Introduction

This essay deals with the circumstances and challenges faced by 22 year old Betty, who became pregnant when she was 15, and now lives with Candy, her six year old daughter. Betty has been referred to the social services cell of the local authority for appropriate social work intervention. She has been engaging in bouts of bingeing and has in the recent past been suffering from vomiting, weight loss and amenorrhoea.

A brief case overview is provided below, followed by its analysis and its various implications for social work intervention.

Case Overview and Analysis

Betty’s mother left her father and her sisters when they were very young because of problems in dealing consumption of alcohol. The child and her sisters were thereafter sent to a home for children, where they lived for many years. Whilst the children did not have any further contact with their mother, they would occasionally receive visits from their father, who worked in a brewery and also suffered from alcohol related problems.

Betty and her sisters spent their childhood in the children’s home, from where they first attended the children’s village school and thereafter went to a comprehensive secondary school near the residence of her father. Betty began to develop truancy tendencies in her early teens and became pregnant from her relationship with an African Caribbean person, when they were both 14. She decided to keep her child who was named Candy, rather than give her up for adoption, and was placed in a foster home situated at a distance from where she had lived for many years. With the children’s home closing down, Betty’s sisters, followed by Betty and Candy, came to live with their father. All the children, including Betty and Candy, lived with their father for the next 6 years.

Betty first met a social worker when she was 22. She thereafter moved with her daughter to a small flat, which she liked and made efforts to make nice and homely. Whilst shifting to her new home proved to be beneficial for both Betty and candy, the death of her father, which occurred soon after she moved out of his home, traumatised her severely. She suffers from bouts of speaking difficulties, weight loss and vomiting and amenorrhoea. Her social service records reveal that she suffered from speech disorder episodes in her childhood as well. Betty has also spoken to her social worker about her difficult relationship with her daughter Candy. Whilst the child is doing well in school and is liked by people, she behaves very badly with her mother.

An investigation of Betty’s history reveals that she may well have been neglected during her childhood. Both her father and mother had alcohol related problems. Her mother left home when Betty and her sisters were very young, following which she was placed in a home for children. Child neglect can be defined to be a condition, wherein individuals responsible for taking care of children permit them, either deliberately or because of inattentiveness, (a) to experience suffering that is avoidable, and (b) otherwise fail to provide the environment required for the development of their physical, emotional and mental capabilities. Neglect can be physical, emotional or educational (Butler & Gwenda, 2004, p 76). Betty and her sisters were taken in the care of social services when they were young and placed in a children’s home. Whilst their physical needs were met adequately and they were sent first to the village and later to secondary school, it is very possible that they suffered from educational and emotional neglect (Grinnell & Yvonne, 2008, p 46). They certainly did not have anybody to provide them with emotional or psychological support or to help them with their school work.

Educational neglect includes the failure of care takers to acknowledge and correct acts of truancy by children, even as emotional neglect can arise from inattention to the requirement of children for emotional support and sustenance (Ghate & Ramella, 2002, p 66). It is evident that conditions in homes for children are unlikely to have emotionally or educationally enriching environments (Ghate & Ramella, 2002, p 66). Neglect during childhood can have adverse effects on the physical, social, intellectual and psychological development of young people (Ghate & Ramella, 2002, p 68). Studies reveal that neglected children are prone to development of insecure, anxious or disoriented attachments with their care givers (Howe, 2009, p 37). Such lack of security in attachment can lead to hyperactivity, lack of attention and involvement in class and lack of initiative and confidence to work on their own (Howe, 2009, p 37). Child neglect is also associated with greater incidence of substance abuse, delinquent behaviour, and early pregnancy (Howe, 2009, p 37).

Betty developed tendencies for truancy, both in her school and in her children’s home, and became pregnant when she was 14 from her relationship with a boy of her age. Teenage pregnancy is widely prevalent in UK, with the country having a highest rate for such pregnancies in all of Europe. Studies reveal that girls from social class V are at greatest risk of becoming teenage mothers. Research evidence also reveals higher incidence of teenage pregnancy in (a) young people in care, (b) young people leaving care, (c) homeless young people, (d) truants and (e) young people involved in crime.

