This practice analysis will provide a critical account of a particular piece of work I did

with one service user whom I shall refer to as AD (protected identity) in accordance with

General Social Care Council codes of practice (GSCC, 2002).

The main focus of this essay is an attempt to illustrate how the use of critical practice

redefined the power dynamics within my professional social work interaction with AD

such that an intervention that had the potential to be coercive actually involved AD

working in collaboration with me to reach a shared responsibility of meeting his care

needs. I shall approach this essay by looking at the challenges of addressing AD’s need

to come off psychotropic medication, against the backdrop of promoting right, risk

assessment/management, partnership work, achieving empowerment and safety. This

will set the scene for discussion on relevant policy and legislative frameworks that

influenced my practice. Following on from this I would examine and analyse the

theoretical approaches that influenced my intervention with AD. The frameworks of anti-

discriminatory and anti-oppressive practice will be considered throughout the essay.

Next will be a critical evaluation of my intervention with AD. I will finish by critically

reflecting on my learning and skills that I will aim to continue to develop.

AD is a 28-year-old British man of Caribbean decent. He first came into contact with

services in the year 1999 and was subsequently given a diagnosis of schizoaffective

disorder and social phobia. He lives in his own council flat in southeast London with his

brother. He was born and raised in London. He left school after GCSEs. After school he

started work as a postman and then did lots of other jobs including working in factories.

He has not been in any since 1999. He is ambivalent about services, about his own

ability to use any help or make any progress. He also sees preceding involvement of

mental health professionals as oppressive, due to two previous admissions to hospital

under Section 3 of the Mental Health Act 1983.

AD’s case was allocated to me three months after I joined the Community Mental

Health Team (CMHT) as a care co-ordinator. My role as his care co-ordinator was in

line with the Care Programme Approach (CPA). In particular, the CPA provides a

framework guiding the process of mental health services assessment and care planning

which integrates the service user’s health and social care needs into one plan as

overseen by the care co-ordinator (Sainsbury Centre for mental Health (SCMH 2005).

My responsibilities as AD’s care co-ordinator include facilitating his care and recovery in

the community whilst offering practical support within a platform of partnership. These

duties also extended to developing therapeutic relationship, liaison with him, his carers

and various stakeholders in order to provide a holistic approach to his care. I also had a

specific responsibility to meet with AD on a fortnightly basis to assess his mental state,

provide medication, monitor risk, compliance, effectiveness/side effects, and to address

social care needs as they arose. These duties were guided by the National Health

Service and Community Care Act (NHS&CCA, 1990), the MHA 1983 and Mental

Capacity Act 2005 (MCA ‘05). Being acquainted with this knowledge of procedures is

fundamental to my practice. I bring to the process a professional value base, skills and

knowledge, which I attempt to continually develop and reflect upon.

AD’s most recent hospital admission was in July 2011. This relapse was precipitated by

non-concordance with anti-psychotic medication and exacerbated by the use of

cannabis. In this context he was arrested and charged with criminal damage after he

smashed up his self contained flat and part of the communal areas where he was living.

He was subsequently held in prison for approximately one week. He was later assessed

and admitted on Section 2 of MHA’83. Following this admission he has remained well

on a dose of Resperidone 6mgs daily however he unable able to appreciate the

dangers of cannabis use.

During a review meeting in November 2011 AD told me he was not happy taking

medication, and that he did not know why he was doing so, he also reported he would

stop the medication completely. Despite efforts to encourage him AD was opposed to

the idea of a gradual reduction of his medication dose or a change to a medication of

his choice. Amidst his history of suicide attempts, thrashing up his flat, cannabis misuse,

the presenting issues with AD were not only centred on how to manage my own anxiety.

It included balancing his right to stop medication whilst ensuring he poses no risk to

himself or others. It was also about how to support him to develop a sustainable insight

into his mental health need. Hence, the need to stay on his antipsychotic medication

albeit at a reduced dose.

Risk has been defined by Adams et al (2009a: pg209) as ‘a generic concept based on

the assumption that the likelihood of loss, harm or other negative happenings can be

estimated or even quantified’. With AD’s risk history, there was great temptation to

wade in and intervene into the situation and coerce him to stay on the medication

(which keeps him stable) as a way of minimising risk of relapse. However, it smacks of

what Hinshelwood (1998: pg25) refers to as ‘doing to’ approach, which meant little

opportunity for reflection and consideration of alternatives. Moreover, AD’s previous

experience of professional involvement suggests that pursuing this course of action will

do little to foster a process of engagement and relationship building, which, in the long

term, might achieve greater success in promoting his recovery and improve insight into

his mental health needs.

