SS4115 Integrated Social Work Practice Au Yin Ting (50577048) Chan Ho Chit Alson (50558114) Chan Oi Wah (50465179) Chan Sin Ting (50568906) Chow Ching

SS4115 Integrated Social Work Practice

Au Yin Ting (50577048)Chan Ho Chit Alson (50558114)Chan Oi Wah (50465179)Chan Sin Ting (50568906)Chow Ching Man (50574022)Ng Hiu Ching (50386465)Tang Yuk Yin (50584410)Wong Hay Man Herman (50592390)Yau Man Ling (50579030)

Flow of presentation

History of integration of social service in Hong Kong Definition of Integration Integration in ICYSC Integration in Youth at risk Integration in IFSC Integration in Rehabilitation Integration in NLCDP Integration in DECC Our comment

White Paper- Social Welfare into the 1990s’ and Beyond Under the welfare programme, children an

d youth services are delivered mainly through children and youth centres, outreaching social work and school social work .

White Paper- Social Welfare into the 1990s’ and Beyond These services all focus on children and y

outh in the local community and could with advantage be integrated and operated on a neighborhood basis so that young people in the same area may be served by the same team of workers .

Definition of Integration

Integration is combining two or more things together. Integration have two main categories, one is involved the change of quantity before the integration. Another is involved the change is quality before the integration.

The change if quantity defined as accumulating different parties to form a bigger one. The change of quality defined as a complicated change that include the co-ordination to fulfil the change and entirely new function after integration.

Integration in ICYSC

Previous Critics before Service Integration

Fragmentation of services (i.e. lacking communication among service units)

Duplication of services or service gaps occurred

Problems in manpower deployment and allocation of resources

Unresponsive to the needs of youth in the community

Process in the arise of ICYSCs 1992 setting up of official committee to evaluate the effectiveness of

the previous children and youth services

1994 The Evaluation Report on the Children and Youth Centre Services in Hong Kong

suggested the ideas of integrated teams outreaching + school + youth centre At the end of 1994, 10 Integrated Teams (IT) => pilot

1997 Evaluation on the Implementation of the Review Report on

Children and Youth Centre Services integrated model is more effective than the previous one

2005.09.01 133 ICYSCs

Start from 1998 The Hong Kong Jockey Club Charities Trust and Lotterie

s Fund Support modernization programmes at ICYSC. The modernisation works included the use of more durable materials and refreshing colours so as to create a lively atmosphere to attract more youth members

Until now (2006) it is the Third Batch Modernisation Programme of Integrated Children and Youth Services Centre.

(source: The Hong Kong Jockey Club and SWD)

Integrated Children and Youth Services Centres (ICYSCs)

Services: children and youth centre services outreaching social work school social work services

For children and youth aged 6-24

Source: Social Welfare Department

Four core programmes• guidance and counselling• supportive service for young people in disadvantaged circums

tances• socialisation programmes • development of social responsibility and competence

Non-core programmes• drop-in service, interest groups, summer youth programmes a

nd study/reading room service are also provided to offer opportunities for children and youth to spend their leisure time constructively.


Other services in some ICYSCs

Overnight Outreaching Service for Young Night DriftersStarting from September 2001, 18 Integrated Children and Youth Services Centres, equipped with additional manpower, vehicles and mobile phones, have extended their service hour and service focus to provide overnight outreaching services for young night drifters over the territory.

Source: SWD

Other services in some ICYSCs Community Support Services Scheme (CSSS) children and youth cautioned under the Police

Superintendents' Discretion Scheme re-integrating into the mainstream education or work force

and reducing the likelihood of re-offending. individual and family counseling, therapeutic groups, skill

training/educational groups, adventure activities as well as recreational and community services.

there are five NGOs operating CSSS and attached to five existing Integrated Children and Youth Services Centers.

Source: SWD

Overnight Outreaching

School social work

outreaching

social work

Children and youth centre

Community Support Services Scheme

+

+

ICYSC

/+

/+

Service/Worker-oriented Integration in ICYSCe.g. children and youth centre services + outreaching social work + school social work services

Advantages in Service/Worker-oriented Integration in ICYSC

For service user promote early intervention, identify those a

t risk prevent the gap rising between the service

s Same recognition (as centre members) de

crease stigmatize


For worker Increase coordination => workers can exc

hange their knowledge and skills Get more insights in services providing or

other areas from joining together with other services’ workers


For service unit More flexibility in deploying manpower and

other resources reduce overlapping services under one management => increase

accountability

Disadvantages in Service/Worker-oriented Integration in ICYSC

For service users Intergraded services => decrease services

provided for their special needs (especially for those marginal youths)

