Day 16

Finally managed to submit my transcripts of all the FGD sessions today after formatting the transcripts and figuring out the seating arrangments. I realised that there were some areas which I forgot to clean up properly (an oversight in the midst of my excitement at completing everything) and so I cleaned those up as well. Being able to submit my transcripts today was quite a happy thing for me as it means that I can move on to the other forms of work I have to do.

Upon attempting to continue my research work today for the literature review, I realised that I had trouble accessing the articles from my NUS account. While I could access the journals, I could not access the articles themselves within the journals. This was extremely frustrating as that meant I could not download the relevant articles, and no amount of my attempting to "reboot" the e-journal system could rectify the problem.

This reminded me of the many times I have had seniors from social work, who had already graduated and were working in the field, ask us to help them access these journals for their research work. While I would never begrudge helping them, I did wonder why they had to ask us for help - shouldn't their agencies and organisations have access to these journals as well? Until we realise that it's extremely expensive to subscribe to these journals and databases, which is why individual agencies tend not to have access to them, and why (strangely enough) the university has a greater variety of journals to access than the various hospitals do.

This to me is quite absurd as we so often are reminded of the need for evidence based practise (EBP), yet to do so would require regular research and forays into what new developments are happening in the field, which would require access to these journals - which we do not have. The question then is why we do not have a central union or society that is willing to purchase subscriptions to these journals and databases, which agencies and social workers can then pay a small fee to tap on. Even the university library membership does not allow access to E-journals and articles, even if you get the "premium" membership - which I find ridiculous, as you are paying no small sum yet you do not get access to what is crucial to every field of research (not merely social work).

While the SASW is doing its best to help professionalise the sector (through things such as accreditation, etc.) I feel that it has the capacity to do a lot more to help the sector, and setting up such a programme would not require as much manpower or logistics (I think) as other things such as accreditation, yet would greatly help to bring the profession to the next level. Makingsuch research resources avaliable to the greater social work community would help to greater professionalise the sector by supporting the drive towards EBP, allowing us to stay abreast of new developments in the field to better serve our clients, and also putting to rest any worries other professions (such as psychologists and psychiatrists) have that we are simply going by "gut feel" without using "proper, sound, evidenced" techniques.

Day 15

I finally finished transcribing all the FGDs! And in time for the deadline of end May as well! The only thing left to do is to format them and make sure that I have finished translating all the words that I had trouble with, that the structure is the same for all the FGDs, and that the unedited portions of raw data are cleaned up.

During this process of transcribing I have come to think about my mother and father growing older. My mum turns 54 this year, while my dad turns 51 - and this is around the same age as some of the participants in the FGDS. Two of my uncles are 60 and over, which technically could classify them as being senior citizens already. Yet I don't think of any of them as being elderly or being senior citizens - they are all so active and don't look their age. In addition to that I suppose the image of them that I always keep in mind is of the way they were when I was growing up, which would be them in their late 30s and early to mid 40s. So when I look at them, I know they are older, but it doesn't quite register somehow. I guess it's a lot more difficult for us to accept that our parents are growing older and will be classified as "elderly" soon, because we never envision our parents growing old. It's almost as if we expect to grow up, and expect them to remain at the same "immortal" age forever, just older than us.

This will have implactions for how we care for our parents in the future, as well as the expectations we place on ourselves in reference to them. For example, I can't imagine having to send my mother to the hospital for regular checkups in the future, the way she does (and sometimes the rest of us) do with my grandmother. That to me still feels like the extremely distant (if ever) future, yet I have to be realistic and understand that that day will come eventually.


In this case, I would have to say that it is always about a mindset change, of us having to be able to be aware of our mindset now in relation to where our mindset will "have to be" or how it will have to evolve, and it would be better if we anticipated and prepared for it. In this way, we can walk ourselves through it (the changing of mindset) instead of getting a shock one day when we realise that our parents have grown old and that the tables have now turned - we are the caregivers, instead of being the ones cared for.



I think that this would be perhaps the most drastic (and often times painful) mindset change, because it requires such a huge role reversal that we are often not prepared for in society. We expect to become parents one day, we expect to become grandparents, but we do not expect to become the caregivers for our parents (though it remains in our subconscious thought that we will one day). It not only involves us taking on an additional role, but involves us changing where we place our parents in terms of how we organise our lives, and also requires that we give up a part of our "identity" (being the child who can always ask one's parents for help). One day, should our parents ever become so frail that we have to look after them like children or newborns even, that would be the most painful, because we would remember the way they used to be when we were young, being completely incongruous with the way they are now.

I certainly do not relish the day when I have to admit to myself that my parents are old, and that I must take on the role of caregiver. I am not sure if I am ready to start looking after my parents at all, and if I ever will be. Fortunately, both my parents are ridiculously healthy, going to the gym frequently and watching their diets consciously, and I am especially thankful that they are both mentally sound. I just hope that when the day comes when I have to help look after them that I will be prepared and know what to do.

Day 14

The day started quite horribly as I lost my phone on the bus ride to work, and could not trace it - which meant I had to get a replacement phone during the lunch break today. So this did keep me mildly distracted during the morning as I tried to sort it out. However getting it replaced allowed me to go back to concentrating on work, and I was able to finish transcribing the fourth FGD, and have started on the 6th FGD (since the 5th was not recorded).

Trying to transcribe this FGD was a little bit more difficult as there were parts spoken in Hokkien which I did not entirely understand (though I could make out bits and pieces here and there). It was quite interesting hearing the elderly switch between Chinese and Hokkien, as if they were aware that Chinese was more "convenient" for the group, but Hokkien was the main "comfort" language, the one they were most at home with and would slip back to now and then.

It made me think about how different the generations have become in such a short span of years, just because of the policies instituted with regards to the "official" language of Singapore and the education system, with English becoming the medium of communication. While dialect is the most comfortable for my grandmother's generation (and mandarin is passable but not their preferred language necessarily), my mother's generation is most comfortable with English or Chinese in general, while dialect is still used quite frequently, and the majority of my generation is most comfortable with English (although Chinese is still used quite a fair bit) and dialect has almost completely disappeared from our vocabularies. This is of course to do with my specific ethnic group (Chinese) and doesn't speak for the other ethnic groups (such as the Malays and Indians, where for example the Malays do use their mother tongue to quite a large extent still).