In preparing to work with AD it was important for me to look at his history, notes and to

engage in conversations with his consultant psychiatrist, his care team and others who

have known or worked with AD in the past. Coulshed describes this as “triangulation”

that is, cross verification of information with others sources (Coulshed, 1991, p28). I

would concede that to be accurate at this information gathering stage was crucial to an

effective intervention with AD. I would therefore, agree with Trevithick (2006) in her

assertions, that planning is a central part of any effective social work assessment.

Assessment as a key social work role is an analytical process involving the gathering of

and interpreting of information in order to understand the person and his/her

environment (Parker & Bradley, 2007). In my experience with AD, it involved core skills

of partnership, communication, negotiations, observation, and reflection (Coulshed and

Orme, 2000).

The assessment process began with an initial meeting with AD informed by an

approach that involves a ‘human’ “being with” another (Hinselwood1998: pg 25). This

involved, being mindful of both my verbal and non verbal presentation towards him. The

values inherent during the meeting were that of respect which I showed through active

listening (Egan, 2002). Ensuring that the meeting took place in a quiet room gave him

privacy and promoted his dignity in accordance with the GSCC code of practice that

requires practitioners to promote the dignity of service users (GSCC, 2002).

My starting point of intervention was how to enable him feel empowered to make his

own decisions about his future (stopping medication) whilst ensuring, that promoting his

choice will keep himself and others safe (Adams, 2009). However, I soon discovered it

was not an easy balance to strike. I found it challenging working around the difficult task

of balancing safety and risk issues and at the same time enabling AD to be actively

involved in the process. To move forward I was guided by the principles of the

exchange model (Smale et al, 2000) assessment tool whilst locating my work with him

within a wider ecological systems framework. This allowed me to take cognisance of my

position within the framework as an agent of the state and AD being the service user at

the receiving end of service. It did not pathologise by locating the problems with AD but

rather guided me to look for the causes and solutions to his problems across all aspects

of his situation and experience. As a result, I did not expect changes to come only from

the AD but also to look at the need for any systemic changes as described by Adams, et

al, (2009a).

Within the mental health care and control debate, I am aware that as a social worker I

have significant power compared to AD hence, my reason of adopting the exchange

model. By using an approach that provided a means of working together whilst

promoting ‘alliance of power’ (Tew, 2007), we were able to exchange information and

explore his hopes and aspirations, rather than focusing solely on his condition and risk

issues. Subsequent discussion revealed that he wanted a life without psychotropic

medication. Not surprisingly, a more in-depth discussion unearthed AD’s ambivalence

about the cost of this goal particularly when he was not willing to engage with any other

therapy. He said he was concerned that both the team and his family would not accept

any attempt by him to come off medication. Although, I disapprove of AD’s decision to

stop medication I did not disapprove of him as a person (Thompson, 2009). I was very

mindful of his rights within the MCA’05, in particular, the right to make what is deemed

as unwise decision. Likewise, my intervention with him was informed by my knowledge

of knowledge of the HRA (1998) bearing in mind his freedom of choice, rights,

autonomy, respect and dignity.

Reflecting back to the model assessment used, I found exchange model was useful as

it saw AD as the ‘expert’ of his own life and ensured the assessment process centered

on him (Parley, 2001). As a result of exchanging information he was empowered to be

actively involved in his own assessment process. I found empowering AD also

empowers me because it facilitated a redefinition of power dynamics in our interaction

such that an intervention that had the potential to be coercive actually enabled AD to

work collaboratively with me to reach a shared responsibility for meeting his care needs.

Within this forum it was of paramount importance that I actively listened and reflected

some of the contents back to him (Egan, 2002). This also reassured AD that I was

listening. In so doing, I have promoted his right to be heard and valued as informed by

both social work values of promoting servicer users self determination and theory base

underpinning my practice (Gscc 2002, Mantell, 2009). I also clarified where appropriate

to demonstrate that I paid attention, got a clear understanding of his experiences, and

checked out assumptions and expectations that may be present. Lishman (1994)

described this part of social work as vital; it empowers service users and boosts their

confidence in communicating their needs; especially when there is a difference in roles

occupied by the service user and the social worker. From this I have learnt that active

listening ‘is not just a vital part of engaging with people but an essential aspect of anti-

oppressive practice’ (Mantell, 2009, p: 18).

