 1974. The exhibition will take place on May 20th2010.
Reference 1 : Data Protection Act 1998. http://www.opsi.gov.uk/Acts/Acts1998/ukpga_19980029_en_1
Reference 2 : http://www.childdevelopmentinfo.com/learning/learning_disabilities.shtml#What is a learning disability?
[ii]Reference3: The Same as You” strategy of 2000.http://www.scotland.gov.uk/ldsr/docs/tsay-01.asp
[iii]Reference 4: Elizabeth Bingham +. (2009). Sociology of Family. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 88-89.
Reference 5: Elizabeth Bingham +. (2009). Sociology of Family. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 124 -125.
Reference 6: Elizabeth Bingham +. (2009). Sociology of Family. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 84.
Reference 7: Elizabeth Bingham +. (2009)Working with People who have Learning Disabilities. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 266.
Reference 8: Cathy A. Malchiodi. (2007). Creativity- Drawing on Process. In: McGraw-Hill Art therapy Sourcebook. 2nd Ed. New York USA: McGraw-Hill. 65.
Reference 9:Regulation of care Act(Scotland) 2001http://www.opsi.gov.uk/legislation/scotland/acts2001/asp_20010008_en_1
Reference A:The Human Rights Act 1998:http://www.opsi.gov.uk/acts/acts1998/ukpga_19980042_en_1:
Reference B : NHS and Community Care Act 1990 http://www.opsi.gov.uk/ACTS/acts1990/ukpga_19900019_en_1
Reference e C: Health and Safety at Work Act 1974 :http://www.hse.gov.uk/legislation/hswa.htm
Reference e D:Biza Stenfert Kroese+. (1997) Cognitive-Behaviour Therapy for People with Learning Disabilities: Routeledge.