What intrigues me is how in a short span of about 40-50 years we have completely changed our mode of communication, and how this seems to be more prevalent amongst the Chinese than the other ethnic groups. This has of course had wider repurcussions, in terms of creating quite a large language and communication barrier between the generations, particularly between mine and my grandparents' generation. Amongst my friends as it is I'm one of the "better" ones in that I can understand and speak Cantonese (although I still need to expand my vocabulary), and I am very comfortable speaking in Mandarin. Most of my friends cannot understand or speak any dialect (except for the vulgarities), and they are not fluent in Mandarin either.

The problem then is that, as it is, the generations already have gaps due to the different environments in which we grew up. With society and technology advancing as rapidly as it is, this gap (in terms of understanding) will simply continue to grow. Having an additional barrier to communication and "connectedness" due to langauge differences makes it even harder to connect to our grandparents generation. Personally this is one of the reasons why working directly with the elderly would be more difficult for me, and I suspect that this might be the case for my peers as well (thus deterring us from going into the eldercare sector).

For my fellow social work students (in my cohort), we have been wanting a proper "dialect school" to be set up to help us learn how to speak the more common dialects in Singapore, so that we will be able to communicate more easily with the elderly. This obviously has yet to be set up, but it is an area that could be looked into. For all the government's talk of wanting to keep family ties in place, one of the greatest keys is communication (as the FGD participants have all pointed out), and so something needs to be done to educate the younger generation (who can still absorb and learn more) so that they can communicate with the elderly, to strengthen these family bonds. The issue is whether the younger generation sees the need for this and can be bothered to learn. Particularly since dialects seem to be "dying out" or at least becoming a rare breed, whether this is even necessary (though I would say it is even if only to preserve our heritage) might be brought up. Ultimately it's whether there is a need from the ground up, which can fit into (and fill) the gap that has sprung up between the generations, which society (and the govenrment) thinks there is a need to address.

Day 13

I am almost done transcribing the fourth FGD, which means that after this I only have one more to transcribe and I am essentially done (barring needing to look through the transcripts again for formatting and checking the two that I need to just check the notes for). It's quite exciting knowing that I am almost done with one of the tasks for this placement, and on time as well (given how this needs to be done by end May). There is a sense of accomplishment and excitement as I begin to move on to the next phase of tasks - and as the entire review begins to take shape (as I do the analysis and literature review). I will however need to figure out how the review should be structured, as the literature review does still revolve around the effectiveness of counselling for elderly (and the population in general) whereas the themes in the FGD revolve around client awareness and the need for public education about what counselling entails as well as how it can help people. Constructing the implications from both these areas of the review will be interesting as both are so different and call for different actions to be put in place - which might mean choosing one over the other, should budget be an issue.

I attended the SDD talk, and that was interesting as I got to hear about the statistics to do with the elderly - both current and projected statistics. The statistics are quite enlightening in terms of how the ageing population is going to affect us in the future, both as a nation and within the social service sector itself. I suspect that the degree of impact is a lot less than what the government has projected currently, just because in the past the government has stated that enough was being done to help elder/target the ageing population - something anyone in the social service sector would have serious doubts about. Particularly after hearing about the sheer numbers we are going to have to deal with, we might have difficulty coping with problems like dementia and depression in the future. This might not so much be due to an increase in prevalence of the disease (as in it's affecting a greater majority of people - which would then need us to examine why it was becoming more prevalent) but just the sheer number of people having it increasing, because of the baby boomers ageing.

Again this makes me think about the future generation of elders - those from my mother's generation, and what type of services and programmes they would need. With a rising number getting divorced and having fewer children to support them, apart from their possible need for financial support, there will be greater need for their socio-emotional needs to be met. This could be done through counselling, through more activities being organised by the CCs and RCs and SACs, and by roping in religious organisations to help "keep them occupied". Whether the future generation of seniors would actually use these programmes however remains to be seen, particularly as they would be more educated and thus the current programmes might not be suited to their needs/wants in terms of how to occupy their time.

This provision of more programmes to meet the demand by the growing number of seniors would also mean a need for more manpower to help run these programmes - and as it is there are insufficient people going into the older adults sector, with most preferring to work with youth and children. Somehow I feel that this is due to our stereotype about what working with the elderly entails - amongst which includes the necessity to know dialects and mandarin. While this will still be important in the future, I suspect that the future generation of elderly will be more well-versed in English, given how most of them were educated in English schools. As such there is a need for us to revise our idea of what work in the older adults sector entails, to keep up with the times and attract new blood to the sector. If we package it in such a way as to show budding social workers (and people from related disciplines) that the work would be challenging and would require a lot of creativity (as they think of new, interesting, and relevant programmes), this could help to somehow draw more people in. Suffice to say we need to make the sector look dynamic and interesting, comparable to working with youth.

Gerontology was another topic that was featured during the talk, and I studied social gerontology in school. It was quite interesting learning social gerontology, particularly learning about the typical stereotypes regarding the elderly/older adults. A lot of these stereotypes have to do with the primary and secondary characteristics of aging, with the stereotypes arising mainly from the secondary characteristics being mistaken for primary characteristics. For example, a lot of people believe that dementia is a "normal" aging process, or that majority of the population gets it. While dementia is linked to genetics, it is not as prevalent as everyone thinks. However it still is a serious problem, and in sheer numbers alone it is going to increase a lot in the next few years. Thus there is a need to educate people on how to detect early warning signs of dementia so they can get the proper medical care and slow down the process, yet also emphasise that it is not a normal aging process. We also need to educate the younger generation to a) learn how to look for early warning signs of dementia in their parents, b) learn how to care for their parents who have dementia (or make preparations for their care), and c) how to prepare for it themselves - in terms of learning how to stave off dementia.

The issue here is that there is a fine line to tread between causing mass hysterics (i.e. everyone thinking they will get dementia) and breeding ignorance (i.e. not knowing the signs of dementia and living in denial about it). This is especially more difficult if the younger generation is not interested in learning about the illness, or sees no need to (because they think that it is so far away from affecting them, either directly or indirectly). We need to somehow breed curiosity and concern in the younger ones to want to learn about this process, how it could affect their parents (and thus indirectly them), how it could affect them directly, and try to get them out of an apathetic state (or the sense of invulnerability that youth seems to bring) and into a "knowing" and caring state.