On reflection, I found that listening to AD enhanced my understanding of his unique

experiences through his own narrative as the expert of his own life. I realised that

enabling him to speak not only allowed me to make sense of his past and present

experiences, it also, according to him, made him feel heard. Reflecting on, AD’s

position as a mental health patient, I was able to understand and ‘stay with’ the

apparent confusion and powerlessness he was expressing, in terms of being subject to

the mental health system (Adam et al, 2009b). This issue of powerlessness seems to be

further compounded by other social discriminations he seems to be facing as a person

of black and minority ethnic (BME) background. Commentators like Golightley (2008)

posits that African Caribbean men like AD are more likely than their white majority

equivalents to receive medication rather than be offered therapies such as

psychotherapy. I realised that having contact with services must be difficult for him

(Maclean and Harrison, 2009) and wondered what it was like for him taking these

medications which have not ‘cured him’. Understanding AD’s needs and circumstances

informed my planning and enabled me to empathise (Mantel 2009) with him and

appreciate what it was like for AD to have a mental health problem and the sense of

powerlessness he felt. It was therefore, my responsibility to follow the provisions of the

Disability Discrimination Act by ensuring he is not discriminated against due his

condition or his race as required by the Race Equality Act (1976).

Intervention

Deciding between the different courses of actions to take in managing potential risks

posed by AD presented a dilemma for me. It raised tensions between his right to live

his life free of interference under article 8 of the HRA (1998) and my duty to protect him

from self harm and harm to others. Though very challenging, my standpoint was to

promote collaborative conditions of open discussion with AD, his carers, the consultant

psychiatrist and the care team. Blaug, 1995 believes that service users benefit more

from partnership rather than control-oriented approach to decision making.

As this discussion has attempted to demonstrate, I strive to adopt a partnership

approach to my practice in accordance with social work values of empowering services

users and fostering their autonomy (Banks 2006). In my work with AD for example, the

use of ‘person centred theory’ to focus on the development of a helping relationship that

foster empowerment was essential. This is in tandem with a person-in-the environment

perspective that is informed by systems theory that requires a putting together a series

of tasks (Task Centred Approach (TCA) as sustained by a partnership approach to

work.

Thompson (2009) explains knowledge on its own is of little use if it cannot be put to

practice therefore, this essay, will at this point examine how I was able to draw on my

knowledge base (i.e. theory’s, research and methods) to intervene in my work with AD.

The theory that guided the CPA was the systems theory. Systems theory emphasises

working at different levels in society. In my experience, this included working with AD,

the network around him (his carers) the professional ‘systems’ that interacts with his

network (Wilson et al, 2008). With this in mind I drew a diagram with AD at the centre

and could at that point draw in some strong systems i.e. his, parents, brother, GP, CP,

and mental health services. I worked collaboratively with him, together with the above

mentioned ‘systems’ to provide support necessary for him to achieve his goal.

While the CPA (DH, 1995c) meeting provided the vehicle for such collaboration, it was

equally essential that the timing of the CPA and its focus was primarily based on his

needs (Adams et al, 2009a). For this to be achieved, I had to undertake some tasks,

(with his consent) prior to a full meeting being convened. As the care co-ordinator with

the responsibility to enact his care plan, my subsequent interventions: included joint

discussion with his psychiatrist, the clinical team with myself advocating for a

collaborative approach to risk management that encapsulated AD’s aspirations and

goals. This generated a more reasonable deliberation on the issue and the challenges

notwithstanding. This joint work it enabled me to share this risk with the team. In the

end, it was agreed by the team that we would prefer reduction whilst remaining open to

work with AD should he disagree.

Another task I set and agreed with AD was to involve and prepare his family for the CPA

meeting. I began by obtaining his consent to involve his family. The purpose was not

only to show respect for his confidentiality, but also to give him control and choice over

how involved he wanted his family to be (DOH, 2005). Moreover, I thought that if his

family were involved given that they were people that he respected their views, and

coming from them might also make it easier for AD to accept the reduction approach.

However, I was mindful that there may be disparity between parties such that his

relatives may share his aspirations: however this was an opportunity I used to enable

them understand him and the choice he has made and support him in spite of their own

opinion.

