Day 30

I finally managed to find a way to look for more journals and to find more articles, ironically by tweaking my search term from a noun to a verb. Somehow it appears that more articles appear when I use "aging" as opposed to "elderly" or "older adults". This is odd as I was previously aware of the need to find as many synonyms as the word you were searching for, but I had not thought that looking for a similar word in a different form would work. However I still have more articles on help-seeking behaviour for the elderly than I do on counselling for the elderly itself (though I need to double check this to see exactly how many articles I have of each type), and it feels like help-seeking articles were easier to find than counselling articles. This still does not detract however from how happy I am that I managed to find a search term that works, as well as figuring out finally how to make proper use of Ovid as an article search engine.

I am very pleased that I managed to find quite a few good articles through this search method though. Ploughing through each article will be a bit of a time-consumer however, gauging by how it took me almost the entire afternoon to plough through a 27 page article. I remember I used to actually skip the main methodology sections and jump straight past results as well and to discussion back when I was first starting university. Obviously along the way we were told that to do so would be entirely silly as then we would not be able to tell if the results reported by the researchers were actually as significant as they claimed them to be, and if the implications they drew were actually credible. Thankfully the more articles I read, the more I begin to get the hang of what each statistic or number means, and my past experience in research modules has helped as well.

I have also (finally) started thinking of themes and headings and some sort of basic structure for the literature review, although I still have a lot to work on for it as I am not sure how to craft it as yet. I am still doing the basic summaries of each article, so that I know how to group the literature and find out what points I can draw on from each article. The difficult part right now is figuring out what I want to present in the literature review, and how relevant it is going to be to what is necessary for the review.Hopefully I can start getting something out by the end of the week, if not I will be lagging quite far behind I feel.

Day 29

I finally finished up the FGD analysis by adding in the discussion portion, and sent it in to my supervisor. I am (obviously) very very thankful that it was received positively, but there is still a lot of tweaking and amendments that I need to do and look at, to make it flow better and to improve the structure of the entire analysis. One thing I had to constantly look at was to make sure that I was not repeating myself and was being as concise as possible, as I ramble on and go in circles quite easily. Especially with regards to the discussion, I was quite anxious to make sure that it was clear and made sense, and that I was not merely repeating what I had said earlier when reporting the findings. I am unsure if I want to throw in some theories, or if there are theories which I can relate to the discussion itself (will need to do more research to find that out). I am also unsure if I have addressed sufficient issues in my discussion that were raised when reporting the findings. I will probably need to take note of that and figure it out.

I am beginning to develop a backlog for my reflections as well, which is not a good thing as they do take quite a while to clear. Thankfully I have developed the habit of somehow taking short notes and saving them as drafts before publishing a brand new reflection each day, so that even if I am unable to publish a new reflection on the blog, at least I will be able to remember what I did and what I learnt when I finally do get down to writing out the blog entry reflections in full.

I also started looking for better ways to source for more literature for the literature review. Because I know that the review is due soon, I need to start focusing on the literature review again, and not become too engrossed o\in the FGD analysis alone. I find that I still need to find a better way to manage my time and split my time up between my work, as I tend to get stuck on one and become reluctant to leave it to go on to the next one (even though that is necessary to ensure that I do not over work just one portion of my brain - or at least that I do not run out of time to complete the other piece of work). I know that the literature review is due soon, and I iwll nee to start focusing on that as well and not merely on the FGD analysis. However, as usual, it was quite a frustrating day to search for articles, because there is as usual a lack of articles.

I am really beginning to sense a huge gap in research which for some reason has not garnered the attention of researchers sufficiently enough for anybody to start pouring new research into.

hopefully tmr will be better for that at least.

Day 28

I have literally just been scouring through journal after journal for the past few days, including today. I remember just the day before yesterday I thought I had struck gold by picking up on a new idea to look at gerontological journals instead of merely psychology, psychiatric, counselling, and social work journals. The rationale behind this would be of course that, these journals having everything to do with the elderly and older adults, that they woul definitely have something specific in relation to counselling for the elderly.

I was unfortunately sorely disappointed. I realise that even when it comes to gerontological journals that counselling is not that "hot" a topic. I find so many articles on other issues such as physical health, mental health, and so on and so forth. You would think that mental health would coincide with counselling as well (unfortunately no). I even find several articles on tai chi, which amazes me somewhat because I have always thought it to be quite a "niche" subject and had never anticipated that it would be of sufficient note to have entire articles written about it. Yet something that one would consider to be quite important and worth examination does not appear in the journals.


Despite "discovering" the term geropsychology (and realising that several articles or journals do refer to it) and incorporating it into my search, I realise I am still not finding much information on counselling for the elderly. This means I might have to go back to searching under the counselling journals once again - which does honestly feel a bit depressing. I am beginning to wonder how many articles I should include in the literature review as well, because I know that the search will never end (there will always be more articles I can look at, more articles I should include or which fit the description). And if I do not make myself stop, I might find that I do not have sufficient time to write the literature review, even after reading and finding all the articles.


I also have begun to wonder how articles are classified - as in how do you determine where to publish your article? For example, if you have an article or research paper on counselling for the elderly, would you go and publish it in a gerontological journal, or a counselling journal, or a social work or psychology journal? Would you publish it in more than one journal (is that even allowed)? And I realise that part of the reason why I do not know where exactly (or how to) look for these journal articles is because I do not understand how the authors and researchers classify their research papers (i.e. where they choose to publish). I wonder if there are specific guidelines set up that I could possibly refer to.