Day 12

I am finally done transcribing the 3rd FGD, which is the longest one yet. Despite it being conducted in English, it still was not the easiest thing to transcribe - again because of the voices being muffled. However it was easier to figure out what they were saying than the previous FGD recordings. Suddenly I'm quite thankful that the FGD with the Lion Befrienders was done in English and without a recording device, because it means that I merely have to neaten up the notes and don't have to do anymore transcribing, though it meant being slightly more stressed during the FGD itself.

After transcribing about half of the FGDs, I'm beginning to get quite excited about doing the analysis, because I am beginning to see so many common themes and issues popping up amongst the various groups. However I would probably have to do some revision about doing FGD analysis (i.e. qualitative analysis) as I have not done this before.

I have to say that I am enjoying this field placement more than what my friends had thought (as they did warn me prior that, this being indirect work with a lot of research, I might get bored due to the lack of human contact). When doing direct work I hardly had sufficient time to sit and truly reflect about the theoretical and macro perspectives about the work I was doing or seeing being done. Instead, I was more focused on reflecting about my microskills, about how the clients were doing and the various cases I was seeing. Being able to take a step back and use different skills and look at things from a different perspective is refreshing.

Doing this placement is making me consider how it would be beneficial for all social work students to do at least one micro and one macro field placement each, so that they get a better feel of the field. Or, for honors social work students to do an additional field placement or internship in a macro setting (so that would total two micro setting placements and one macro setting placement). This way they get to experience two very different direct practise methods/settings and environments, and get to experience indirect work as well. While it was unfortunate that I have to redo my placement, in many senses I am very thankful that I do get to experience three different practise settings, as that gives me a much better understanding of how all the different aspects/arms of the social services work and how they interact and influence each other. The logistics of doing a third placement however would possibly not be welcomed by the school or the students, particularly as it does eat at the school holidays. It would be an interesting thing to suggest to the school however - particularly in relation to modules such as policy planning and research.

Day 11

Trying to complete the transcribing today was extremely frustrating because the participants on the recording were so muffled, I had to keep replaying the same segment for 20 minutes to suss out what the speakers are all saying. This is both due to the quality of the recording itself (it being very echoy and participants not being equidistant from the recorder) and also my earphones - which are not of very good quality. Oddly enough this is making me appreciate my older pair of earphones which had a very clear sound. Although this is not actually related to social work at all.

The good thing is that I am almost done transcribing the first FGD. And slowly I am beginning to appreciate how difficult it is to be a transcriber. The most difficult thing to do is to decipher what the different "layers" of people are saying, because so often there are multiple people speaking at once. Then you need to figure out who is merely chit chatting, who is adding important information to the dialogue, and who is actually answering the question. While it would be much easier for me if we made them take turns or signal before they spoke during the discussion, that would obviously be problematic and create too much cumbersome structure to the FGD, which would affect how much information and opinions are generated during the discussion itself. In fact I feel that the more interactive the group is amongst themselves (without the facilitator intruding) the better, because then they are more likely to bounce ideas off each other, build on those ideas, and there's a greater sense of which opinions are shared amongst the group and which are personal (and possibility minority) opinions.

One thing that I have taken note of though is how my supervisor conducts the FGD. Being able to review the tapes allows me to pay closer attention to the soft skills used (as opposed to during the discussion itself when I am scrambling to take down notes). I realised that it's almost like a "mass counselling" session, in the sense that each participant is attended to individually and allowed to carry on for a bit before being pulled back to the main line of discussion. This happens even if the discussion goes seemingly off-tangent for a while, so that the dicussion still flows but the structure still does remain (but it's more flexible). I also realised that by doing this, we managed to discover quite a few things that we would not have if we had stayed entirely strictly to the few questions given. By following the participants on their train of thought, we managed to discover new points that we initially did not plan on picking up (for example the idea of the lack of awareness and publicity with regards to counselling), and it actually helped us to realise that the focus of the review needed to be tweaked (or at least put on the back-burner while other issues needed to be dealt with first).

This illustrates very clearly to me the gap that often exists between the perceived needs of clients (as dictated by the "experts" in the industry) and the real/felt needs of the service users/clients themselves. So often we assume that because we can see how certain services/programmes are useful/efficacious in dealing with certain issues/problems, that the existence of these issues/problems dictates that we must introduce these programmes/services immediately. However, so often we do this without doing a needs assessment, or having a dialogue with the service users to find out what they feel is the issue that must be dealt with or addressed first. For example, this review was intended to ascertain the effectiveness of counselling and whether service users would use such services - yet what we found out is that they weren't aware of such a service, and that they did not even understand what "counselling" is about. In such a case, the effectiveness of counselling can then be considered irrelevant, or at least not of immediate concern, because the service itself is not even understood. If something is not understood, clients cannot possibly discern how such a service could benefit them, and would thus not utilise the service.

Tying in with my previous post where I discussed thinking about the client as a customer instead, we need to understand what the clients want and what they understand as being what they want before we can provide services that they will utilise and find useful. To tie this in with our position as knowing what could benefit clients without clients realising it at all, what we can do is find out what the clients want (e.g. emotional relief, financial aid, problem resolution), then match it up with specific services/programmes which we know would fit the bill and help them resolve their issues, and explain to the clients how these services will help. We cannot continue to merely prescribe programmes and services and expect clients to be positively affected by them, as people tend to be more resistant towards things they do not understand. We need to begin to think of clients as thinking and opinionated individuals, and "demystify" what the services provided are.

Day 10 - part 2

Today we conducted the final two FGDs for the counselling review. I was quite excited because the FGDs were held at a Senior Activity Centre, which I had never been inside or actually encountered before. I'm not sure if the place "met" my preconceptions of what an SAC is supposed to look like, but it did seem quite empty, and for some reason I was looking for a karaoke set hmmm...

I got the chance to do the FGD today, which was quite exciting because I had never conducted a discussion group with clients or service users previously. It was different this time because while I had conducted groupwork with youths previously, it is entirely different when you conduct a group with adults whom you are actually asking a favour from (as opposed to conducting a programme with). I was quite conscious about needing to go down to their educational level and not to sound as "ang moh" as I usually do, and while typically being local is not an issue, for some reason when it comes to work I tend to be more "official" sounding, for lack of a better word. This time I felt that my sounding more polished worked against me to some extent because it would mean that no matter how well I could connect with the participants in terms of content, they would not not reach that level of comfort of being able to share as freely with me as I would have liked. Since this was my first FGD I don't expect to be able to so quickly fit in with the participants; however it is something I need to take note of and work on in future work.