In preparing for the CPA, I took him back to how what happened in the past led to his

relapse and the issues that came up for him. We also held pre-CPA meeting prior to the

full meeting and explore the social support available to him (though his father and

brother were unable to attend as initially planned). Another reason why the meeting

was held was to explain the CPA as a framework for his care planning in preparation to

a full meeting where it was expected that they would fully participate in the decision

making process. This was in accordance to the principles of Task Centred Approach

(TCA) which emphasises collaborative problem solving approach and developing

people’s capacity to make small significant changes in their lives (Maclean & Harrison,

2009).

Furthermore, we had continuing individual reviews to enhance our relationship, monitor

compliance and assess risk issues as part of the care plan. This provided me the

opportunity to work with him in developing a sustainable insight into his condition. This

involved my providing him with leaflets on his diagnosis, and him reading the leaflets

and sharing with me what he understood at subsequent reviews. It also allowed us to

review what has been achieved, what was not going well and how to make changes. It

was within such reviews that he reported that his brother would not be attending the

meeting whilst his father would like to come in early on the day to enable us go over the

agenda prior to the CPA. I found using a task setting – approach advocated by Epstein,

L. And Brown, L. B. (2002) helped me and AD to focus on agreed goals.

Diclemente and Prochaska’s (1984) cycle of change, a theory learnt from the Dual

Diagnosis training, applied to much of my work with service users. Many of my clients

whom I have worked with have substance misuse issues. AD in particular have been at

‘pre-contemplation stage’ and not ready to change and subsequently failed to become

abstinent. I found that having knowledge of this theory enabled me to understand why.

Combining this approach with person centred principles put forward by Rogers helped

me to be non-judgmental and accept AD’s decision when he told me he was not ready

to address his substance misuse. According to Rogers (1975), it is vital for social

workers to have unconditional positive regard for clients by having a non-judgemental

attitude even when they do not condone the service users’ actions (Cited in Trevithick,

2005 pg:269).

On reflection, I still read up on social work theories. As a newly qualified social worker

this is crucial to my professional development. I discovered that I am becoming

increasingly confident in the critical application of theory to practice. I found that I tend

to lean towards an eclectic approach when applying theory to practice (Lehman and

Cody, 2001). From my fairly young practice experience I have seen how this approach

has empowered my practice by helping me to ‘pick and mix’ different theories to the

benefit of services users. I have learnt that this is really the most effective way to work,

given that no single theory provides a clear explanation of a service user’s situation. I

am mindful that as a social worker I deal with complex situations and each one is

unique. As such, ‘service users have a right to expect an approach tailored to their

particular situation which draws on the best that a whole range of perspectives have to

offer’ ( MacLean and Harrison, 2009, p: 237). As I have noted theories were essential

to my work and formed a background for much of my understanding and my work with

AD

There were some ethical dilemmas inherent in my intervention, especially when working

within a team that consist of professionals from other fields. Banks (2001, p21) suggests

that ‘ethical problems and dilemmas are inherent in the practice of social work. Working

in collaboration with other professionals has its own benefits. It is also not without

tension. For example, while the psychiatrist’s emphasis was on medication during AD’s

CPA meeting other social issues were given lesser priority. As noted, and rightly so, in

my opinion by Trevithick (2005), the view point of professionals in terms of decision

making is of often determined by their professional value base. For example, AD’s

anxiety that if he stopped medication his benefit would be cancelled seemed to be

glossed over by the psychiatrist. Surprisingly he was complying with the psychiatrist

who seemed eager to keep him on the same dose of his medication. I knew he was not

being honest because I checked with him if it was okay when the psychiatrist left the

room. He told then me that he complied because everyone thinks that it is the best

thing for him. My heart sank at the statement because it echoes a sense of

powerlessness. In order not to collude with the feeling I reminded him that it was his

meeting and our suggestions should not override his decision and I expect him to be

able to tell the psychiatrist his wishes. Although the outcome was a reduction, AD was

happy as he had achieved something and according to him the process felt different this

time around.

Looking back, though I did not set out for the CPA meeting expecting that AD will

completely stop his medication, on the other hand, I had expected him to be able to

assertively tell the psychiatrist his wishes and choices. In retrospect, I still do not know

why I did not challenge him openly. I questioned whether this was about my own

powerlessness or my intention to mirror to AD that we are on the same page as a team.

Although he did not tell me, I think that I may have modelled powerlessness to him as I

could not challenge the doctor myself. This also brought up issues of my own

powerlessness as a newly qualified social worker and an experienced psychiatrist within

an organisation dominated by the medical model of disability (Sayce, 2000). It also

opened me up to the oppressiveness of the system towards individuals like AD. With

medical model still being prevalent in mental health, the use of partnership as working

principle still remains variable and uneven (Thompson, 2009).