Whilst parenthood can certainly be a positive and enriching experience for normal people, it can also bring about many negative consequences for teenage mothers (Duncan, 2007, p 307). Such problems include (a) adverse physical and mental health outcomes, (b) lesser chances of completing education, (c) greater likelihood of living in the households of others, and (d) greater probability of being lone parent (Duncan, 2007, p 307). Teenagers who become parents are known to suffer from greater socio-economic deprivation, low self esteem and greater incidence of sexual abuse (Duncan, 2007, p 307). The children of such parents tend to have lower birth weights, lesser likelihood of being breast fed, greater chances of growing up in lone parent families, and greater probabilities of experiencing poverty, poor quality housing and poor nutrition. Such people also show greater tendencies for smoking and alcohol abuse (Duncan, 2007, p 307).

“Common problems amongst teenage mothers include depression and anxiety during pregnancy, financial, social and partnership problems and more negative life events (relationship break-ups, parental separation and lack of community and family support). Teenage mothers are more likely to diet or to smoke during pregnancy. The high smoking prevalence amongst people facing social and economic deprivation suggests that smoking may be used as a stress coping mechanism. However, there is a close association between smoking during pregnancy and adverse outcomes such as low birth weight, infant mortality and delays in child development”. (DHSSPS, 2004, p 1)

Betty, whilst she has lived in a designated children’s home, and has been educated in standard schools, may have suffered from neglect during her childhood and has experienced pregnancy in her early teens. Both these experiences can result in adverse physical, emotional and psychological outcomes. A social work report reveals that she was prone to suffer from speaking difficulties in her childhood, which could well be the outcome of an emotional and mental distress at being separated from her parents. This speech disorder surfaced again when she was 22, very possibly on account of her emotional traumatisation at the death of her father, who had provided her with shelter for 6 years after the closure of her children’s home. Her other ailments namely bingeing, vomiting and amenorrhoea could also be related to her disturbed upbringing and her psychologically disturbed state, which appears to have been aggravated by the death of her father.

Methods of Intervention

Betty is emotionally and mentally disturbed because of the death of her father and the behaviour of her child, Candy, towards her. Such emotional disturbances appear to have resulted in eating disorders, vomiting and weight loss. Apart from these ailments, Betty is also suffering from amenorrhoea. She needs medical and possibly psychiatric help and should be referred to mental health professionals and the local GP for appropriate support. Betty’s basic vulnerability arises from her status as a single parent, her past of a teen mother, her lack of earning capacity and her difficult relationship with her daughter. Such problems could lead to reduction of self esteem, depression and consequent mental and physical ailments.

Social work practice in such circumstances should first focus on understanding her case and her background and thereafter formulate appropriate intervention strategies. Social workers must in the first case adopt appropriate anti-discriminatory, anti-oppressive and person centred approaches in dealing with her case (Nash, et al, 2005, p 23).Thompson, (2001, p 7), advances the theory that anti-discriminatory approaches essentially arise from personal, cultural and social (infrastructural) influences that are experienced by individuals over the course of their lives. These influences affect the socialisation of individuals and result in deeply entrenched attitudes that surface unconsciously and influence their actions and behaviour (Thompson, 2001, p 11). Social workers, many of whom come from affluent and educated backgrounds, are very likely to have developed entrenched discriminatory attitudes towards disadvantaged segments of society and could well approach the problems of service users, from different racial, ethnic, social and income backgrounds, with preconceived notions and attitudes (Butler & Gwenda, 2004, p 83). Dominelli (2005, p 41) has also time and again emphasised that discrimination is pervasive in UK society and its social work infrastructure.