What made me a bit more cautious about the FGD was that it needed Malay translation because most of the participants were more comfortable with speaking in Malay. I have never worked with a translator before, and often it is a bit difficult to know whether I should ask for a translation or wait for the translator (in this case the manager of the SAC) to translate. I was also unsure if the participants were quiet because they could not understand what I was saying or if they were thinking or shy to answer. I was also unsure if I should ask them individually, something I observed my supervisor doing frequently - I wanted to, but was hesitant of sounding repetitive. The few times I tried to ask them individually (by directing the quesitons at the quieter ones), they tended not to answer, or the more prominent ones would end up speaking up instead. I think I could have made better use of the translator, by asking him to translate and to prompt each of them to give an answer - this way I could have elicited individual replies from all the participants instead.

I also need to learn to simplify questions I realise. I tried to but I was not always successful - something I realised during the session itself. I need to be quicker at being able to assess the level of understanding of the participants, to pick out the words that they would have trouble with, and find ways and means to be able to rephrase the terms into phrases they would understand and relate to. However it was quite heartening to be able to elicit responses from the participants, though it would have been good if I could have generated enough rapport with them and within the group itself for the participants to start discussing amongst themselves.

I attended the disability network in the afternoon, which was quite interesting. Having someone who straddles both the service provider and service user worlds brings a lot of interesting things to the table, in terms of being able to provide better insight into the service gaps and service possibilities for working with the disabled. I often wonder what it's like, when you have people with disabilities working in the social services - do they feel a greater sense of motivation, and do they feel a greater need to advocate for clients? Do they empathise more with clients because they experience similar problems and challenges, or do they somehow become more disdainful of the clients precisely because they had the same (or similar) challenge in life, yet they (service provider) managed to overcome these challenges and become successful? And as a client, would I feel better understood and more comfortable with a therapist or service provider who had either the same or a similar disability as me? How would this affect how I react to therapy/treatment/service provision? This would actually be a very interesting area of research to look into, and could have potential implications in the field of social work with the disabled.

The speaker also talked about a new way of thinking of the client as a customer, and how when you think of customers you think of profit, you think of businesses - in which case you would do anything to make the customer happy. In light of that, the phrase "the customer is always right" comes to mind. In contrast, when we think of the term "client", that tends to bring to mind the idea that we as service providers are the experts, and that we should tell the client what they should do. While we are taught that the client is the expert of their own lives, we inevitably will tend to think of how their lives fit together and will impose our own ideas of what is better for them. However, if we think of the client as a customer, then we will strive to meet every one of their needs (instead of the bare minimum), and see how else we can serve them aside from just what they come to us for (e.g. they may approach us for financial aid, but could benefit from family counselling and youth programmes for the children). In this way we stop taking our position for granted, and return to what the profession is actually about - serving people, in a manner that addresses their lives holistically, using our expertise not to exploit but to find additional areas to help them.

Day 10 - part 1

Due to the length of this entry, I have split up the reflection into two parts - Saturday first, then Monday later.

The session with the Lion Befrienders on Saturday was interesting - to hear about counselling from their point of view, not merely as non-service users, but also as service providers to the elderly. While theirs is not a counselling service that they provide, but according to the previous FGD where the participants highlighted the importance of their befrienders/volunteers (who would help them not feel so isolated), having the volunteers was a good follow-up to the initial counselling services. In light of this, it was quite interesting hearing some of the views that the befrienders themselves had with regards to the counselling services in the community.

What I suppose was most surprising to me (though it should not be by this point) is that the befrienders themselves were not entirely sure about what counselling was really al labout. they had a rough idea, knew that it was benefitial for the elderly, for youth, and those who were depressed (and perhaps for those with dementia as well), but they did not really know much about counselling for the general public. What was more surprising was that they would urge their elderly befriendees to go for counselling, and would encourage friends who were facing troubles to go for counselling, but they themselves would not go for counselling.

This seems to be a recurring theme amongst participants, even the ones who participated in the last two FGDs this morning - that they would encourage friends to go, but they themselves would not. I then am always curious to pose the question - why the difference? If you believe so strongly that the counselling would benefit your friends, why do you feel that you yourself would not go for counselling? Do you think that it would be less benefitial for you somehow? Why such contradicting stands? Of course to ask these questions, while they would make the participants pause to think, are quite jarring and can be seen as being very rude - which is not a good thing. I wonder if this has to do with the Asian mentality or if it is just something inherent in most people in general.

Another thing about the FGD on Saturday was the concept of counselling and counsellors to the layman. I was quite surprised that the befrienders were unhappy about the counsellors being so adamant about protecting the confidentiality of their clients' information. While I understand that they want to help their elderly and that some cursory information about them would be greatly appreciated, it is very difficult for counsellors to be able to divulge sufficient information to pacify the befrienders, yet to keep sensitive information private to protect the client. It was actually quite bewildering to me that the befrienders were unaware of our code of ethics and suggested that these be bent, or that the ministry/NCSS actually institute a policy for these ethics to be "bent" (or to be rewritten). I suppose it was particularly shocking for me that one of the volunteers, who is a counsellor volunteer himself, was one of those who suggested this. It made me wonder if there was a possibility that clients' confidential information was being revealed to others outside the counselling room already according to the "best judgment" of counsellors, and how this might greatly compromise the confidential nature of the helping relationship with the client, and also nullifies the idea of client self-determination (in terms of determining who he reveals this confidential information to). If doctors are allowed to keep patient information confidential (even from family members), why is that same professional ethic not viewed as stringently for our profession? Then of course it makes me reflect on the age-old tussle of the paradox between sanctity of life, client self-determination, and confidentiality, for example when it comes to the client wanting to harm themselves or somebody else.

The sheer length of that last paragraph and how many run-on thoughts are present in it just reminds me sometimes that it is good to sit down and reflect, to get my thoughts in order. I suppose this links back again to the idea of professionalism and "professionalising" social work. The mere presence of (and adherence to) a code of ethics can be considered evidence of us being professionals. Yet not only do people not always respect us as professionals, but ask us to compromise on our ethics/skills and essentially ask us to act unprofessionally.

