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Discussing The Chrysalis 3 Tier Community Service Social Work Essay Essay Example Discussing The Chrysalis 3 Tier Community Service Social Work Essay Paper Discussing The Chrysalis 3 Tier Community Service Social Work Essay Paper Scientifically talking, chrysalis is the phase of a moth or butterfly, when enclosed in a steadfast instance or cocoon. This is a protected phase of development. The bureau I was placed in for 10 hebdomads is besides called Chrysalis because they offer support through an mediate phase of development for their clients. A A Chrysalis offers hope, protection, encouragement and support for their clients in any phase of development. My placement study will supply a description of the arrangement bureau and its context ; discuss the bureau ethos which is strongly based on the significance of chrysalis ; analyze their client group ; and sketch my observations of the prevailing theoretical accounts of intervention used by Chrysalis. My placement study besides aims to supply a brief overview of my responsibilities ; show a instance survey ; show how I integrated academic theory into my instance survey ; and detail my personal and professional development. Chrysalis is a Tier 3 Specialist Community Service which offers structured interventions for drug users and household members life or working in Dublin 7 ( Weaver et al, 2010: 54 ) . Chrysalis is funded by the North Inner City Drug Task Force ; it is governed by a Voluntary Management Committee ; and it is a Company Limited by Guarantee with charitable position. Chrysalis has served the Dublin 7 community for over 10 old ages and it is located on Manor Street in Stoneybatter. Chrysalis utilises the tools of the Progression Routes Initiative which seeks to better service bringing to those go toing drugs services. It works with multiple bureaus to explicate and implement strategic interagency solutions to place barriers to patterned advance. An of import platform for this work is the development and execution of the Interagency Case Management and Community Detox Protocols ; in partnership with the Homeless Agency ( Chrysalis website ) . Progression Routes intends to develop case-management to guarantee that service users receive a systematically high quality service that supports their journey through a clear and accessible continuum. These protocols are presently being piloted with some drugs services in the North and South Inner City Drug Task Force Areas and Homeless services across Dublin. Others have progressed from flying to execution and Chrysalis has done so for the past 4 old ages. Progression Routes promotes QuADS ( Quality Standards in Alcohol and Drugs Services ) which is a steering quality criterion model for Community and Voluntary services in the Drug and Homeless Sectors. The Agency Ethos Chrysalis reflects the values and purposes of the Progression Routes Initiative in their proviso of community based specialized drug appraisal and coordinated care-planned intervention intercessions. Their vision provinces that Chrysalis plants in concurrence with the HSE, Community GP s and other community services and is supported by the North Inner City Drug Task Force ( Chrysalis Information Leaflet Responding to the Needs of the Community ) . Their ethos provinces that Chrysalis believes socio-economic fortunes are a major causal factor in relation to drug issues within the community , they acknowledge the community s demand, and back up its attempts to develop positive responses to drug issues and seek at all times to work in a supportive, non-judgemental and suitably confidential mode ( Ibid ) . This ethos ensures that each client is treated in a gracious, thoughtful and individualized mode instead than using a one-fits-all attack. This entails that all clients receive support within a safe and protected environment to let them to develop. It remains true to the definition of chrysalis . The Client Group Chrysalis provides referral based client services which are categorised as Core Community Drug Work, Counselling/Family Therapy service and Chrysalis Female Sex Worker Initiative services. The chief community undertaking provides services influenced by the Progression Routes Initiative such as key-working, Case Management and Community Detox Support. All services are influenced by Harm Reduction doctrine such as Crisis Intervention, Brief Intervention, Advocacy, Referral to specialised services ( medical, lodging, legal and dependence services ) , Motivational Interviewing, Harm Reduction Information and Holistic Treatments such as Reiki. For stable drug users and any household members affected by drug usage, there are Reding and Family Therapy services. The Chrysalis Female Sex Workers Initiative provides services to a more helter-skelter and lower threshold client group than