Day 26

Finally finished up the very first complete draft of the analysis! All that is left is for me to edit it a bit more and then send it in again, particularly as my supervisor is going on leave and will not be able to access any additional work I do on the analysis until Monday itself. This means I need to work fast to get the work done. And with the literature review on the back of my mind, I anticipate that I will probably need to stay back a bit later to get more work done (in the coming weeks).

I am beginning to understand now why it is so easy to OT in such jobs, because the work is almost endless and you are handling mutliple projects and meetings at a time. So not only is time management important, but sometimes it is simply not possible to get everything done on time within the 8-9 hours you work a day. Bearing in mind that I am only doing a small part of what everyone else here is doing, I think it is quite amazing that people manage to go home on time, or that they do not become overly stressed about the work here.

I continued doing research (or trying to) to find articles for the literature review. It is truly getting frustrating that I am unable to find articles regarding the elderly and counselling. It makes me wonder how there could be such a serious gap in research literature. As I look at the content and abstracts of the various articles I come across during my article search, I find many of them sound interesting - but many are also too niche, as if they are attempting to look into one particular aspect in a bit to make a name for themselves by taking on such a different area in research. While I do think that niche areas need to be researched, it appears that everyone is so busy trying to find these interesting niche areas that something as "common place" as evaluating the effectiveness of counselling for the elderly becomes neglected and actually becomes obscure (or at least not common place).

And then I find that there are several topics that seem to be over-researched, that I keep seeing as I try to find articles on counselling - things such as counselling elderly with HIV, or with alcohol problems, or even drug use. Which makes me wonder then - are the elderly not the only ones who think that counselling should be left for those with "serious issues"? Are even researchers (and perhaps even practitioners themselves) holding onto the mindset that if you are "okay" or without mental or physical health problems that you do not need counselling? If that is the case, then we might need to not only educate the elderly and the public about the uses for counselling, but even remind researchers and practitioners that counselling can be for everyone, no matter how big or small your problems are, as long as you are in need of a listening ear or a fresh perspective on a problem, or even if you want to improve your interpersonal relationship skills.

Day 25

I continued with the analysis today, and it is almost done! I am still trying to ensure that I have sufficient quotes to support the findings however, as I realise that a lot of what the participants "said" were not really said by them. Instead, they mentioned something, my supervisor helped to reframe it and clarified if this is what they meant to say, and then they agreed with the clarification. While this does give evidence to support our findings, it means that I cannot safely give what that particular participant said or affirmed as it was not spoken by them personally.

However when you think about it, it is true that it is important for the words to come from the client. As the interviewer, very often it is easy for us to be seen as an "authority figure", or for participants to think that because they were fortunate enough to get chosen, for them to want to give answers that will be pleasing to the interviewer, or simply because they want to help our cause. Interviewer bias thus could become a serious problem if we were to take such quotes to represent "what the client said", even if it was truly mere clarification and not coercion at all. Thus we have to be careful to ensure that, for the sake of the credibility of the study and findings generated, that we stick as closely as possible to what the participants themselves said.

To ensure that I do not lag too far behind in my literature review as well, I continued reading some articles and getting the essential parts out of them to collate into my basic summary of journal articles. This is to ensure that when I do begin writing the literature review in its entirety, it will be easier for me to know what important points to take note of, which articles support these points, and also make it much simpler for referencing. The only issue is that as I look at the summary of the articles, I begin to worry that I have insufficient articles for the literature review.

This means that I might have to resort to taking the systematic reviews which I found and use the articles they revewed to hel p"beef up" the review report. This tends to be a "trick" that my friends and I use in university - when we find an article that is useful and good for our asisgnment or research (particularly when we are having trouble finding articles related to our topic or subject), we take note of the references used in the article and search for those articles as well. I am not sure how good or valid or reliable a research method that is )as it could frnakly lead to some bias - since those areticles were chosen to support the initial article and so might not give the full objective picture) but it is a way to get around not having sufficient material for research.

Day 24

Finally finished the analysis for the FGDs! I am quite happy that it is more or less done - now all that is left is to put in the quotes, which will take some restructuring of the report itself (to ensure that the quotes flow and do not "stick out" of the report). I have started worrying about the literature review however because I essentially stopped reading and reviewing articles when I started working on the transcripts and analysis for the FGDs, which is not good as it means I have quite a bit to catch up on. I need to ensure that I finish sorting out the analysis soon so that I can begin sourcing for more articles again, particularly as I know how difficult it is to find articles related to the elderly and counselling.

The network today was very interesting, and I was fortunate enough to be able to listen to all the different speakers share. Hearing about the differnet types of dementia and how the disease affects different parts of the brain was very interesting! It explained how some symptoms turn up in some patients with dementia but not in others, and why some are seen as being "more manageable" than other elderly with dementia. It had not occurred to me that dementia would affect more than one part of the brain as it has so many different symptoms, and how by affecting specific parts of the brain more so than other areas that it would mean that specific symptoms would develop more acutely than other symptoms.

It was also interesting to see them using the A-B-C framework to do with dementia, as it reminded me of CBT, although in a different context. It reminded me that sometimes theories are not merely useful for the specific things they hope to explain, but that we can borrow their frameworks and ways of looking at things and adapt them to new contexts. It was quite enlightening to look at the "antecedents" to problem behaviour not just being the dieasease that affects it, but the environment as well (like if they dont like the activity and are bored they woule act out more than if they were occupied). The way we ourselves act and react towards them can have a huge impat on their behaviour as well, and can actually result in the very consequences we were hoping to avoid initially.