Workers’ discussing time increase => delay services implementation

Disadvantages in Service/Worker-oriented Integration in ICYSCFor Workers Irresponsible workers slide their works to other easily Increase worker’s pressure to complete the resources

within the services in the same unit (especially spaces and funding)

Higher demands in worker different skills and knowledge (specialist vs general)

Increase time using in communication and centre duty or related works => increase work load but decrease the services provide to some target group (less time to outreach)

Pressure increase as work load increase

Disadvantages in Service/Worker-oriented Integration in ICYSC

For service unit Increase time-using in management and divi

sion of labor One supervisors supervises more workers =

> decrease the quality of supervision (now more focus in services provided but less focus in supervise workers ability and performance)

Difficulties in Service/Worker-oriented Integration in ICYSCFor workers Some people found difficulties deal with different

type of services users (e.g. those previous centre base’s workers do not know how to communicate with those marginalize youths)

Some workers have their bias towards those marginalize youths in reality

Conflicts between workers from different services as there are different working style towards different services (e.g. those in outreach sometimes different to those in centre-base)

Difficulties in Service/Worker-oriented Integration in ICYSC

For service users More conflicts between service users (e.g.

parents do not accept to those marginalize youths)

Difficulties in Service/Worker-oriented Integration in ICYSC

For service units Not enough spaces to implement different

services at the same time in the golden period (e.g. after school time, on sat. etc.)

Difficult to manage the large team Difficulties in allocation of resources to

deal with the different needs in community

Solutions in Service/Worker-oriented Integration in ICYSC

For service users Education to service users (more acceptan

ce)


For workers Self-learning to equip themselves Training in conflict mediation Understanding the benefit of integration Remind of social workers values and principle (p

eople is unique and have different needs and workers should accept to their service users


For agency Increase the labour employment to reduce

workers’ work loads Set clear guideline to workers in cooperati

on with others Frequent meeting for workers to share and

clear the difficulties

Profession-oriented Integration in ICYSC

e.g. police + social worker in Police Superintendent Discretion SchemeTeachers cooperation with social workers to hold activities for students at school

Advantages in Profession-oriented Integration in ICYSC Increase the quality of services as there

are different professionals involved in the treatment or services provided

Provide some specific interventions or services as the hot issues. (e.g. different strategy in police and social worker)

Disadvantages in Profession-oriented Integration in ICYSC Increase time-using in contacting and

collaborating with different kinds of professionals

Increase time using discuss and so delay the services implementation

Difficulties in Profession-oriented Integration in ICYSC Workers said that the cooperation between the p

rofessionals are difficult as they are from different background and whole different ideas and values (e.g. police vs social worker) => consensus is difficult to reach

There are difficulties to compromise the time to contact and discuss together

Difficult to set the working boundaries, i.e. to state clear which profession take charge in which one

Solution in Profession-oriented Integration in ICYSC Hold a preparatory and detailed briefing

and sharing before the service started Remind the benefit of integration =>

common goal => aims at helping with service users

Method-oriented Integration in ICYSC

Advantages in Method-oriented Integration in ICYSC More flexibility to fulfill service users different

needs (social work principle: human is unique) Help in more effective way (implement group

works rather than only case work) Keep worker updating their skills and knowledge

(self-improve) in order to fulfill the need May increase the involvement of systems in

helping service users (e.g. link to parent and family from some activities or group work => increase bonding => decrease delinquent behavior )

Disadvantages in Method-oriented Integration in ICYSC Increasing work load in workers as they

need to prepare different methods provided to services users

Increase pressure to workers as the demand in different knowledge and skills increase

Difficulties in Method-oriented Integration in ICYSC There are difficulties in changes services

method (e.g. more centre base services) Not enough space to provide different

activities in limited area (i.e. golden time in service users)

Solution in Method-oriented Integration in ICYSC Giving training for workers to up-date or increase

their knowledge Holding joint meeting for workers to share and

learn from others Regulate workers’ working hours to encourage

them to self-learn More supervision to workers (this may need to

increase the number of supervisors as after integration, the ratio of supervisors to workers decrease)

Agency-oriented integration

e.g. initiate youths volunteers to provides services in the elder centre

Advantages in Agency-oriented integration in ICYSC Increase the resources Utilize the strengths among different agencies

Different agencies can provide various resources, like manpower, financial support, professional or specific knowledge and skills

E.g. volunteer group (Youth + Elderly or Youth + Rehabilitation Center), researches (HKFYG + Universities)

Advantages in Agency-oriented integration in ICYSC Reduce the overlapping of the services

In the past, C&Y center and school also hold the social skill trainings in the same district, the services are overlapped; after integration, ICYSC can hold a social skill training once for the same target.