the typical client treated within Core Community and Counselling/Family Therapy services. In add-on, the Chrysalis Female Sex Workers Initiative offers specific needs based injury decrease services including Outreach, Health Promotion and Materials ( rubbers, dental dike, lubricator, personal dismaies etc ) , Street Safety Advice, A Crime Reporting Scheme called Ugly Mugs , a really exciting new Mobile Health Clinic and a new Women s Pre-Entry Group. The Women s Group, in partnership with Coolmine, is unfastened to all adult females and is non sole to sex workers. The Predominant Models of Treatment The prevailing intervention theoretical accounts that Chrysalis utilise promote run intoing the client where they are, commitment to behaviour alteration and non seeing relapse as a failure instead it is a natural phase of recovery. I will briefly summarize the different theoretical accounts I observed and so show my usage of them in my instance survey. Harm Reduction ( HR ) HR benefits drug users, their households and the community. The ethos and aims/objectives of Chrysalis are clearly influenced by the HR theoretical account of intervention. It is offered across all their services. The International Harm Reduction Association ( IHRA ) states that HR refers to policies, programmes and patterns that aim chiefly to: reduce the inauspicious wellness, societal and economic effects of the usage of legal and illegal psychotropic drugs without needfully cut downing drug ingestion ( HRA website ) . Motivational Interviewing ( MI ) One of the cardinal factors with MI is covering with ambivalency, the ambivalent desire to transport out one action while pulled by the desire to transport out an opposing action. There are five principals for MI: express empathy ; develop disagreement ; axial rotation with opposition ; back up self-efficacy ; and avoid debate ( Miller A ; Rollnick, 2002 ) . The chief ends of MI are to set up resonance, elicit alteration talk, and set up committedness linguistic communication from the client ( Ibid ) . Humanistic Theory MI is a manner of being with a client, non merely a set of techniques for making reding. MI builds on Carl Rogers humanistic theories about people s capablenesss for exerting free pick and altering through a procedure of self-actualization i.e. carry through their full potency and they must first experience credence from their key-worker or instance director. In order to ease growing a lovingness clime is indispensable, one that requires the key-worker or instance director to be congruous, have unconditioned positive respect for the client every bit good as show empathetic apprehension ( Rogers, 1980: 115-116 ) . Transtheoretical Model ( TTM ) or Stages-of-Change Model HR schemes are based on a common premise: Peoples are finally capable of doing an informed pick in their ain best involvement. The picks they make depend on their preparedness to alter. The TTM was foremost proposed by Prochaska and DiClemente in 1986. Harmonizing to them, there are six phases of alteration: precontemplation, contemplation, readying, action, care, and backsliding. Patients can be conceptualized as traveling along a continuum marked by these phases. It is of import to observe that the alteration procedure is cyclical, and persons typically move back and Forth between the phases and rhythm at different rates ( Wanigaratne, 2006 ) . Case Management Protocol this includes run intoing the demands for psychiatric or physical intervention, household and societal relationships, basic endurance demands, safe adjustment, employment, leisure, cultural and religious demands ( 2001: 732 ) .This was non covered on the academic course of study in the Michaelmas Term or Hilary Term at Trinity College, Dublin. However, it could be considered an extension of the Harm Reduction doctrine and the Strengths position that Chrysalis draws on. Rosen A ; Teesson describe case-management as a united system of all services required by the client and: Case-management encourages and sustains ongoing contact with staff in bureaus while at the same clip puting the client at the Centre of their ain intervention and attention. The case-management inaugural aids clients to entree intervention and services that they had antecedently encountered barriers to. Weaver et Al. in MacGregor advise that these barriers included a deficiency of information and ineligibility for support ; long waiting lists ; a disfavor of assignments and bureaucratism ; shame and stigma ; travel ; fright and negative experiences of anterior intervention ( 2010: 89-93 ) . It ensures that no client falls through the clefts and it is influenced by the Biopsychosocial Model. Biopsychosocial Model Zinberg summarised the premiss behind the Biopsychosocial Model devised by Engel ( 1977 ) which offers both a model for understanding dependence and a model for