Dementia has always scared me, both in terms of what if my parents get it (as I do not know how I would cope being a caregiver, given mine and my brother's potential working hours, reluctance to get a maid, and potentially not being able to cope with work and care), and also in terms of what if I get it. I do not like the thought of not being able to control my mind; losing control of the body is very scary as well, but at least you can help to strengthen it, prevent itm and it is relatively simpler to treat the body. Losing control of the mind is something I fell i would have less control over somehow - in addition to the fact that the mind controls the body and so many other things (so in all likelihood if the mind goes, the body will too - but not necessarily vice versa). Without the body, you can still think, talk, interact with people. However, if you lose the mind, you cannot do so much, and cannot think straight. This is when it would be easy to become a burden to others, as when you cannot think for yourself, others have to constantly think for you. This is something I would not want for myself, as losing your ability to think is almost akin to losing who you are as a person in fact.

Watching the elderly perform also reminded me of the time I helped to conduct a practise research at SAGE toa payoh last year, where we worked with the elderly for 12 weeks to put up a miniature performance. It was a little like reminiscence work in the sense that we tapped on their memories about the past and and asked them toe reflect regularly. So for me, to be able to see the final product of a programme that was run for a much longer period was intersting. I must say that the actors were very good, and the play was relevant in terms of the issues it raised - they were easy to identify with and would be good for an audience of all ages.

This makes me begin to wonder if it would be possible to do something similar with movement. I can see why eldelry would hesitate when it comes to movement because it is something that can easily highlight their frailty, and possibly show up their inability to do certain things (due to wear and tear with age). But given how the elderly are so active in the community clubs in activities like chinese dance and ballroom dance, I am sure that there is a away to do movement expression with the elderly as well! This is something for me to think about, particularly given my interest and intention to go into dance, and what with the aging population in Singapore, this could be a new need (either a service gap or a market opportunity) for me to look into.

Day 23

I am finishing up the analysis today! Have finally combined both the service and non-service user FGD analyses, grouping them together under the headings I finally managed to come up with for the overarching themes. However I will need to ensure that the phrasing of the words is analytical so that it does not become a mere fact-finding report, which will be important. This is particularly so as there is so much data to report and include. I also will need to make sure that I do not become too "long-winded" in my report as that is something that I tend to do in my assignments in general as well.





I also need to examine the structure of the report, to figure out how to place the various themes (to ensure that there is a logical flow in the report), and also how to "blend" or meld the two different groups of participants together. As of now this is a bit difficult, partly because I think I am trying ti find a way to make it such that I do not have to do too much rephrasing (or actual rewriting on the whole). This might be quite difficult however as I would need to make it an entire and cohesive report, as this is one FGD series, rather than two separate ones.





Another consideration I need to keep in mind is that each "theme" has several "subthemes", which I will need to make clear during the report. However, I am as yet unsure if I should put headings for these subthemes, or leave everything under singular main themes. There are pros and cons to both; personally, I just worry that it might be a bit choppy if there are headings for all the subthemes as well. For now though it really is about the phrasing and "converting" what I have on hand from a basic summary to an analysis.





Soon I will have to start looking at what quotes I could use to substantiate the findings in the report, and I have to ensure that there are sufficient quote from all the FGDs if possible, balancing between the service and non-service users. This is important as I want to pick out the quotes that best represent the findings and the implications as such. Thankfully I can make use of multiple quotes, to give a more wholistic and substantial foundation to build the report findings on.





I also am beginning to realise that when I start getting into this sort of work (to do with actual crafting of reviews and reports) that it is very easy to lose track of time, and to not attempt to go deeper in terms of my reflections (whether it is while doing work itself or after work). Interestingly I did not anticipate this until I started trying to write my journal reflections - then I realise that I was beginning to get stuck.





I think that this is truly what happens when we start getting involved in work, as we get lost in the flow of work that keeps coming in we forget (so often) to stop and reflect about what we are doing, why we are doing it, and the implications this can have both for ourselves, our clients, and the social work sector as a whole. This could actually limit how far we can push ourselves and the sector, as reflections actually do help us to gain deeper and fresher perspectives, allowing us to look at what we are doing again and giving our minds the space to fully absorb what is happening and generate better ideas and thoughts that we can build on.





I wonder if it would be possible to set aside 15 minutes at the end of the work day for workers to reflect on things that happened during the day? Although it might be seen as a chore for people to have to spend the last 15 minutes or so at work to think deep, as it would be easier to merely drift off into space and let the mind "rest" and "blank out".

Day 22

Today marks the second day of work on the analysis of the focus group discussions. Earlier I decided to split the analysis into service users and non-service users, but as I tried to analyse the content of the FGD in this way I found that it was not economical and not effective, as there was too much of an overlap in terms of the information generated in the groups. I also realised that I had never seen any other report split an analysis in such a way previously, particularly when there were very similar questions asked in the different groups. However I continued with the analysis (or reporting of the findings) of the service and non-service users separately first so that I would have actual material to work with, before combining the two into the final analysis report.





So in order to figure out how I should do the analysis, I made use of my access to e-journals and found an FGD analysis online, so I could take a look at the general structure and structure my analysis accordingly. I realise that it helps to reference other works as such, particularly when they are credible and well respected journals (and researchers), as then I would be basing my report on reports found to be credible and reliable with good structure - setting a much better foundation than if I had attempted to fumble along on my own.