Disadvantages in Agency-oriented Integration in ICYSC Increase time-consuming on cooperation

The operations of the agencies are different so that the workers need to spend more time to regulate and understand other agencies at first

Spend time on discussing about the service or project implement that suit for the agencies

Difficulties in Agency-oriented Integration in ICYSC In practical, the workers have many servic

es (case, group & programme) in their center so that they do not have any spare time on coordinate with other agencies

Solutions in Agency-oriented Integration in ICYSC Preparatory information of the agencies an

d detailed briefing before the implementation

The supervisor in those agencies can flexibly regulate / reduce their colleagues’ workloads

Locality-oriented Integration

e.g. 地區青年高峰會

Advantages in Locality-oriented Integration in ICYSC Up to date => community need

E.g. 地區青年高峰會 http://www.hkcss.org.hk/cy/2006%20youth%20summit.pdf

Enhance the cohesion in the community Increase the interflow with the agencies in same local Reduce the administration processes

Easy to referral the cases to get suitable service or intervention

E.g. when the school social worker discovers the student who is lack of social skill, and he can refer the student to the center for follow-up.

Assemble the resources

Disadvantages in Locality-oriented Integration in ICYSC Inefficiently on division of labor Difficult to evaluate the service / project

with different agencies

Difficulties & solutions in Locality-oriented Integration Difficulties

Consensus of the operation Various service units or workers have their own

mind sets and policies

SolutionsRegular locality meeting to increase the

communication between the different service units

Client-oriented Integration

e.g. one-stop service

Advantages in Client-oriented Integration in ICYSC one-stop service in IT teams

School, Center and Outreach teams can mutually coordinate

Service users conveniently get many services in a center

Diversity and hostile of service (fulfill and enrich the development, prevention and remediation)

Disadvantages in Client-oriented Integration in ICYSC Learn delinquent behavior easily

all types of services users come together in a center, also the delinquency

Low integration among the delinquency and general adolescent Difficult subcultures, lifestyles and behaviours

Difficulties in Client-oriented Integration in ICYSC Physical obstacles

Every IT team operate a huge area, some service users live far away the center so that this kind of target are difficult to interact and help them although they face the problems

The workers needs to walk outside more to touch with the target that affect their daily work / serve in the center

Solutions in Client-oriented Integration in ICYSC The center can establish a sub-base for to

uching with the far away users Increase the manpower on division of labo

ur

Our comment in ICYSCs

Our comment in ICYSCs 1+1=2? >3 some workers say that reality 1+1<2 Government FSA => increase competition between

agencies in the same field (fight for the fund and member number) => reduce the chances of integration

May influence the quantity, quality and effectiveness on services

Now IT team is still in experimental period, no definite guidelines or examples, lacking practical knowledge

IT & IFSC overlap the services, low cooperation with the service => fight the market => workload increase

Our comment in ICYSCs

After Lum Sum Grant ＝＞ “換血” problem=> insufficient experienced workers (may affect the quality of service provided)

Market-oriented service (complete of resources, seems like doing business)

NOT much differences between the C&Y center and IT team Frontline or powerless social worker just followed the service trend

(may be from boss, may be from government), but not hold the trend ( 牽著鼻子走 )

Increase work load in centre base duty and management =>decrease what workers really want to do => decrease their morale

Integration in Youth at risk

The Rehabilitation services for the youth ex-offenders integrated under the Shau Kei Wan Integrated Children and Youth Services Centre

Process in the arise of Project Phoenix

1992 First develop of Project Phoenix (PP) In North PointSupported by other fundingCooperation with Police ForceCasework based, no membership Individual statistics submit to Social Welfare

Department (SWD)

1993 Pilot Community Support Service Scheme (CSSS) for more district, PP responsible for the Hong Kong IslandSubvene by SWD

Process in the arise of Project Phoenix 2002 PP integrated in the Shau Kei Wan Integr

ated Children and Youth Services Centre (ICYSC)All the workers in the ICYSC shared duties to

take up PP’s cases and activities for public youth at the beginning. C&Y workers stopped to take up PP’s cases after the ICYSC’s service was more developed after the new integration model.

Process in the arise of Project Dawn and Project Solar 1997 Developed Project Dawn

Generated with Hong Kong Correctional Services Department, expansion of PP

Supported by other funding Still under the IT Also at Shau Kei Wan ICYSC office at the beginning

2004 Developed Project Solar (same service with Project Dawn for different target group) Project Dawn and Project Solar (PDS) moved the

office to Wan Chai, work separately from Shau Kei Wan ICYSC, but still named to under this centre and service

• 2006 PP & PDS under MC’s CSSS• Separated from the management of ICYSC

Methodist Center (MC)

C & YProject Phoenix (Since 1992)

1990s – 1st stage of integration(Vertical integration)

Project Dawn(Since 1997)

IT

Fig. 1(Simplified Framework in MC on 1990s)

Methodist Center

Project DawnAnd Project Solar

2006 – 2nd stage of integration(Partial integration)

Project Phoenix

CSSS ICYCS

Fig. 2(Simplified Framework in MC on June, 2006)

C & Y

Service/ Worker-oriented Integration Unit of C & Y service and youth at risk

service join together in the same service centre. The services including common recreational

and educational activities for all the youth to join. There will be also some activities specialized for fulfilling the requirements of the probation order of the service users of PP.

