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The role of the Social Worker in ARV Rollout Based on Social Work Practicum Experience at Sinikithemba Clinic, Mc Cord’s Hospital Durban, South Africa. Presented by Tracie Rogers Social Work Unit Department of Behavioural Sciences UWI, St. Augustine. Social Work Practicum.

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presented by tracie rogers social work unit department of behavioural sciences uwi st augustine

The role of the Social Worker in ARV Rollout Based on Social Work Practicum Experience at Sinikithemba Clinic, Mc Cord’s Hospital Durban, South Africa

Presented by Tracie Rogers

Social Work Unit

Department of Behavioural Sciences

UWI, St. Augustine

social work practicum
Social Work Practicum
  • Social Work Unit

Behavioural Sciences/ Faculty of Social Sciences – University of the West Indies, St. Augustine

School of Social Work & Psychology, University of Kwazulu Natal, Durban, South African

  • Placement at Sinikithemba Clinic, McCord Hospital
  • ARV Roll out at Sinikithemba

Adult

Paediatric

overview of presentation
Overview of Presentation

Role of the Social Worker in Pediatric ARV Treatment and Management

Role of the Social Worker in Adult ARV Treatment and Management

Group & Community Work

The Potential of the Social Worker

the social worker in pediatric arv treatment and management
The Social Worker in Pediatric ARV Treatment and Management

Three Areas of Focus:

  • Psychosocial Assessments
  • Intervention
  • Evaluation
the social worker in pediatric arv treatment and management5
Psychosocial AssessmentsThe Social Worker in Pediatric ARV Treatment and Management

1. Assessing the Child

2. Assessing the Family System

3. Assessing the Support Structures

making a psychosocial assessment
Personality & Adjustment to Living with HIV/AIDS

Level of Disclosure

Child’s Functioning & Developmental Stage

Education/ School Based Needs/ Peer Relations

CD4 Count %/ Medical issues & concerns

The present family structure

Regularity of the Care giver

Family’s capacity for supporting adherence to ARV regimen

Stability of the Family

Level of Disclosure among family members

Norms, Values, Beliefs, Socio-cultural Dynamics

Religion/ Spirituality

Financial Stability/ Welfare needs

Making a Psychosocial Assessment:

1. The Child2.The Family

making a psychosocial assessment7
Making a Psychosocial Assessment:

3. Assessing the Support Structures

  • The Extended Family Support System
  • The Environmental/ Community Support System
  • Institutional Support
    • Placement in a Children’s Home
initial interview
Initial Interview

Goals:

  • Make psychosocial assessment
  • Identify and create initial care plan to target presenting problems
  • Evaluate ARV readiness

Protocol for child under age 14 – caregiver(s) is/are primary client(s); child is integrated where if developmentally mature enough to contribute to the interview; limited confidentiality for children

Protocol for children above age 14 – adolescent is primary client; caregiver(s) is/are integrated into the interview process; adolescents are interviewed individually as well as with caregiver(s)

Family/caregiver’s support structure or support system of the residential facility in cases where children are institutionalized are assessed specifically in terms of their capacity to provide for a child living with HIV

disclosure planning acceptance of status
Disclosure Planning & Acceptance of Status

Is the Child aware of his/her status?

What is the caregiver’s attitudes towards disclosure

Assessment of the safety of disclosure for the child

Assessment of disclosure risks and benefits explained to the caregiver(s)

Where the child is under the age of 14 and the social worker’s assessment differs from the caregiver’s, the social worker clarify concerns and provide continuous support and information to the caregiver(s) in the interest of the child’s safety and wellbeing

Where the child is over age 14, the social worker advises caregiver of the legal ramifications for persons who are sexually active and HIV positive

Caregiver(s) encouraged to disclose to children and the social worker should work with them to disclose in a systematic and psychologically safe way

the social worker in pediatric arv treatment and management10
The Social Worker in Pediatric ARV Treatment and Management

Three Areas of Focus:

  • Psychosocial Assessments
  • Intervention
  • Evaluation
intervention
Intervention
  • Formulating an Intervention Plan
        • Connection individual, family & community resources
  • Intervention in the Family System
        • Accessing social welfare
        • Family Testing & Counselling
        • Addressing stigma and discrimination
  • Direct Intervention with the Child
        • Counseling in specific issues identified e.g. coping, social skills
        • Making referrals
the social worker in pediatric arv treatment and management12
The Social Worker in Pediatric ARV Treatment and Management

Three Areas of Focus:

  • Psychosocial Assessments
  • Intervention
  • Evaluation
evaluation
Evaluation
  • Case Evaluation
    • Is the SW providing relevant, reliable and valid service
    • Is the SW meeting needs of clientele
    • Is the SW providing ethical service
  • Continuous Case Management
    • Adherence monitoring
    • Welfare needs
    • Advocacy
the social worker in adult arv treatment and management
The Social Worker in Adult ARV Treatment and Management
  • VCT as the Gateway to Care and Treatment
  • Referrals to Social Work
    • Social Workers & Counsellors
  • The Social Work Intake Interview
    • The Social Worker as Enabler, Advocate, Resource Moblizer

Our primary concern is linking clients to comprehensive, holistic support services

  • Intervention & Evaluation:
    • Linking people to programmes
group community work at the sinikithemba clinic
Group & Community Workat The Sinikithemba Clinic
  • Teenage Support Group
  • Playgroup
  • Grannies Support Group
  • Adult Support Group
  • Income Generation Projects
  • Youth Projects
the potential of the social worker
The Potential of the Social Worker
  • The Professional Capacity of the Social Worker in HIV/AIDS Care and Treatment
    • Counsellor
    • Negotiator
    • Advocate
    • Activist and Coordinator
    • Administrator
    • Educator
    • Researcher & Programme Developer