This led to me eventually drawing up basic overarching themes that the content of the FGDs mostly addressed, whether in the focus groups for service users or non-service users. Doing so allowed me to be able to fit the questions (whether in the original semi-structured questionnaire or added along the way) according to both the issues the question was addressing as well as the responses drawn out from the questions themselves, via theme. The basic overarching themes were generated according to the objectives of the FGDs, how closely associated they were to other themes (i.e. could a more specific theme be added to another to create a more general theme), and findings generated. From here I began to see where the various paragraphs of the individual analyses could be combined, where I should keep them separate (as not all questions were posed to both FGD group types), and where I needed to rework both the service and non-service users together.




This will need more work over the next few days or so in order for me to fully be able to make the report cohesive and comprehensive enough though. So I since today I focused on the service users and intergrating that into the combined report, tomorrow I will see how to intergrate the non-service user FGDs into the combined report. I must keep the flow in mind though.

Day 21

We visited 2 different SACs today, which was an interesting experience. Not having really visited an SAC for the purpose of looking at its programmes and activities before, I was quite excited to look at what was happening at the ground level for the elderly.





I was very impressed at how one SAC clocked 180 programmes in one year, aside from running daily programmes and activities. Of course after being told that you can have as many as 40 programmes in one week during Chinese New Year, I adjusted my level of "being impressed" - however given how that centre has only 2 people running it, I am still quite amazed that they managed to do that even with the duties and programmes that run daily at the centre itself.





One thing I did notice however is how much space the second SAC had - more so than a lot of VWOs and FSCs that I have been to! The first SAC in comparison (and even the one at Kaki Bukit where we went for the FGD) are much much smaller in comparison, and this means of course that the programmes they can provide for the seniors there are necessarily much more limited due to space constraints, leading to a big difference in their ability to serve the community there. This makes me wonder if this is taken into account when assessing their KPI at the end of each year.





It also makes me wonder how the government also allots space for social service providers, particularly in areas that require several different types of service providers (e.g. FSC, SAC, etc.) because as I heard there was one SAC that could no longer expand because there was simply no space left. In such a case how is it possible to provide sufficiently for residents and clients if the SACs themselves do not have the resources? Again, this boils down to competition for resources and being creative enough to know a) how to get those resources (particularly if they are out there but not necessarily easily within reach, or if you have to compete for them), and b) how you make the most of and stretch the resources you already have.





One of the SAC managers also shared that someone at the same position as herself (a manager) at another centre was on the board of directors for her centre, which I found extremely strange and odd, particularly as this is someone on the same level as her, and within the same organisation itself, and also within the same (public) sector. This makes no sense to me, and does not seem entirely right somehow. If it were between sectors (public and private), I could understand to some extent. If it was between different organisations, it would also not be as odd, although I might still find it a tad questionable. However, for this to happen within the same organisation and for someone who is supposed to be at the same level as herself being placed above her as a superior on her board of directors seems almost wrong to me. If i were her, I wouild feel extremely small, and be quite demoralised. For a peer to be elevated to such an extent by your bosses such that she practically becomes your boss would be extraordinarily uncomfortable, and to me messes up the entire hierarchy of the organisation itself.





I can imagine it would be even more demoralising if all this was going on, and you are actually doing a good job at work, and you yourself know it, but your higher ups and bosses do not see it and keep comparing you to someone with whom it is actually impossible to compare. Someone who has an infinite number of years of experience over you, and with more man power, will obviously do better in terms of KPI etc. There is no way you could surpass her given your constraints and limitations. However, somehow her bosses seem to expect her to do so, which is entirely unfair, particularly as they do not acknowledge how good a job she has done in turning the centre around in such a short frame of time. Rather than encouraging and affirming her, they put her down - and put her down even further by elevating her colleague/peer to the status of being her boss.





Listening to her talk about all this made me feel sad and quite indignant on her behalf, particularly as I would expect people in the social service sector to "know better", being involved in a sector where treating people with dignity and affirming the self-worth of each individual is of top priority (and amongst one of the main reasons why the SACs were formed in the first place)! Yet this is something they do not seem to be practising within their organisation itself, with their staff. I believe that if an organisation is going to "sell" something, they have to practice it in their own "back yard" first, within their organisation.





The sad thing is that she is so full of passion for the work, but she is leaving the job. In this sector, there is a huge necessity for passion for the work you do, if not you burn out very quickly. As you do not need to be trained in social work to do this job, getting a social worker into this sector would be difficult. However, you still must get someone with a heart for the elderly, and yet has fantastic administration skills, is extremely resourceful (as you have to find your own resources), has great PR skills, have good rapport with the elderly (as you need to connect with them to keep them coming to the SAC), and be able to multi-task and have good time management, because you have to do all this at once, and run several programmes and activities and organise all of them at the same time (or concurrently). There is so much work to do, yet the pay is not amazing, and without recognition and affirmation from your bosses, it is no wonder that it would be easy to burn out in this sector.





I did think that it might be good to bring in a special counsellor or community worker into the centres whose sole job/purpose is to work with the elderly, build rapport, build strong ties with the community, and provide counselling services as well - all the "extra" parts of what the SAC manager seems to be doing (but is not exactly directly within the job scope). However, there is insuffucient budget, social workers might still not want to go into this sector (because it has no prospects - it is essentially a dead-end job), and also there would be an overlap of resources with already available counselling services (such as the 3 main counselling centres for the elderly). Also, I realised that yes, one must keep in mind what the purpose of the SAC was - to increase social interaction of hte elderly through programmes, and keep them from becoming isolated socially, especially as these are the elderly living in one or two-room flats. Thus we need to make sure that they have people looking out for them, particularly the frail elderly who are not sufficiently ambulant. As a community, we need to keep them busy and occupied - and this is the very first objective that the SAC must fulfill first.