making a tract to recovery. It highlights the emotional jobs of the client and besides brings attending to the relationships with environing. Zinberg ( 1984 ) referred to it as Drug, Set and Setting . Marlatt A ; Gordon ( 1985 ) use the backsliding procedure as ground to back up the demand of the Biopsychosocial Model ( Lecture, Kevin Ducray, October 2010 ) . Ducray asserts that the theoretical account is understood as a theoretical account of the best patterns , because it proposes the most appropriate set of intercession programmes and services to run into the client s demands. Case-management is surely influenced by the Biopsychosocial, Harm Reduction and Strengths Models in supplying motivational, integrated and individualised services to the client. Overview of My Duties Initially, I was provided with a transcript of Chrysalis policies to read, which are connected to the streamlined policies of the Progression Routes Initiative. After detecting an appraisal, I felt comfy plenty to carry on my ain comprehensive appraisals. After measuring a client, I identified their specific demands or barriers to come on. I presented their instance at Weekly Staff meetings and I made recommendations based on the client s degree of motive to alter and the type of service they required. As a key-worker my undertakings included prosecuting with the client ; guaranting consent ; finishing a elaborate holistic appraisal and developing a attention program ; recommending on behalf of the client ; working to carry through attention program actions ; prosecuting and sharing information with other bureaus as required ; maintaining relevant instance notes/records ; and guaranting that client aims should be expressed as SMART ( specific, mensurable, accomplishable, relevant and clip edge ) and be on a regular basis reviewed for advancement ( Doyle, 2010: 11 ) . Other general responsibilities included replying the phone and taking messages, go toing hebdomadal staff meetings and biweekly client debrief meetings, developing the Women s Pre-Entry Group with Coolmine and the Chrysalis Client Satisfaction Survey. I will detail my undertakings further in the Professional Development subdivision. Case Study Michael I presented Michael s instance to the hebdomadal staff meeting and I was assigned as his key-worker. I called him to set up our first key-working session. I considered Michael to be at the preparation phase of the Transtheoretical Model. I believe he had moved from the action phase by detoxing from diacetylmorphine and benzodiazepines in the infinite of a twelvemonth back to the contemplation phase and forward to his current phase of preparation to be after for dolophine hydrochloride detox. He had already started to do little alterations towards this by cut downing his dose with his physician before relapsing by exceeding up.Michael was referred to Chrysalis by Soilse and I arranged a reciprocally convenient clip for an appraisal. In his appraisal, Michael outlined that he needed aid to use to the Lantern to detox from dolophine hydrochloride as he had started to cut down his dolophine hydrochloride with the aid of his physician. He had been addicted to heroin and benzodiazepin es but detoxed from benzodiazepines and was now maintained on 70mls of dolophine hydrochloride. He besides required aid with using to RAS ( Rental Accommodation Scheme ) as he had lived in private rented adjustment for 16 months and after 18 months he would be eligible for this strategy. Michael advised that he had programs to go to DCU and analyze Physics and Astronomy. He appeared to be extremely motivated and self-conscious as he realised his intended programs to detox would take precedence for the following twelvemonth and pave the manner for his surveies the undermentioned twelvemonth. He besides displayed committedness by go toing all of his key-working Sessionss and he was normally 15 proceedingss early! This preparation phase is characterised by the client jumping into alteration excessively rapidly, driven by anxiousness and exhilaration. Michael decidedly exhibited marks of both of these as he stated that he besides wished to give up coffin nails! I gently reminded him of everything he had detoxed from in the past twelvemonth and asked him what his short-run end and long-run end was. He advised his short-run end was to cut down dolophine hydrochloride to 50mls to be eligible for the Lantern and so detox from dolophine hydrochloride. His long-run end was to be methadone free, in RAS adjustment and enrolled in university. His desire to give up coffin nails was rapidly forgotten, as he realised it could do him to get worse by making excessively much at one clip. He decided to concentrate on the first measure of cut downing dolophine hydrochloride to use to the Lantern. Michael so admitted to me that he had non been wholly honorable when he