Case study 3: Hannah
Hannah was a first year social work student with mental health difficulties. She had experienced agoraphobia and acute anxiety for a number of years which she had managed well in the three years before her arrival at university. When she became particularly worried or stressed she experienced anxiety attacks and her blood pressure
would rise. Whilst attending university, a range of support measures were put in place, and with the exception of one occasion when she had needed to leave a lecture, she had successfully completed her first semester. She was about to undergo her first placement with a statutory agency providing services for children and families. Like all social work students, she was particularly worried about how she would manage this new and demanding experience.
A number of different issues were identified with Hannah by the university disability adviser. She felt that she became very tense in new and/or unusual situations and that this might result in anxiety attacks. She was aware that she would have to meet with service users (people she didn't know) and go to new environments. She did not want to be seen as 'not able to cope' and wanted to perform well in practice. She was especially concerned that she might experience an attack when she was with a family. She could recognise when an anxiety attack was coming on and usually found that going for a walk
and taking '10 minutes out' was sufficient for her to manage her anxiety. Stress often exacerbated her condition and she needed to take regular breaks throughout the day to prevent this building up.
Adjustments negotiated:
The following adjustments were agreed with Hannah to enable her to meet her practice learning outcomes. They were then agreed with the university department and the practice agency to ensure that they did not compromise any academic and/or professional standards:
- A pre-placement visit to enable Hannah to familiarise herself with the physical environment and be introduced to key members of staff including her practice assessor/teacher. A member of disability support staff also came on this visit to provide additional support to Hannah in negotiating her adjustments.
- The practice assessor/teacher and agency staff were asked to take into consideration Hannah's need to be adequately prepared and supported when undertaking a first visit to a
family or when confronting other new experiences. A system was to be set up for Hannah to have accompanied first visits with a gradual reduction in support over time to allow her to complete visits independently as the placement progressed. The level of support and its reduction were discussed and agreed between the practice assessor/teacher and Hannah throughout the placement.
- Hannah was given the opportunity to take regular breaks throughout the day in agreement with her practice assessor/teacher and in accordance with the schedule of activities/workload asked of her (e.g. coffee break, lunch break).
- The adjustments were reviewed at the end of the third week of the placement by the practice assessor/teacher and Hannah.
- Hannah took responsibility for communicating any additional needs or concerns to the practice assessor/teacher.
- Both Hannah and the Practice Assessor/Teacher agreed that it might be necessary at times for these support arrangements to be adjusted slightly to meet the requirements of the placement learning experience (for example, a break might not be possible as scheduled). All the agreed adjustments were formalised in a letter to Hannah, the practice assessor/teacher and the department placement co-ordinator by the member of staff from the Disability Support Service.
Outcome:
Hannah successfully completed all learning outcomes for the placement and met the required national occupational standards. The level of support she needed for working with families was gradually reduced over a two month period when both Hannah and the practice assessor/teacher were confident that this was no longer necessary. Hannah continued to experience anxiety at times throughout the placement but worked closely with her practice assessor/teacher to develop strategies to manage this.