It might be useful then to make it clear to people working with us in multi-disciplinary teams, and then to the greater public, that social workers do have a strict code of ethics which we have to adhere to. We need to emphasise that this is NOT to protect our status as professionals, but is to protect the client and the helping relationship in which we operate and empower the client. This protective factor helps to create that "bubble universe" that makes the client feel safe enough to open up about their problems and begin to work on them with the social worker/therapist.

This idea of ethics also made me think about our practise of social work in both the local and international communities. So often we emphasise the necessity to link our work to the local multi-cultural Asian context (especially since I have been doing a lot of research both in school and here in NCSS) and that of course is important. However, we forget that we also practise social work within the wider international community - which means our standards have to be up to that of our overseas counterparts, and we have to remember that as much as we represent Singapore to that community, we also represent our international counterparts within Singapore. We cannot simply align ourselves to either context in our practise - we need to be mindful of both. So we cannot simply say that we can bend our ethics to "fit the local context" if it is "in the way", because there would be severe international repercussions, particularly when our counterparts also work in Asian contexts without having to compromise these values.

I guess one thing I did not expect would surface that much in my field placement this time was ethics (apart from ethics to do with research), so the fact that one simple FGD has managed to make me think so in-depth (and circular) about ethics was surprising to me as well.

Day 9

Today was the fourth FGD session at O'Joy centre, the second session with service users. What struck me about this particular session was that there was a caregiver there as well, and caregivers of elderly are typically either the spouses or the children of the elderly. In this case it was the wife of an elderly man, who lives in JB. Her coming all the way down for the FGD was very surprising and quite touching.

During the discussion, I noticed that she had the tendency to take on the role of a co-facilitator, explaining and elaborating on the questions asked to the gentleman participant who seemed to be slightly hard of hearing and quieter in general. I wonder if this is an extension of her role as caregiver (since caregivers are often the intermediaries between those under their care and everyone else in general) or simply part of her character and personality.

More importantly though it was interesting because in Singapore the caregivers of elderly (or even for special needs persons as a whole) are a vulnerable population in and of themselves in the sense of the stressors that accompany the multiple roles they have to play daily. While there are support groups and all for them, I get the distinct impression that they are still a group that is insufficiently supported in Singapore. Typically caregivers have to deal with the stress from caring for their charge, work-stress (if they are working), stress from financial issues, and so on. Added to that the stress that many place on themselves in terms of feeling guilty about their feelings of resentment, being tired or angry etc. That is a lot of stress that they have to deal with, and typically they do not have an outlet to vent at or someone to vent to. So to be able to hear from the viewpoint of a caregiver in this session was quite enlightening, particularly as she felt that counselling actually did help her and her husband.

Apart from the discussion session itself, looking at the way the centre was decorated (with pictures and items from yesteryears) and learning why it was done up in such a way was a good learning experience for me. I have done work with older adults before as a theatre student, where we worked with SAGE to conduct a 12 week drama workshop with a small group of seniors, and we tapped on their memories of the old days as well, asking them to bring items that reminded them of important parts of their childhood, as well as bringing music from their era to play on the stereo when we conducted exercises with them. Being able to recall memories that are often associated with happier and more carefree times is a good form of therapy and a good way to break the ice and put the elderly at ease. For some reason I had not thought of using that in a social work setting despite my having used this in the arts before.

Thinking deeper about this, sometimes I feel that we focus so much on the problem at hand and trying to help people "get better" as quickly as possible that we forget to explore more interesting and creative ways to help bring relief to the client. Particularly as these more creative methods have less empirical evidence to support their efficacy (particularly quantitative evidence), sometimes it's difficult to get the support necessary to begin to explore such avenues in working with clients.

In addition to that I wonder if we as social workers are willing to begin exploring new avenues of counselling or therapy, or if we are so set and comfortable in our ways of working that we feel there is no need to explore these new avenues of therapy. Or if we as a society in Singapore is ready for that, given how even traditional counselling is difficult to "push" for with our clients (and how they don't even know what it constitutes). However, in this case it could be possible as well that the new avenues of therapy might be able to counter this, because they would not involve as much "talk" but more doing, which might appeal to some clients who are less in favour of talking about painful secrets and experiences so easily.

At the end of the day however, the crux of the matter is whether people are willing to admit that they have a problem that they do not have the resources to fix - often this means there must be a "letting go" of their pride, which is an issue for Singaporeans (more so than face). In that case, we might have to consider how to "repackage" coming forward for help - that it does not mean that you are helpless, but that you have difficulty tapping into your natural, inner ability and resources to cope with a particularly stressful situation in life. In this way, it would perhaps make it easier for clients to come forward and seek help.

Day 8

I finally finished transcribing the first FGD today. Considering how I expected to be able to finish transcribing one FGD within one day at most I have a lot more work to do - which should still fit within the timeline set out. This has made me fully appreciate the issues with the way I work, as I tend to need little distractions along the way to ensure that I can work for longer periods on the same piece of work. At home these distractions would include taking snacks or having the television on in the background, or having music on. In the office it consists of drinking more tea/water and alternating between reading journal articles and transcribing. The only issue here is that this could affect my ability to be more efficient at my work. I need to find ways to make myself increasingly more effecient at work I feel.

Today was also the first seminar for field placement in school, with Mr Benny Bong. It was a bit strange being the only year 4 there and knowing nobody else except Yu Wei. I'm still not sure if they know that I am a year 4, or if they assume that I'm a year 3 with Yu Wei. As usual I realised that I end up talking more than most of the others in the group, despite my conscious efforts not to - simply because it can get frustrating when a question goes for a long time without anyone coming forward to offer any opinions.

It was interesting to see how NCSS' role fits in with the other social work roles that the other students are currently in, and made me really consider how the macro and micro sectors continually affect each other (and need to continue to challenge each other). To understand the necessity to do programme reviews to ensure service quality and relevancy so that funding isn't being channeled into programmes and services that are not benefitial at all, and through this to find service/programme shortcomings and gaps.

As usual, one of the issues that came up was the concept of advocacy - the necessity to advocate for our clients. Obviously the other students had faced some issues about advocating for their clients in direct practise (for example advocating for an elderly patient who was physically able but was beginning to experience dementia). However, it was interesting to note that we all have this grand idea of what advocacy is like in social work - the concept of striking or petitioning or making a lot of noise (literally) so that the governing bodies take note and pay attention to us - yet obviously this cannot really be done in Singapore due to our strict laws regarding strikes and public speaking and assembly, and the notorious amount of red tape that bureaucracies carry.