told that he had reduced his dolophine hydrochloride. Yes, he had reduced ; nevertheless he had been exceeding up with street dolophine hydrochloride, and now he did non experience ready to use to the Lantern. I intentionally did non notice on the fact that he had non been wholly honorable, and focused on the fact that he trusted me adequate to confide in. Now we could fix a attention program that would non travel excessively rapidly for him and we could park the Lantern option. I recommended that Michael besides rede his physician that he had been exceeding up, so that the physician could help him in returning to 100mls and avoid topping up and so cut down in the hereafter at Michael s gait. Michael was relieved to hold confided in me and thanked me for being nonjudgmental, for understanding his state of affairs and for listening. When I wrote a screen missive for Michael s RAS application, he requested that I noted that he did non wish to be housed in Finglas. Michael s petition was due to negative association with his old diacetylmorphine usage there ( Drug ) , the possible triggers for backsliding if he was housed at that place ( Set ) in Finglas ( Puting ) which draws on the Biopsychosocial Model and Zinberg s sum-up of this.I discussed other options such as the Community Detox Support Protocol and Coolmine Stabilisation programme. I asked Michael to hold a non-committed think about them during the hebdomad and I reminded him to concentrate on his short-run end of keeping his dolophine hydrochloride at 100mls with his physician. I affirmed that the end of subjecting his RAS application was completed which was a positive measure towards the hereafter. I pointed out that he had been homeless for 4 old ages while addicted to drugs ; but now he had been settled in private adjustment for 16 months and was on do lophine hydrochloride care with programs to travel to university. His present state of affairs was the consequence of difficult work and immense motive to alter on Michael s portion and he should be proud of himself as this was a monolithic accomplishment. Michael appeared to be happy to be reminded of this and stated yeah, I suppose it is one measure at a clip, and I ll acquire at that place . At his following key-working assignment I explored with Michael his apprehension of detox and its deductions and what support systems he had in topographic point. I went through the Community Detox Support protocols with Michael and advised of the hazards and his duties. By the terminal of the session he had a good apprehension that detox was a slow procedure that did non go on in isolation and that follow up and aftercare were all portion of the on-going procedure. Based on this, Michael is now committed to get worse bar to help him in bracing en path to his end of detoxing. I advised I would confer with the squad at the following staff meeting to measure which staff member would be the best tantrum to supply him with backsliding bar guidance. Michael besides advised that he was holding jobs with paying a measure and I said I would recommend on his behalf and supply his inside informations to St Vincent de Paul so they could set up a house visit and supply nutrient verifiers. By non holding to worry about arrears, get the better ofing this barrier would help him in concentrating on his recovery. I believe and hope that little stairss and consistent support will authorise Michael to make the action and maintence phases and accomplish his long-run ends of detoxing from dolophine hydrochloride, settling into RAS adjustment and analyzing in DCU. I wish him all the best.At the terminal of my arrangement Michael was having aid as per the Biopsychosocial Model and rules of case-management. He was go toing Relapse Prevention guidance, St Vincent de Paul had contacted him in relation to nutrient verifiers, his RAS application was submitted and he was committed to keeping his dolophine hydrochloride with the aid of his physician. In his RAS application signifier he advised he wished to use for the Scheme because I live beside drug traders and I am a recovering nut. I want to construct a better hereafter for myself and be drug free, and I have programs to analyze in DCU . I recognised Michael s place within the Transtheoretical Model and I applied the principals of Motivational Interviewing and Humanistic Theory to my attack. I observed Harm Reduction in action which asserts that slow, incremental alteration is more permanent, and more accomplishable than seeking to alter everything all at one time. Through key-working, I utilised the principal of case-management and the Biopsychosocial Model and addressed lodging, fiscal every bit good as medical demands. I used the same principals on my other clients who seemed to react good to this attack. I discovered the truth behind the slogan manners affair . If word count