Modern social work theory and practice also recommends the adoption of person centred approaches towards service users. Service users, it is now widely accepted, should be placed at the centre of the social work process; with due regard given to their need for dignity, independence and self determination (Howe, 2009, p 48). Social workers, whilst dealing with Betty, with her history of living in a children’s home, teenage truancy, and teenage pregnancy, can very likely (a) have preconceived notions about her background, upbringing, education and attitudes, (b) take little cognisance of her helpful nature, her love for her father and her affection for her child, and (c) adopt attitudes of “I know best” condescension in their assessment and intervention practice. It is thus imperative for the social worker dealing with her case to consciously overcome discriminatory attitudes, adopt a person centred approach, communicate with understanding and empathy and involve Betty in all intervention suggestions.

The social worker should in these circumstances engage Betty with open ended questions about her problems and difficulties. Betty should be allowed to express herself as completely as possible without interruption in order to obtain a more complete realisation of her physical, emotional and mental strength (Brachmann, 2010, p 1). She should be asked to explain the ways and means in which she has coped with the various crises in her life and asked to explore and discuss her various strengths and weaknesses (Brachmann, 2010, p 1). Such discussions can well help in alleviating her feelings about the difficulties and hopelessness of her situation, enable her to think about positive lines of action and formulate suitable exit strategies (Grinnell & Yvonne, 2008, p 55).

Betty should be asked to choose the different reasons for her crises, focus on one issue at a time, and thereafter sequentially explore and analyse the different challenges confronting her. Such a strategy will help her to address the different crisis factors and find effective ways to address the diverse challenges (Adams, et al, 2009, p 107). It would thus be possible for her to individually focus on her physical and emotional difficulties, her problems with bringing up her child, and her financial challenges. The social worker should lead Betty in conversations that emphasise non-directive exploration of the various crisis issues (Adams, et al, 2009, p 107). Encouraging her to open up by asking different types of open-ended questions may help in obtaining revelations or in greater realisation of the various issues, which in turn can help her and the social worker in the making of informed choices (Brachmann, 2010, p 1). The social worker, once she expresses something specific or something that she would wish to alter, can become more direct in asking her to implement such changes (Howe, 2009, p 53).

Betty is now 22 and has brought up her child for 6 years as a teen parent, doing her best at the same time to help as a non earning member in her father’s family. Whilst Betty can no longer be technically classified as a teen parent, she continues to suffer from the vulnerabilities of such people, who are considered to be among the most vulnerable members of British society. Studies consistently reveal that children born to teenage mothers are more likely to have comparatively worse outcomes in terms of physical and mental health and education. Adolescent births are also related to higher levels of mental health difficulties, violence with partners and social exclusion (Coley & Chase-Landsdale, 1998, p 152). Contemporary teenage mothers have lesser likelihoods of competing in the job market. With teenage child bearing being automatically disruptive for secondary education, it is far more difficult for such people to complete their education in the more expensive contemporary day environment (Clemmens, 2003, p 94). The children of teenage parents are thus more likely to be economically deprived and socially excluded. When adolescents become parents, their education is likely to be delayed and even discontinued. Their employment opportunities are lesser, their incomes are likely to be low and they are less likely to develop long lasting relationships. Such people often require welfare support for prolonged periods (Duncan, 2007, p 307).

Betty, it is evident, suffers from physical and emotional problems. Adequate medical attention needs to be provided to her physical and mental condition in order to ensure that she recovers from the traumatic experience of her father’s death, is able to overcome her eating disorders and develops a stable, enriching and rewarding relationship with her daughter.

The UK government’s social work policies and infrastructure for teenage mothers provide for a number of intervention programmes (Asmussen & Weizel, 2010, p 2). Social workers provide case management support by visiting teen mothers and members of their families in their homes. Such visits help in promoting problem solving behaviours, identifying personal difficulties and challenges and in finding ways and means for overcoming them (Asmussen & Weizel, 2010, p 2). They encourage mothers to find jobs and pursue their education further. Case managers also plan and hold meetings with such mothers and their family members, wherein all participants work towards developing appropriate support plans (Asmussen & Weizel, 2010, p 2).

Social workers help teen mothers by the development of mutual assistance groups, where such people can receive and give assistance between each other. Young mothers like Betty can also be appropriately educated and trained in developing and managing small businesses (Asmussen & Weizel, 2010, p 2). They are, after the completion of such training makes them ready to run their businesses, assisted to develop and formulate business plans for their projects. The funding for start up costs for such project is provided after project plans are approved by trainers (Asmussen & Weizel, 2010, p 2).