I also do wonder about the system, with the CEL in place now and how necessary or helpful it is at all. It is still in the early stages and early years, so it is too early to see just how useful it can be as a "one-stop centre". However, it decreases collaboration at the ground level - I would not know which worker I am working or collaborating with, would not know what the worker is like (and if their working style would suit my client), and it might also be difficult to see how far along the collaboration is and what is happening with my client "at the other end". It might make the social service sector more impersonal, as collaborating becomes more impersonal, and this might take its toll on the sector, as social services have been thriving on a lot of personal links and connections all these years (with workers developing relationships working with each other and tapping on those to better serve clients). So the question is, with CEL now in place, would it be possible to still keep these ties? And would the CEL system be as or more effective than using such networks, or less so?

During the time spent talking to the managers at the SACs, I noticed my supervisor using a lot of micro skills with them. It was very interesting to see tracking, probing, reframing, affirming, etc. coming into play even with people within the sector. Then slowly the SAC manager started opening up, from being very bubbly and being extremely positive and optimistic about how things have improved at the SAC, to actually talking about matters close to her heart that were bothering her, and finally to hinting that she might be resigning. What I realised was that a big reason for her being able to open up is that with the use of the micro skills, there was a sense of trust that she could talk to and open up to my supervisor (and I am sure she also wanted to prepare them for her resignation). It is quite amazing to see how micro skills can really come in and help people to open up.

That being said, it appears that there are a lot of people leaving the sector, which makes me wonder if it is just a coincidence or if there is something which the sector and the major players in the sector (such as NCSS or MCYS and the various organisations in charge of the SACs) need to address. Social workers would not go into the sector because they would not want a job that cannot go anywhere, yet it is not as if it is easy to groom individuals with the passion for working with the elderly and who have the people skills to do so coupled with the administration and resource skills necessary to run such a centre (particularly as there are likely to be better paying jobs out there that require people of similar skills). In that case, the government might need to step in to find ways to keep people in this sector - just like how they need to find ways to keep social workers in the social services, and find new ways to "entice" people to join the profession.

Day 20

I have finally started analysing the FGDs after collating the information. I still need to reference other research projects though to fully understand what I need to do and how to do it. Picking out specific themes that run through out the FGDs will be interesting, and having summarised all the FGDs will help with being able to pick out these themes. It also helps that after reading through the transcripts over and over I have quite a good idea about the specific themes and similarities between the various FGDs. I have yet to decide however how to break down the report - do I put the service users and non-service users together, or go by questions, or by general themes (particularly as there were some things that both service and non-service users both suggested and were in agreement about).

One thing I have to be careful about is that I actually analyse the findings and not merely deliver a summary of them. I am still a little unclear however as to how much I am supposed to include in this report, as I want to make sure that it does not overstep into the recommendations that I will be making in the subsequent report.

As I started to pick out the themes and headings and put specific questions together in groups, I began to realise that attempting to tructure the report based on questions would be near impossible, as many of the questions we finally posed to them were not a part of the interview questions prepared, and not all the questions were asked to all the groups (as some questions surfaced only during the later part of the series of FGDs). I had to find a way to group the similar questions together, and find appropriate headings or titles for each of these groups. However this still needs a lot of fine tuning, and I am glad that I get the chance to do this now during my placement as it affords me the time to be able to rewrite and redo the analysis (should I need to).

Day 19

Finally managed to finish the summary for the FGD of non-service users, as there as so much information to group together for easy reading. Even now I am not sure I managed to include the full richness and depth of the information gathered in the summary - however I think it will have to do as it is afterall just a summary, and for my own reference to make analysis of the data easier.

Now the summary is done I will be able to start on the analysis tomorrow, so I am finally moving on along the schedule. However I am still not entirely sure how to do the analysis - whether I report the findings and make inferences/comment about them, to comment on the implications this might have on the wider population, or just do a simple report. I might have to look at how other reviews and researchers did their analysis to figure out how to go about it. In all likelihood I will have to do a few drafts before being able to submit the final copy. hopefully I will be able to submit the first draft by Wednesday or Thursday.

Miss Peace came for the mid-placement visit today, it was nice seeing her again as typically in school I do not get to meet tutors who are not currently tutoring me (due to busy schedules all around). The visit gave me a lot to think about, particularly how to apply theories into my practise here, and in my reflections. In direct practise, while at times I would have to sit and think about what theories are applicable, it is more straight forward as these theories have to do with the client and the reasons for the client's presenting problems (in assessment), as well as how to best intervene to help the client. However, in an indirect setting, being able to apply theories is more challenging as I am no longer dealing with the client directly, but am instead looking at the client population as a whole within the context of the country's entire population. In fact, the concept of "client" is changed as well, as NCSS not only serves the interests of the public, but also the various VWOs, and as such they can be considered as "clients" as well (perhaps mandatory clients?). However, Miss Peace suggested that I consider theories in relation to the tension between micro and macro practice agencies and practitioners, which is something I have always been aware of but had never actually sat down to think about in terms of theories (it was all about "common sense").