allowed, I would besides offer a instance survey of the group dynamic within the Women s Pre-Entry Group. Personal Development The squad I was placed with are antic. I ever felt a portion of the squad, and that my parts were valued. I recognition this both to my avidity to take on anything they threw at me, and their inclusiveness and supportiveness. This arrangement has enabled me to reflect on co-dependency. Gerald May noted that within co-dependency ironically, it is the most sympathetic, compassionate, loving individuals in the nut s societal circle that are most likely to fall into such collusion ( 1988: 51 ) . The ground I made the determination to alter callings from insurance to dependence was based entirely as a consequence of the personal experience life with my spouse who was dependent on intoxicant. Through theory, I learnt that the properties of compassion, love and continued hope would hold me to be co-dependent and be viewed negatively within the Disease Model. From my arrangement, I discovered that if they are used within boundaries, these qualities are a positive for working within harm decrease and they enable me to expose Humanistic qualities and Motivational Interviewing principals towards clients. I discovered it is healthy to trust for the clients and to swear in their interior strengths, resiliency and self-efficacy. It is non my function to fix clients. Within the dependence intervention industry, I will be invariably challenged to incorporate emotions and carry uncertainnesss, whilst keeping a positive attitude and a solution-focused attack. My challenge is to interpret theory into practical, effectual and authorising solutions for my clients. Sometimes I found it hard to be patient and listen to the clients because I allowed myself to believe further in front than the client ( in a manner I allowed myself to read their heads ) . I realised that there was a hazard of seting words in the client s oral cavity or completing their sentences. I needed to larn to exert a batch of control and subject over that and actively listen at the client s gait instead than at my ain. On contemplation, I could impute this to over-excitement and nervousness or at worst to my ain fright of neglecting in the chase of my ain self-interested desire for a perfect key-working session. Upon deeper contemplation, I was trying to cover up my deficiency of assurance in a new state of affairs by moving like I knew it all. I may besides be excessively critical of myself, as I did non really interrupt any of the clients ( I was merely afraid of making so! ) and I received positive feedback from my clients. Michael stated You re merely superb thanks so much! and Daniel told me you hold a great bosom for this industry! and presented me with a pot works. I thanked him and I advised him that while I could non accept personal gifts, I could accept it on behalf of the squad, which satisfies policy guidelines. The feedback from the clients indicated that they felt they had received empathic hearing, support and authorization through their ain self-efficacy. I discovered that I do non hold the power to authorise others, but alternatively, I can assist people empower themselves. I have observed and utilised the prevailing theoretical accounts of intervention within Chrysalis, and I will endeavor to spread out on these accomplishments throughout my calling. I learnt a great trade about myself on this arrangement. The journey taught me about my personal resiliency, my ability to work under force per unit area and my ability to take control of complex state of affairss. I was besides able to derive a far greater insight and cognition of how to advocate people in many-sided state of affairss including protagonism, crisis state of affairss, injury and a figure of other extremely nerve-racking state of affairss. It taught me about the importance of supervising and self-care to avoid burn out something which seems to be really prevailing within the dependence field. I appreciated the degree of supervising provided to me. All of the lasting staff were systematically available to me despite their busy agendas and my supervisor conducted regular supervising Sessionss with me. They provided positive relationships for illustration playing as function theoretical accounts, exhibited a common communicating manner, general support and deputation of duty. They were generous with supplying their expert cognition and they provided instrumental consistent support throughout my 10 hebdomad arrangement. Professional Development I was asked by my supervisor to develop a Chrysalis Client Satisfaction Survey ( CCSS ) by telephone of all 2010 clients. Some clients nomadic Numberss were unapproachable. Of these, some were current clients and we were able to carry on the study face to face after their key-working or guidance session. 