It seemed that nobody had actually thought of looking at the service gaps and actually doing something actively about them - we all knew of some service gaps, yet all we actually did was talk about them and perhaps provide some feedback through the "proper channels" that something needed to be done. Nobody had thought of going out on a limb to actually do something tangible, such as approach a VWO that could be a potential stakeholder to set up a fund or service or programme that could address this need and gap. By doing so, this would allow the VWO to provide a service/programme that the government agencies might be hesitant to provide due to government philosophy etc. and in so doing help to address the gap.

I feel that it is unfortunate that our generation has grown up with all this "new found" ability to think critically, yet we lack that initiative that our forefathers had to go out and do something about it "with our bare hands". Instead we are so used to the system that we believe that there is nothing left for us to actually do; so instead we write and speak (while being politically correct) and wait for something to "fall from heaven". I think there is a great need for the new social workers coming into the field to learn to "step up to heaven" and understand that there ARE actually ways we can impact the system without going against it, as long as we can be bothered to do so.

Finally Mr Benny discussed the generalist role of the social worker, howe we know a lot about everything, but not enough about specific things. In kepeing a holistic view of the person, we are very important in ensuring that every aspect of the issue is addressed and taken into consideration, thus ensuring balance. So we are a profession that is important, but because we focus more on breadth than depth, we become a "jack of all trades". This is possibly why some might not think of us as a "legitimate" profession, but rather something that a volunteer can do - which is extraordinarily far from the truth. Unfortunately I always get the impression that we as a profession tend to be less respected than a lot of other professions, which seem to prefer depth (however lopsided it might make the situation) to breadth, or who would rather just stick different professions that cover depth together and expect them to be able to come up with a cohesive holistic view of the situation. Which almost never happens.

Perhaps we need to somehow "specialise" in our ability to link the individual and the environment together - but how? How do we make it such that that becomes our obvious expertise and people respect that as a "valid" expertise? Is it even possible to make the general a "specialty", or do we need to repackage the profession as a whole? So the professionalisation of the profession (at least in the eyes of the public) is tough. And in fact this might also not even be entirely desirable as this might make the client populations we serve feel like we are elitist and exclusive, which goes completely against what we must be to help them, and defeats the purpose of our job, which is to help make the system and all its available resources accessible to our clients; this would necessitate us being viewed as accessible to them as well. If we were to attempt to make ourselves seem more like experts, this might compromise our rapport and relationship with our clients.

The question then becomes how do we balance the two? And how can we help other professions to understand that accessibility to clients is not the measure of ones professionalism (i.e. the less accessible you are does not equate to your being more an expert or professional)?

Day 7

Today was a continuation of the transcribing work I started yesterday on the first FGD from SAGE. It isn't proving to be as easy as I thought it would be - in fact it's not easy at all - but I must persevere. I have to admit that while I want to do a "perfect" job of transcribing and get every translation right (from Chinese to English), I'm beginning to realise that to do so is exceedingly difficult for a few reasons.

Firstly being able to encapsulate the meaning of certain Chinese words in English is almost impossible - I often have to translate a single Chinese word into two or more English words just to fully express what the speaker was attempting to say, and even then it feels at times like specific nuances are lacking. Secondly, there is the issue of not being able to hear the speakers properly, due to their voices being muffled, mumbling, and of course when the voices overlap (which happens unfortunately very often). It becomes literally impossible to pick apart what anyone is saying, at which case I have to unfortunately depend on my notes, which are unfortunately not necessarily 100% word-for-word of what the participants said.

Lastly, at times it feels a lot simpler to simply paraphrase what they are saying, or ignore the lengthy examples or irrelevant parts of the conversations. However I am not sure how ethical that would be in the scale of a proper research project. For now I am doing that due to time constraints and trying to suss out the important information from the chatter. I am aware though that for full on research projects this is probably not advisable - makes me wonder how researchers actually accomplish that, what with so many interviews and focus groups they would have to transcribe during a limited period, and particularly if there are language and audio clarity issues like there are in my case.

Aside from transcribing, I'm in the middle of reading a lengthy research article on Chinese belief systems - about whether local Singaporean Chinese are more inclined to use and believe in the Western models of psychotherapy etc. or if they are more inclined towards indigenous models, such as feng shui and dang ki. They include a lot of variables such as educational background, whether they are therapists/clients/non-clients (of counselling), socio-economic status, religion, and so on. While I have yet to finish the article, I'm beginning to think if this study should be replicated amongst the minority ethnic groups as well, as I am sure that the Indians and the Malays have their own indigenous beliefs which could be preferred to the Western psychotherapeutic models as well. If this is the case I wonder if the findings from such findings would be similar to those from this particular study.

Day 6

I finally started transcribing the FGD discussions today, and discovered that it would not be as easy as I had hoped (or thought). The sound of the session can get quite unclear at times, and when the voices overlap it's almost impossible to differentiate who is saying what, or what is being said at all. Then there is of course translating it from Chinese to English, which takes some time for me as I want to make sure that I am as accurate as possible and stick as faithfully to what they have said in order to make sure that nothing is lost in translation. Sometimes I find myself rephrasing and rephrasing what I type to make it as "perfect" as possible.

Then of course there is the need to keep replaying certain parts of the discussion in order to get all the information out, particularly parts where I cannot hear the speaker properly. This means that sometimes it can take 10 minutes to get just 1-2 minutes of the discussion recorded accurately.

When it comes to such situations, I am glad that I took notes during the FGDs so that I can match what is being said to the speaker, and so I can more accurately "decipher" what is being said. Initially I had wondered about the necessity for note-taking, but now I wholeheartedly agree with doing so. It would be quite daunting to attempt to transcribe the FGD without the notes.

On the side of conducting the literature review, I am still finding it extremely difficult to find anything counselling-related to the elderly. While even a general search in google for counselling in general turns up several articles (and even more so in the specific counselling/psychology journals), when I do a search for counselling for the elderly or older adults almost nothing comes up. Instead, I see an overemphasis on health and medical journal articles about helping them cope with specific diseases or getting them to be faithful in taking their medications.

