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Social Work Practice With Families: Summary of the Legacy of Loss

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Working with children and families in the framework of child welfare system is one of the most complex areas of social work practiceSocial work education attracts people with a special sensitivity for social ills, eager to be involved in a noble cause. Child welfare and especially child protection seem to be such a cause. Yet, social work graduates are not rushing by the thousands to join the Administration of Children’s Services.

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Witnessing suffering is difficult

Regardless of self-awareness, self-care, and support, witnessing suffering on a regular basis can be overwhelming. Arbore, Katz, and Johnson note that “being present to suffering on a daily basis places huge demands on our psyches, our souls, and our very being.” Eric Cassel, a physician, wrote a definitive article on suffering that has guided many professional interventions. He defined suffering as the “state of severe distress associated with events that threaten the intactness of the person”, and described suffering and its impact in broad terms. Cassel acknowledged that suffering is ultimately a personal matter, even though one can suffer enormously at the distress of another person. Although it is accurate that suffering usually is linked with physical pain and related symptoms, it goes much further. Suffering affects personal relationships, personal performance, personal transcendence or meaning, even one’s personhood.

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Since siblings are taken by different relatives or orphan homes, it means the children have to be separated; this is worsened by the fact that the orphaned children are usually divided among the relatives without regard to their specific personal needs and requirements. For the children who opt not to move with the relatives or those who have no relative to go to, it may mark the beginning of child headed households as they are forced to live on their own. Even under rare conditions where the child is adopted by a well to do household, little or no attention is given to the orphaned child because these households will always give the orphans the last priority. This is supported by evidenced from Case and Ardingtomn (2006), who found that a child, whose mother died but stays in a family with children having their mothers, will have a 20 percent, reduced chance of completed education. According to the Suryadarma, Pakpahan and Suryahadi (2009), these social changes can significantly affect both the psychological and physical well-being of the affected children

These changes frequently lead to stressful conditions as the child faces new constraints and demands.

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Thus, this is where clear communication between the patient and the family, along with a signed power of attorney and advance directives, can be critically important

Allying with the patient and the family should be a top priority for the social worker who has gotten to know and understand the patient and family and is, therefore, in a position to advocate for the patient and family’s decisions. If there is conflict within the family, the social worker can hold a family conference to reiterate the patient’s wishes and plans.

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Case, A. & Ardington, C. (2006). The impact of parental death on school outcomes: longitudinal evidence from South Africa. Demography, 43, 401-420.

Suryadarma, D., Pakpahan, Y. M., & Suryahadi, A. (2009). The effects of parental death and chronic poverty on children`s education and health: Evidence from Indonesia. Web.

Hunter, S. & Williamson, J. (2000). Children on the brink 2000: updated estimates and recommendations for intervention executive summary. Washington, D.C.: USAID.

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