Should this situation arise again I think I would be more open in challenging the

psychiatrist. However, I must ensure this is done in a professional and constructive way

that respects all parties involved without destabilising team dynamics. Also to model to

the client that no one profession have the monopoly of explaining mental distress and

that he has an element of choice in deciding how he interprets his own experience.

I have also learnt through reading up on issues of power that to challenge is to retain a

balance between, on the one hand, resisting being dictated to by other relatively

powerful groups (whether politicians or professionals) whilst responsive to what they

say, and even more importantly, what clients have to say about the nature, quality and

outcomes of our practice (Thompson, 2009). Although I remain mindful that I am not the

sole arbiters of what constitutes good or acceptable practice I must nonetheless ensure

that in future my voice is heard too and with clarity.

Evaluation according to Parker and Bradley (2007) is the process for measuring the

effectiveness of my practice, and whether desired outcomes from planning, assessment

and intervention have been achieved. Though the exchange model of assessment is

desirable due its partnership principles, Beckett (2005) argues that there are

contradictions with using this model especially when clients are under some form of

compulsion. I would argue that it was how I used my legal powers and my professional

self as a social worker in my interaction with AD that was the crux of developing true

partnership with him (Rutter and Brown, 2012). I am mindful that having legal powers

does not absolve me from my duties to AD. He has a right to be treated with respect,

openness and honesty in my interventions with him (Banks, 2005). To me this included

acknowledging to him the impact of the system that I represent have in his life,

specifically his feelings of marginalisation; an interest in the everyday affairs that matter

to him through a ‘hands on’ approach that showed among others my emotional

closeness to him (Ramon and Williams 2005:15). This extended to identifying and

acknowledging to him what stopping medication could do and could not do. And to

recognise that the medication is just a part of his recovery plan and not the whole plan

and that the plan was helpful in building our relationship.

Reflecting on AD’s situation and other examples from my practice experience

particularly from assessment and social work methods, I have demonstrated the

importance of planning for a desired outcome. All of the above incorporate the ideas of

empowerment and participation of the service user (Warren, 2007). I used the guidance

of the NHS&CCA (1990) and formulated care plans detailing appropriate services.

Moreover, adopting a multidisciplinary approach underpinned by systems theory, was

important in assessment and care planning as it gave a holistic overview of the AD’s

needs. Throughout my work with him, the assessment process was continuous and I

was active in locating potential resources to meet his needs. It was also partnership

based as part of service user inclusion in accordance with the guidelines of ‘The Ten

Essential Shared Capabilities Framework’ (DH/NIMHE (2004).

Theory and practice correlate and I have been able to holistically integrate both

together. I found my practice to be anti-discriminatory and person centred as it placed

priority on AD’s goals rather than the organisation. Thompson (2009) believes this is the

best way to engage servicer users. On reflection, the value of person centred theory in

AD’s case was that it enabled me to involve him to work out his choices and

preferences. Although he did not achieve his goal of stopping medication completely, he

did however, achieve little success (medication reduction) than large failures

(Thompson, 2009).

However, the PCA was limited because its focus on individual change tends to ignore

the importance of changing the external constraints, including social structures that are

oppressive or discriminatory (Thompson, 2001). For example, it failed to address AD’s

powerlessness in being a subject to mental health service. Despite the above

mentioned limitations the PCA enabled me to maximise his strengths just as it resulted

to AD’s growth and development. Even though, in small steps but it was definitely a step

forward.

Use of system theory (Payne, 2005) was equally effective as well given that nearly all

individuals belong to some system or other. It also gave the opportunity for all parties

involved to jointly participate in the care plan development. Conversely, because

systems theory takes on board all views from all the various systems regarding an

issue, it can be challenging for the practitioner when there are conflicting views on an

issue. This I found to be true during the clinical meeting where I was advocating for AD

to have his medication reduced whilst the psychiatrist was reluctant to agree. Knott and

Scragg (2009) suggests that reflective practice involves one critically analysing ones

approach and contact with service users. In my experience with AD, I found that theory

did not totally prepare one for every eventuality or absolve me from the emotional

challenges associated with mental health work. Theory did, however, offer me a firm

basis from which to start to understand and approach my service users (Payne, 2005).