This makes me wonder if there is too much of a focus on the physical health of the elderly, with a lack of considering the holistic well-being of the older adult in terms of their mental but particularly their social/emotional health and well-being. It feels almost as if they think of growing old as a disease that needs to be managed and taken care of rather than seeing them as older versions of ourselves - meaning that whatever needs we have now, we are likely to still have in the future, just to a varying degree. If we feel the need for our socio-emotional needs to be attended to now, then we cannot expect those needs to magically disappear or to become less important when we get older.

The problem lies then in getting the various professions (such as doctors, psychologists, social workers, etc.) to begin to place a more holistic emphasis on the older adult and to take a professional stand that physical health is not the be all and end all to consider. While social workers might acknowledge this, we somehow are hesitant to do much research into this relatively unpopular aspect of the population. As for doctors, they would still be more likely to focus on "fixing" their physical health problems first, followed by any mental health disorders - socio-emotional issues tend to be followed up on last, and typically in relation to an adequate "care plan" being in place for the elderly instead.

In the Singapore context, this might mean that the ministry might have to take a stronger stand about the need for the elderly's psycho-socio-emotional health to be considered as a top priority alongside physical health. It might also mean that social workers (medical social workers in particular) would have to consistently work with doctors (and educate them) towards a more holistic view of the patient. This latter aspect is of particular importance as it would affect the groundwork, which is where the client/patient would feel the difference the most.

The question this begs then, is if we as social workers are ready to advocate for our clients as such, and if at the more macro level if we are willing to use research as a means for advocating for clients (by showing that effective interventions that help with their socio-emotional well-being also affect their overall health and wellness, including the physical aspect).

Day 5

Today's FGD was very interesting and eye-opening for me in terms of understanding the differences within the elderly demographic in Singapore, and also in terms of being able to see quite clearly the difference in socio-economic status of the elderly.

While I had been informed that the elderly at RSVP would be more on the corporate/professional side and would be higher educated, it still came as quite a surprise when the discussion began and I started hearing their views and their opinions of what is currently being done and what else needs to be done in the field to help the elderly. The manner in which they speak and the topics they touch on went alot deeper than what I had heard in the prevoius two FGDs; even their ideas went beyond what the others had discussed, such as the necessity to input preventive rather than merely remedial services and to detect issues at the primary touchpoint such as in hospitals.

This made clear to me that even I had my own notions of what older adults should be like - I assume that that they mainly speak Chinese or dialect, speak broken English, and have a basic education of up till secondary school at the most. I was not prepared that they would be highly educated and for all of them to have a tertiary education. With this in mind, I realise that even amongst the social work students (and society in general) that this could be the prejudice, conscious or not, that we have in working with the elderly, and that this could be the reason why so many would rather not go into working with the elderly. This would be a problem in the future if our mindset or the construct we have about the elderly does not change, while the demographic of older adults does begin to change (as those in their early 50s, who tend to have gone through university, begin to age).

In this case, the way we present programmes and services in the next 10-20 years would have to change drastically as well, as we begin to prepare for a highly educated aging population that would be used to being independent working professionals and adults, who might not be prepared for aging or who might have more Western leanings in terms of what they understand about the aging process.

While trying to think about how programmes might have to change for those about to become old, I begin to understand the difficulty in trying to help the current elderly and reaching out to them while having to bear in mind the "incoming" elderly when crafting service programmes. With such a perceived difference within this demographic the challenge of remaining relevant is crucial and not the easiest thing to do.

I also began to realise the importance of Active Aging, particularly after this FGD. The difference between the two FGDs with non-service users and the FGD with service users is really astounding, and while I did expect a difference I did not expect such a huge dichotomy. The FGD today further highlighted to me the reason why the government is pushing for Active Aging, and also for the elderly to become volunteers (as they have good ideas about how to help at the ground level, and can also connect with other elderly and continue to feel a sense of fulfillment).

Day 4

Today was spent mainly trying to find more articles suitable for the literature review, reviewing the ones I had already selected to determine if they were relevant to the study, and to suss out what their findings were.

One thing I noticed was that for several of the studies, counselling is as effective as normal medicinal care in terms of helping patients cope with depression (i.e. their depression gets better), and that the important part of counselling was not so much the method or theory used but instead the way the counsellor conducted the sessions (i.e. the environment of the counselling and the person of the counsellor). This was especially interesting to me as I had always assumed that CBT would be the most effective therapy in terms of aiding depression, and that counselling would only be effective if medicine was involved. The thought of the possibility of replacing medication with counselling was quite mind-boggling, and I wonder if this would be culturally suitable to Singapore (where people believe so much more in medicine - although several people hate taking medication - than in counselling).

The idea that the theory behind counselling might not be as important to clients' progress was also interesting, because for decades psychologists and social workers and counsellors have debated about the strengths and limitations behind each theory and model, and which ones suited which cultures and problems/issues. Yet at the end of the day to the clients, this did not really seem to matter as much as the counsellor just being there to guide them through, and the quality of their relationship with the counsellor.

This started me thinking that perhaps the importance behind these models and theories (besides to help us understand the clients better and know how which areas to focus on in terms of therapy) is not as important to the clients, but rather more important to helping the counsellors and therapists themselves become more congruent in their identity as a therapist. By being able to explore the various models and theories, therapists are able to see which ones appeal to them and make sense with their own worldview and paradigms, that match their value and belief systems. This would allow them to choose the best model for them to work with, allowing them to be truly genuine and congruent as they conduct therapy and counselling with clients. By being able to align their self-identity with their identity as therapists, this allows them to conduct therapy as a "whole being", which would create a "smoother" foundation on which to build the client-therapist relationship.

Putting this aside, I am finding it increasingly difficult to find articles that relate specifically to counselling for the elderly. As one article observed, there are few research evaluations that focus on the elderly, and thus there is a gap in the research literature in this aspect of the field. Which I worry would cause problems for the literature review as I attempt to write it. In regards to finding literature for the other age groups to show the efficacy of counselling, that is not a problem. However finding one that would be culturally applicable to Singapore is proving a little difficult as well. This will be a challenge for me as I continue to source for articles that will firstly a) address the age group that is of primary importance, the elderly, and b) meet our necessity for culturally-appropriate research.

Am looking forward to the focus group at RSVP tomorrow! I understand that they are better educated - however I am not sure how much of an impact this will have on the information we will gather, or on the way they carry themselves (and where they place primary focus in terms of aging issues and counselling).