The problem is, however, that as students we do not really learn about such theories in school to deal with power play or the tension between the micro and macro settings and such. We understand that there is this tension, and we know how it comes about, but we do not closely sit down to examine the theories that explain all this tension. I wonder if this is something that the school could consider incorporating into our syllabus, as it might be useful in helping us learn to "deal" with each other when we finally do go into different fields of practise and find ourselves at loggerheads with each other. If we could really understand the theoretical framework and basis of the tension, then we could (as practitioners and supervisors) be able to take a step back, understand the other's point of view, and from there learn to work together in a way that will benefit both sides without having unpleasantries happen.

However, if I were to sit down and think about it, I can easily come up with reasons for this tension and mistrust between micro and macro practitioners. Firstly, there is a perceived lack of transparency on both sides (#1); micro because they want to protect their own interests and their territory, and macro simply because there is often so much red tape (or because they need to keep certain things confidential initially as it will affect the service sector). With this lack of transparency, mistrust develops on both sides, as we are not sure of each others' objectives (#2). Sometimes these objectives are hidden subconsciously, whereas other times they are hidden with an agenda. When we cannot tell what each others' objectives are, we would be loathe to reveal information that the other party asks for, as we do not know if they will use this information against us.

On the micro side, there is often also a feeling of power play (#3) by the macro agencies, as they are typically the ones that hold the key to funding and resources. Thus, micro practise agencies might feel "threatened" or "bullied" or think that the macro agencies are being bullies, when in fact they could simply be doing their job to ensure that services being provided to clients are effective and efficient.

At the end of the day, a lot of it boils down to perceptions and perspectives, which unfortunately are not as easy to change as we like to think they are. It would take a lot of work, openness, being willing to share information, and essentially taking that leap of faith to trust that you are working towards a common goal (to help the service users) for us to begin to change such perceptions and perspectives.

Day 18

I started on the FGD summary for non-service users today, and realised that there is a lot to do. Especially as the RSVP group went "off tangent" during the discussion, that means that it might be more difficult to summarise the discussion and "split" it up into themes (i.e. generating themes might be more difficult). However there were a lot of good opinions and ideas generated during the discussion, so I do welcome the challenge, and am excited at what I can do with the ideas generated for the analysis later.


I also had another supervision session today, and it was a very interesting session! Being able to discuss the ideas and reflections I have had over the past few days/weeks allows me to really be able to bounce ideas off another's perspectives and opinions, and helps me to get a better, more well-rounded view of the current situation. It allows me to appreciate what is being done and get a better sense of what needs to be done, as well as what can be done.

During the entire duration of this counselling programme review for the elderly, we have heard two very salient points - that the elderly do not know what counselling is (and thus do not know about the benefits of counselling and are also not aware of counselling services in the community), and that the elderly are worried that going for counselling will upset their children. Thus it seems that what we really need to do is target public education, instead of merely targeting counselling programmes to make them "more effective". Even if your counselling programme is the most effective in the world, if people do not go for it (because they are not aware) then that makes it redundant.

It is important to consider however, who we should focus the public education on. We all believe that the elderly might need to be "educated" on the perks and availability of counselling. However, if they are still worried about what their children will think, then this will not be effective enough. Thus, we need to educate the children instead of the elderly (or in conjunction with the elderly).

As most of their children are working adults, they don't understand that their parents need psycho-socio-emotional support. A lot of them think that providing for their financial and physical needs is enough and sufficient. However, they fail to realise that providing these basic necessities is insufficient - just like the rest of us, the elderly also need a social support network, and friends to interact with. Being so busy with work to provide for them, their children often forget this and are not able to provide for these needs sufficiently. At this point, someone else has to step in to help meet the needs of the elderly - and the children need to realise this and understand that asking for help does not mean they are not providing for their parents. It merely means that there are resources in the community they can tap on to ensure that their parents are provided for in every aspect of their lives. If we helped them to understand that counselling can attend to needs that they cannot attend to and that that is quite normal and does not mean they are unfilial, then perhaps the would be more willing to allow their parents to come out for counselling, and perhaps even encourage them to do so.


We discussed communication with the elderly as well, and how there tends to be such a huge gap between the elderly and the new generation, not merely due to technology, but also due to a lack of communication (due to langauge barriers). However, my supervisor pointed out that often we use this language barrier as an excuse not to communicate, and how this often is used to hide ageism. There are many other ways to communicate, such as through touch, hand signs, or even just being there to help out around the house. Instead, we say that we don't speak their language and then don't even try to communicate with the elderly. It is this distinct lack of effort that makes it quite clear that langauge isn't so much the barrier as our mindsets are.

The problem then, is how do we overcome this ageism? The Koreans had an exhibition of sorts where the kids had weights and restraints tied to various parts of their bodies so they could feel what it was like to be old physically - this was to help them understand why the elderly are the way they are and move as such. While this might help to some extent in Singapore, I think what needs to happen is that we need to actually educate the kids from young that the elderly are not "defunct" in society, but that you can learn a lot from them by listening and communicating with them. Even something as simple as asking to hear about stories from their youth would be a good way to connect with them.

Possibly another way to correct this mindset is to begin with the parents, by communicating to them that the way they treat their elderly parents is very likely to be the way their children treat them when they grow old (monkey see monkey do, after all). So if they make the effort to talk to their elderly parents, treat them with love, and raise their children from young with an attitude of love towards the elderly, then it would be more likely for the children to grow up with a healtheir attitude towards the old.