Social work programmes also provide education in life skills, which is delivered over 8 weeks in group formats (Asmussen & Weizel, 2010, p 7). Such sessions promote the enhancement of knowledge and skills in various areas associated with parenting, social understanding and behaviour management. Leadership development amongst such mothers is promoted by giving them various responsibilities and roles in different types of group activities like planning of social events and development of committees (Asmussen & Weizel, 2010, p 9). Studies on these various projects reveal that their use leads to increase in the educational achievements of mothers and lessens the chances of repeat pregnancies. It also enhances their sense of well being and reduces utilisation of illegal substances. Studies on these programmes are however yet to reveal their impact upon child outcomes (Asmussen & Weizel, 2010, p 9)

The various techniques that can be used by the social worker to make Betty open up and focus on her various challenges have already been discussed before in the course of this essay. The social worker should, in line with such techniques, encourage Betty to think and discuss about her specific challenges, namely (a) overcoming her present physical and mental difficulties, (b) establishing a stable and rewarding relationship with her daughter, (c) furthering her education, (d) increasing her earning capacity and (e) leading a more enriching and socially inclusive life. Open ended questions and discussions over different sessions on each of these issues can help Betty in becoming emotionally more positive and in finding appropriate exit strategies for her different challenges (Butler & Gwenda, 2004, p 92).

The social worker can help her in discussing various alternatives like (a) medical and psychological health, (b) counselling sessions with her daughter, (c) formulation of programmes for completion of education and / or increase of earning capacity and (d) greater inclusion in social and community life. Appropriate intervention plans can be made after obtaining taking Betty’s active agreement on specific action plans.

Conclusion

This essay concerns the social and economic and challenges faced by 22 year old Betty, who became pregnant at 15 and now lives alone with her six year old daughter. Betty has been engaging in bingeing bouts and is suffering from vomiting, weight loss and amenorrhoea.

Betty’s mother left the family when the children were very young because of alcohol related problems. She and her sisters were sent to a home for children, where they would occasionally receive visits from their father. Betty and her sisters first attended the children’s village school and thereafter went to a comprehensive secondary school. Betty began to develop truant in her early teens and became pregnant from a relationship with a boy when both of them were 14. Deciding to keep her child, Betty, her child, Candy, and her sisters spent the last 6 years with their father, following which she moved out with her child to their own small home. She was severely traumatised by the death of her father and is concerned about the negative attitude of her child towards her. She now suffers from eating and speech disorders, is losing weight and experiences episodes of amenorrhoea.

An analysis of Betty’s history reveals that she may well have been neglected during her childhood. Childhood neglect can adversely affect the physical, social, intellectual and psychological development of young people. Early parenthood can also bring negative consequences like adverse physical and mental health outcomes, lesser chances of completing education, greater probability of living in the households of others, and more chances of being lone parents. Such people suffer from greater socio-economic deprivation, low self esteem and greater incidence of sexual abuse.

Social work practice, in such circumstances, should first focus on understanding her case and thereafter formulate suitable intervention strategies. Social workers must adopt appropriate anti-discriminatory, anti-oppressive and person centred approaches in dealing with her case. It is imperative for the social worker to deliberately prevail over discriminatory attitudes, adopt a person centred approach, communicate with understanding and empathy and involve Betty in all suggestions. The UK government has a number of social work policies and intervention programmes for young mothers. The social worker should engage Betty with open ended questions about her challenges and difficulties. She should be allowed to express herself freely in order to obtain a fuller understanding of her challenges as well as her physical, emotional and mental strengths.

The social worker should discuss different options like (a) her medical and emotional status, (b) engaging in counselling sessions with her daughter, (c) formulation of programmes for completion of her education and / or increase of her earning abilities and (d) ways and means for increasing her inclusion in social and community life. Appropriate intervention plans should be made after obtaining Betty’s active agreement on specific intervention programmes.