Day 3

Today was exciting as it was the first time I attended a focus group discussion! It was an entirely new experience to me as I had never attended an FGD before, and it was also conducted in Chinese. I was actually concerned that I might affect the flow of the dicussion or that the participants might temper what they had to say as they might have thought I would not understand them completely. I was also concerned about my ability to fully understand what they had to say as while I am proficient at Chinese, should they choose to use a dialect other than Cantonese I would not be able to translate at all.

What struck me most about the two FGDs today was the difference between the two separate groups of participants. The service users were visibly much less active and more sedate than the non-service users, who were an exuberant group. While I was expecting some difference, I was not expecting such a vast dichotomy between the two. This might have to do with my prejudices about the elderly however - I tend to associate older adults with being more sedate and having a calmer disposition, so to have such a lively group of non-service users was a surprise.

This however highlighted to me the truths about the various theories I have learnt in school, to do with gerontology - such as role theory, social exchange theory, etc. The seniors with stronger social networks and who led much more active lives were visibly happier, healthier, and younger looking as well. The group which admittedly were less active was more sedate and "down cast". The salience of the concept of Active Aging really hit me at that point.

It also made me reflect on how I might age in future - being so active now, I would need to occupy myself after retirement with things other than household chores or my (future) duties as a grandmother. Factoring in the physical ailments that come with age however make me wonder how active I would be able to keep myself in future.

In terms of the subject of the FGD, I was surprised at the responses from the participants. I had always suspected that the services available in the community were underpublicised to all age-groups, but I was not aware that (for example) not being told which hotlines were specifically for the elderly would make a difference in their utilising the service. I also had previously thought that trying to "save face" would be a deal-breaker for whether the seniors would use the service, but this somehow did not seem to be such a big issue for them. What mattered more were the preconceived ideas about what counselling was about - that it was only for those who were severely depressed.

It made me realise that, similar to several other community services available, that publicity was important not only in getting the message out there (and making the public aware of the services) but more importantly, in framing how the services are perceived by the public. This is especially important as we begin to introduce newer and more "up to date" services in the community, which undoubtedly would have mindsets that might not be able to comprehend how these services would be of use to them. In trying to do our jobs as social workers, it is vital that the various ministries (and the government) help to frame the services in a more positive light to the community; if not, no matter how good a job we might do as service providers, we will never be able to fully meet the needs of the community.

One thing I am concerned about would be transcribing the material collected through out the FGDs, as I am not sure how clear the tape recorder will be (or if I will be able to differentiate the various voices). Hopefully the notes I took in the FGDs will help with that!

Day 2

I found out where the surplus goes! This was plaguing me because in school we continually feel that there are insufficient funds or resources allocated to the programmes in the social service sector, despite our nation obviously doing well economically year after year. I would like to figure out how great a percentage gets allocated to the social service sector each year as part of the budget however, and how much is allocated to salaries VS programmes. I honestly feel that more needs to be done for the welfare of social workers ourselves, since we keep advocating for our clients yet hardly seem to advocate for ourselves. I don't know which ministry's purview this falls under however. Hmmm.

Having to think through my learning goals yesterday and today, I realise that I truly do need to learn how to conduct research and focus groups, as these skills I have not had the opportunity to make use of in the field as yet (and honestly barely in school as well). I do want to experience what it is like to really work in NCSS, and if possible to see how service gaps are identified and policies formulated, as these are what in turn affects the programmes and services the various agencies provide (or cannot provide) to service users.

Being finally able to start researching for the literature review today was good, but frustrating. I was unable to open the journal articles as the computer does not have adobe, but more than that - I could not seem to find any articles relating to counselling efficacy in general, or for the elderly. All that seemed to turn up were articles relating to contraceptives and smoking. This is probably due to my research skills not being refined enough, and is something I will need to work on. Perhaps I should focus on specific therapies/models first (such as SATIR) since they are currently in use by the counselling centre(s).

I am wondering at this point however whether the counselling programme should use one specific model or theory across the board, be it for elderly or even across the age groups. I understand not having a standardised model as one approach would not fit everyone, and it would definitely not fit every agency. However I wonder how this could affect effectiveness and efficacy for the programme itself. I suspect that as I read up more about the efficacy of various counselling approaches (in relation to the elderly) this could be cleared up.

Tomorrow is the first focus group discussion I will be attending! I am both excited and nervous, as I really have no idea what to expect. I'm not sure how my presence will affect the discussion, being both a stranger to the service users and looking strange as well (not looking Asian). I wonder if I would be able to conduct a focus group discussion or to help facilitate it, and I am also anticipating the transcribing work I will be doing. Hopefully I will be able to cope with the work load!

(edit: If Adobe cannot be installed, I discovered I can use googledocs to open the PDF files as an interim measure.)

Day 1

Today was my first day at NCSS for field placement, and being an indirect practice "agency" I was not sure what to expect. For my previous placements it was simple enough to know what to expect - sitting in with my supervisor for case sessions and programmes were likely activities. Not completely understanding the scope of my placement or the department I would be in for NCSS meant I felt I was "going in blind" for this placement.

It turned out to be a fruitful day thankfully. Not fully understanding the scope of work NCSS covered despite my 4 years studying social work in NUS, being able to finally experience the work first hand will be a good learning experience I feel. It was enlightening to find out that NCSS essentially handles the fund allocation for the various programmes, while conducting programme reviews and service gaps / needs assessments.

Reading up on the various programmes under the elder service development department, I began to realise that the main aim of several programmes (aside from active ageing) was to help the elderly age-in-place, to give them a sense of independence and dignity, allowing them to remain mobile and to continue living in a comfortable and familiar community setting, while giving them as much support needed to do so.

This helped me to better understand the belief system informing policy development in regards to the elderly, which will help me to orient my point of view in working here at NCSS (so that my perspective can be better aligned and more in tune with the agency's). This is important, as knowing the agency's angle will help me to understand how to help review the counselling programme in relation to this belief about ageing in place. It will help give me a direction and focus as I do the literature review in the coming weeks here.

I do however have questions relating to the funds budgeted for each FY and the funds finally allocated to the various VWOs, as there seems to be an annual surplus, and the annual reports do not cover where the surplus goes. I would like to find out what happens to the surplus..

Hoping to start reading up for the literature review tomorrow!