With the changing demographic of elderly and with the baby boomers moving on to old age, however, things may be different in the future. We would have more educated elderly, and English speakers would be more prevalent. This means that we would then have a much wider spectrum of service users, which will have a lot of implications for the way we practise in the eldercare sector. This would mean modifying current programmes and services, and possibly having to intiate new ones to cater to a higher-order thinking elderly population. While we can hope that this will mean more active agers, less socially isolated elderly, and stronger ties with the younger generation (due to a reduction in language barriers), we cannot assume this will be so. We need to continue observing social trends in the upcoming decades, and constantly re-evaluate and review the programmes currently available. However, doing so on a large scale will take time (and an immense budget) - so perhaps one way to do this would be to also encourage the agencies to do regular programme reviews to ensure that they are meeting the needs of their service users, and to see where the perceived service gaps are - and this information can be passed on to the ministry and NCSS for consideration of new programmes and policies.

We then discussed the professionalism of social work, in terms of advocating for ourselves as professionals. As social workers, we focus so often on advocating for our clients and vulnerable populations, that we forget to advocate for ourselves. In fact, there is a distinct adversion to advocating for ourselves as professionals - which is not good! We need to value our skills enough to fight for our rights to be recognised as professionals and to be paid accordingly - if we do not value ourselves enough, then how will society value us? If we do not fight for it and believe in it ourselves, then society will not see the need to change their current stand and mindset (that we are just "more expensive" volunteers, and that anybody can do our job). We need to start fighting for ourselves, and understand that gaining a better reputation as professionals can help our clients as well, in that we might be able to get better help for them (in terms of collaboration) and be able to push for more funding and resources, as respect for our profession grows. This can lead to better programmes and services for clients.

The problem, however, is that so often to be seen as professionals, our work must be "quantifiable" - we have to prove that what we do is "worth something", and has solid proof of its effectiveness (and often efficiency). However, we are so afraid to claim credit for client change partly because it is difficult to say for sure (100%) that the change is due to our intervention, and also because of our strong stance of empowerment (wanting the client to know that they brought the change about and that they can do it again by themselves). Thus it is very hard to claim that there is value here in what we do, although we know that there is, and very often clients also do affirm that there is a lot of value in the work we do. However, because we consistently refuse to claim credit, it makes it hard for us in our bid towards professionalism. I wonder, then, if we might need to ask our clients to help us in our bid to advocate for ourselves - by getting them to speak out about how we helped them to be able to help themselves - as this would not undermine our efforts to empower our clients, and could in an odd way help to empower them as they realise that they can help us too.

One thing about working in indirect practise that I greatly appreciated was that it helped me not to merely look at one aspect of the client, but to have a more macro view and to look at the client population as a whole. Very often in direct work, because we are dealing with our client's specific individual problems (as these are where we need to fix our interventions), it becomes easy to forget to look at the wider picture. Even if we do look at the client population (after seeing several cases with the same presenting problem or the same demographics facing similar issues), we tend to look at only one aspect of their issues and not as a whole. Either that, or we neglect to see how this population fits into the wider service demographic of clients, and we tend to not notice service gaps OR only to see the service gaps and not other service options open to them. By working in such a macro setting, I begin to see that even within one client population, there are so many differences and permutations in terms of issues and services needed, as well as how (when you look at it within the context of the entire demographic of Singapore) this will be different in the future, when more people begin to fall under our service jurisdiction (in this case, the baby boomers becoming senior citizens). Then you begin to be able to see possible trends that might arise, and are able to start planning services and programmes that could become necessary in the future.

Day 17

I completed the first summary of the FGD service user groups today, to help me collate the information and identify trends/themes in the responses of the various participants across the FGDs for easier analysis later. I have to decide though how to structure the analysis as I would have to separate the non-service users and service user FGDs, yet there are several questions that overlap, which I might then instead decide to analyse together (as that would make the most sense, as opposed to repeating myself by analysing them separately then putting them together).

I am quite excited because it feels like I am getting into the meat of the work now, not just the cursory transcribing (though that was not easy either). However being able to sit down and start the analysis feels like I am finally starting on the review - beginning the process of looking at what information and findings the FGDs brought about, which will affect what we look at in terms of the reviw of the counselling programme. In fact, in putting together the summary, it makes me realise that so often we set out with an idea of what to review when doing research in the field, or of the hypothesis or project we have in mind, and how by the end of just the FGDs or interviews themselves we realise that what we really should be reviewing is something else entirely. This is quite similar to what we have seen here in the process of doing the FGDs - that while we were looking at evaluating the effectiveness of the counselling programmes, that what really needs to be done (more than instituting a set model or more centres) is actually increasing public awareness of both what these services are and where they are available.

It makes me wonder whether before we really start out on any research efforts, whether we should do a pre-research "feel" of the field, like a needs assessment to ensure that what we are researching is actually relative to the needs of the client populations and addresses the real service gaps in the industry. If not we will find that our research is two-steps ahead of the field, and not in a good way of pre-empting needs of future potential client populations.

I also attended my second seminar in school today with Mr Benny Bong, where we discussed the concept of spirituality in our work with our clients. It was interesting that when we started with a simple word-association "game" that there were so many different concepts that people linked to the idea of spirituality. However it took quite a while to get as many different words as possible on the board, which we realised was because we were hesitant to offer up our own ideas of spirituality and religion. When trying to figure out why there was this hesitation, one thing that was brought up was the fact that we have been "trained" since young to tread lightly when discussing and talking about this concept of religion and spirituality.