60 % of all clients were approachable, and of those, merely 1 % refused to take part. It was a fantastic chance to originate a closed inquiry study, create and implement the questionnaire ( Appendix A ) and set up an online system to collate the information and generate studies ( Appendix B ) . Current clients were besides offered an chance to fall in a Users Forum to do recommendations to better the services provided by Chrysalis and to guarantee that they have a voice. The Chrysalis Board of Management was delighted with the consequences of this undertaking. I attended a direction meeting to get down a new Women s Pre-Entry Group in partnership with Coolmine. This is focused on end puting with optional patterned advance to Coolmine, or the client s chosen bureau. I was the designated minute taker, and during the meeting I was given the duty of certain undertakings by a due day of the month. These undertakings included making a Flyer ( Appendix C ) ; making an Attendance and Evaluation Sheet ( Appendix D ) ; making a referral Form ( Appendix E ) ; and making a Certificate of Attendance ( Appendix F ) . My work was favorably received by both Chrysalis and Coolmine. I have non included my Meeting Minutes as an Appendix as this would go against confidentiality. I co-facilitated one Women s Group session as an observant pupil. This was a superb chance to see the group dynamic, detect the motivational manner of facilitation, and see how clients at different stages of alteration or motive affected the group dynamic. I participated in a figure of Outreach displacements for sex workers which can be described as frontline, low threshold work typifying harm decrease principals. The purpose is to set up contact with marginalised groups in their environment and supply them with appropriate support such as safer sex stuffs and harm decrease information, and contact inside informations to set up an assignment. My supervisor outlined an assignment for me to measure the Mobile Health Clinic and find if it is feasible undertaking. Unfortunately, due to its mechanical jobs, I was unable to finish this study. However, I believe it has the possible to supply an priceless injury decrease service to sex-workers in their ain environment. It will supply an advanced service in Dublin offering a free GP service on a to the full equipped vehicle with entree to local pharmaceuticss for free prescriptions. It will besides supply a waiting room with a lavatory, a GP consulting room, a confidential one-to-one Outreach room, tea and java devising installations and a Needle Exchange Service. I attended interagency case-management meetings as an perceiver ; I visited bureaus to advance the Mobile Health Clinic and Women s Group ; and I was an built-in portion of Staff Meetings and Client Debrief Meetings. The latter was a comfy supportive environment for common aid between staff. I besides completed HRB signifiers for my key-working clients and assisted the counselors with their signifiers if they were inexperienced with these. I developed the accomplishment of composing concise instance notes and the art of fixing for the following key-working session. On a hebdomadal footing I visited Alcohol and Drug Agencies in Dublin to detect their ethos, locations and do contacts ( e.g. Ana Liffey, Saol and Merchant s Quay ) . This enabled me to rede my clients better if I had to mention them to another bureau. I attended a Traveller Conference at Pavee Point, received two yearss of Needle Exchange preparation and one twenty-four hours of Progression Routes preparation. The arrangement experience is a give and take state of affairs. The bureau takes off the parts I made to their work, and I take off the benefits of personal and professional development as outlined in this study. I became familiar with Case Management Protocols and interlinked those with theoretical accounts and theory from university ; developed key-working accomplishments ; made interagency contacts through networking and protagonism ; discovered professional function theoretical accounts ; and gained assurance through supportive staff and feedback from clients. My Learning Aims at the start of my arrangement were exceeded by the acquisition chances provided by Chrysalis ( Appendix G ) . Decision I would be delighted to return as a voluntary and resume appraisals and key-working. I would besides be really interested in co-facilitating a new Partner Support Group. I believe there would be a immense demand for this service ; peculiarly one that draws upon the Strengths Perspective. I exhaustively enjoyed my clip at Chrysalis, and my lone sorrow is that it was so short. I would wish to thank all the staff at Chrysalis for welcoming me so wholeheartedly, for including me in the Chrysalis squad and for liberally sharing a wealth of cognition.

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