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.