We live in a multiracial, multireligious society, where we practise freedom of worship and recognition - yet because we are so cautious about not creating any animosity or sense of favouritism, an atmosphere of tension is created in our trying to be "fair" to all the religions. Thus we don't talk about such sensitive topics in the open, and when we do it's all extremely politically correct - often to the point where we might be afraid of sharing our own beliefs with others (or disclosing them even). We seem to live side by side yet draw a clear boundary between the areas of religion from each other. It is quite ironic that in order to keep the peace, we create a tension that can cause difficulties in doing everyday jobs, particularly in sectors such as ours (and in other sectors like teaching) where despite it being necessary to talk about spirituality with clients, we often cannot broach the subject first (or at all) because of the secular nature of VWOs, and the worry that we might be seen as trying to impose our religious views on others - a big no-no in any service sector.

The discussion led to how we seem to lead a very dichotomised life here, where we separate the religious and sacred from the secular (whether or not that is feasible within our religions). We take up different roles according to the situation, and which "roles" we take up will dictate how freely we talk about our religious and spiritual beliefs. If one thinks about it however, it is quite incongruous with the concept of the self though - we are supposed to be whole, integrated individuals, where every aspect of our lives makes up who we are and shapes our character and values and belief systems. Yet one of the biggest influences of this - our spirituality, whatever that entails - is left out in certain social contexts, in order to be appropriate and politically correct. The question is whether this dichotomy is actually necessary, or if it is something at we impose on ourselves (and as an extension tend to impose on others we interact with daily).

Then there is the concept of how our secular laws constrain our ability to express our spirituality. Because Singapore is situated in the place it is - centred amongst Muslim countries - and because of the make up of our society, we have strict laws in place to ensure that religious harmony is maintained. That entails not bad-mouthing any religion on a public domain or setting(including the Internet), not discussing or actively promoting religion in schools (except schools with a religious background), and so on (I am not sure if it's illegal to evangelise to a Muslim in Singapore, and I cannot seem to find information about that). While this is all well and good if we were all attempting to bad-mouth and put down each other's religions and spiritual views (as this would cause great unrest, like the riots we had back in the 50s and 60s), it also leads to us being constrained in expressing our spirituality. At times, merely talking about our religion can get us into trouble if done in the wrong context, even if it is just within a discussion about the differences between the religions or answering a question objectively when asked. Mr Bong shared how a counsellor once got into trouble for answering a student's question about her own religion, even though the student followed the same religious beliefs as herself. This I find so strange, as it was not as if she was spreading her religion or trying to convert students to her religion. She was merely following up on a question the student initiated, which helped the student discover more about her own spirituality - an important component in one's adolescent years as you try to develop your own identity.

While I understand wanting to protect people (especially impressionable young minds) from being coerced into a belief system, I also know that children will be curious - and the more you avoid telling them something (or withhold information from them), the more curious they are going to be regarding the matter. This will lead to them finding their own ways and means of obtaining the information - typically from the internet - which might lead to information that is inaccurate and very possiby harmful. Wouldn't it be better to educate them in an environment that the government can control and regulate than to have them "run wild" and not be able to regulate what goes in? There are many extremist websites for the many different religions on the internet that I have encountered that go completely against what I know to be the truth about these religions (having friends who practise the religions). I have even encountered some from my own faith that are so harsh and disrespectful to others within and without my faith that shocks me because it is such a misrepresentation of what the faith is about. What worries me further is that people who read the website will assume that everyone who is from the faith follows the same beliefs, which is not true, and it is worrying that I might not be able to correct that notion if I encounter them when with a client precisely because of the laws and regulations in place regarding such matters. Should then it come to light which faith I am from and if I cannot assuage the client's negative perceptions, that could get in the way of the helping relationship.

One of the tasks given during the seminar was to think of a time when we had ignored or had not addressed a client's spirituality issues, so I shared about an experience where I sat in for a session my supervisor was conducting with a client. During this session the client was convinced that her daughter's behaviour was brought on by a spirit her boyfriend/friend was using to control her, as the way she behaved outside (bubbly, outgoing) was very different from how she was behaving at home and otherwise. She also alleged that the spirit was responsible for her daughter not remembering the events that led to her getting pregnant as well. However, my supervisor suggested that it could also be due to her not wanting to share with the mother, and also due to her going through adolescence (where teens tend to have conflict with their parents). It seemed as if she thought it was a bit of a joke that the client felt it had something to do with spirits.

Mr Benny pointed out that sometimes, because our frame of mind does not understand or cannot accept what the client is saying, we block them out and ignore what they say that has to do with this concept we are not comfortable with. We essentially reject this, and it could be a conscious or subconscious rejection of the idea. The issue, then, is whether it is respectful to give no regard to the client's worldview, or to ignore such a huge portion that makes up that worldview - their spirituality. How effective would our work be if we ignored the client's worldview and simply imposed our own because our worldview cannot comprehend theirs?

In such cases, I feel that we need to respect the worldview of our clients and try to put ourselves in their shoes, such that even if we cannot understand or accept their worldview, we can understand why they adhere to it, and from here help them to work through their issues. Merely ignoring such a huge aspect of their worldview will lead to an incomplete assessment and intervention on our part as practitioners, and will also possibly leave the client hanging and possibly confused, if our intervention and suggestion does not fit into their worldview (or clashes with it). Ultimately we must be able to come down to our client's level, and ensure that the interventions we make will not help and not harm the client.

One way to do this is to ensure that we ourselves are comfortable with the topic of spirituality, which would in all likelihood entail us being comfortable with our own spirituality in the first place. Only when we ourselves are comfortable and confident in our spirituality will we be able to attempt to look at spirituality from our client's point of view, without fear of being influenced or derailed from our own belief systems. Thus for us to be able to discuss such an important aspect of being with our clients, we must first be able to talk about it "with" ourselves and our friends first.