Maximizing AD’s participation (Warren 2007) and consulting him as the expert

(Ferguson, 2007) not only allowed us find an explanation which was helpful to him, but

also gave him a voice, sense of self worth and full citizenship. Furthermore, his

narratives were invaluable in providing an insight that neither romanticises nor

underestimates the meaning, impacts and consequences of his mental distress (Lester

and Glasby 2007). Respecting and appreciating his lived experience of mental distress,

and establishing partnerships based on incorporating his perspective into all our work

were crucial to anti-discriminatory and anti-oppressive practice (Thompson, 2001). From

this, I have learnt that involving him through the whole process was essential to the

notion of inclusion and recovery.

The decision to go for a gradual reduction was made in adherence to principles of

recovery approach to mental health practice and what I knew about the last relapse. I

was also aware of other options but I chose this because it reflects the point of view of

the recovering individual instead of the clinician’s, it constitutes a major departure from

traditional notions of “cure” or “Symptoms” (Repper & Perkins, 2003). Recovery, in the

domain of mental health, is seen as a process in which a person tries to transcend the

situation characterised by one or more of physical or mental impairments, functional

limitations, or social handicap (Repper & Perkins, 2003). The aim is that AD will be able

to renew the meaning of his life and that he will be able to perform his social roles.

The challenge for me then was how to convince AD to take the medication with some

reduction and enable him to live his life despite the symptoms. I found it a challenge

worth trying because in my opinion it was the best option available. Reflecting back on

when he relapsed nine months ago. I perceive the way I used my protective powers

then, due to my own anxieties may not have allowed me to use my ‘co-operative power’

of mutual support and challenge to establish a relationship based on alliance of power

(Tew, 2006).

Kolb has shown that “Learning is the process whereby knowledge is created through

transformation of experience” (Kolb in Thorpe et al 1993:155). Reflecting on my practice

experience: I must acknowledge that supporting AD specifically has been a rewarding

experience which has not only helped consolidate my practical experience post

qualification, but has grounded me in the legal frameworks and policies governing

Mental Health Social Work (MHSW). I found the combinations of the principles of anti-

discriminatory practice and anti-oppressive practice, honesty, and transparency have

equipped me with the competence needed to understand and engage service users.

Indeed I have through this piece of work realised that if we do not theorize, social life

would remain a cauldron of unorganized experience and practical action would be

impossible. I believe my ability to reflect on the experiences that I have had, has helped

me to develop better self awareness and self knowledge and this I believe will invariable

assist me to further consolidate my practice.

I have also come to see that MHSW is what Cree (2007) calls ‘a balancing act’. That is,

I need to constantly balance the competing needs to promote service user’s right and

public safety as well as the need of different family members whilst balancing my own

values and belief systems with those of whom I worked with. Such as to understand but

not completely condem the perspective of the psychiatrist’s view of medication I realise

that this is not an easy balance to strike though, but the support/supervision I received

from, (line manager and colleagues) enabled me to manage dilemmas and conflicts. In

addition, effective supervision was crucial to my learning as it gave me a ‘safe and

nurturing’ space to critically reflect on my practice, ventilate my feelings, admit my

shortcomings and improve on my practice. I believe my skills in areas of

communication, assertiveness, negotiation, and reflection have been consolidated and

improved and will also prove useful for future engagement processes.

I am aware that partnership can be problematic, however, by taking steps that enshrine

the values of partnership for example, by recognising that the responsibility of resolving

the situation is shared and discussed the issue at the clinical meeting where it was

agreed that the team will support a gradual reduction. I have also learnt that focusing on

the aim of my intervention and working in partnership with AD enabled him to rebuild

confidence in himself, our relationship and the service in general.

In conclusion, the major focus of this essay has been a discussion of a particular piece of

practice. This was tackled in four ways. First, I highlighted upon a number of key laws and

policies that underpinned my intervention with AD. Second, I critically examined anti-

discriminatory and anti-oppressive practice in terms of the choices available to service

users and how social work values, theories, were used to work in line with the standards

set by the social work profession. Third, I critically evaluated my intervention with AD,

including key values used. Fourth, the essay discussed my learning outcomes, both

professionally and personally, and the ways in which I can improve my practice in

future. This essay has not purposed to close the debate or provide a final solution of what best

practice should be as it will be both unhelpful and unrealistic. Rather I have attempted to provide

a picture of practice experience with a particular individual. On this note therefore, I believe that

best practice for me as a practitioner to be is constantly engage in reflection and in reflexivity to

ensure good practice which is neither discriminatory nor oppressive.