Method-oriented Integration

PP & PDS are casework based. Groups and other activities, like fans’ club, basketball team, will be held for the service users to participate. Talks and promotions: Both for the potential

service users and the community to understand more about the service


There will be many theories used in doing the case and group works in this service. The most common theories are Motivational Interviewing, REBT, Experiential Learning, Social Cognitive Theory, etc.


Advantages: Gain more funding to support the service, and for

the community education, preventing drugs takenpromote positive side of the service userseliminate the discrimination towards the ex-

offenders, like “Love you life” Anti-Drugs Talk held in the community centre Causeway Bay by PDS in 10/2006.

Client-oriented integration

Same client, different need 1st stage integration: PP, PDS and C&Y are all

targeted at youths. They have different needs ICY: Interests PP+PDS: Jobs/Study, addictive behaviour e.g. therapeutic groups (emotional control)

Locality-oriented integration

1st stage integrationPP targeted on the Hong Kong island, while C

&Y targeted on the East District in Hong Kong island.

PP was integrated under Sai Wan Ho IT center because of the locality reason

Advantages of integration1.1 Flexible human resource to enable

effective resource allocation to service delivery1st stage of integration:

Some workers did not have concrete C&Y work (e.g. case/group) on hand when the database of C&Y are not well established

These C&Y workers could be responsible for the cases in PP

Advantages of integration

1.2 Flexible human resource2nd stage of integration:

Different parties coordinates to enable work complementary within the agency(e.g. in staff meetings, meetings for team leaders, annual planning meeting)

Workers in PP participate in C&Y community functions


2. More target users could be servedPDS as a component in CSSS, not under

ICYSCEnable PDS to further develop its own system

e.g. in fund-raising to recruit more workers and peer counselor


3. Workload of the ICYSC could be reduced/ shared Past

Centre in-charge in ICYSC: responsible for all matters, including ICYSC center-based, PP and PDS

Present Centre in-charge in ICYSC: responsible for general stuff in

ICYSC Centre in-charge in CSSS: responsible for rehabilitation

matters (PP) in ICYSC Both: directly reported to headquarters

Disadvantages of integration

1st stage of integration:

1. Inadequate room for each componentsPP, PDS and C&Y serve different target

group, as each components expand, the IT center provide inadequate room for service-delivery of each components under IT


1st stage of integration:

2. Risk of conflicts between target groupsPP, PDS and C&Y serve different target groups

PP & PDS: Youths at risk (edged youths) C&Y: Youths

There is a risk when the service-users of PP & PDS would have affected the atmosphere in the IT center, which caused conflicts


2nd stage of integration:

1. Role duplication between CSSS and ICYSC, on Project Phoenix (PP)Before 2nd integration, PP was under IT.

There was a new branch of CSSS formed (See fig. 2). PP was both under CSSS and ICYSC. The duplication of role may be possible

Difficulties and Solutions to the integration

　　　　　　　

　1. For the service unit: Difference of service

planning views between ICYSC and PP. PP’s service boundary is Hong Kong Island, and ICYSC, the planning will be different.

• Workers had to decide how much time and effort put in the ICYSC’ s activities.

• They needed to struggle for the balance of their duty in PP and the basic duty of the ICYSC.

Difficulties and Solutions to the integration1. In the orientation of every staff when they first

attend the centre, centre will pass the concept of having duty on help the two services in the centre.

─ Solutions: Workers should have the mind set that the two services are in the same boat and just the working methods and target groups are different.

Difficulties and Solutions to the integration

2. The system and requirement’s difference, workers had to adapt to the new requirement. For examples, PP at first did not have membership system.

Solutions: PP created a new system of distinguish their cases from members to non-members by charging membership fee, and paying different fees for the groups and activities their should join.

Difficulties and Solutions to the integration3. The physical area are not large enough to hold

activities to the three different target groups. ICYSC’s activities are for all the youths to join; but PP and PDS’s activities are only for the specific

youths to join. there are needs for place for different services’ groups

to be held at the similar time in the same centre. Solutions: Physically, PP and PDS were moved out of

the ICYSC’s centre, to have their own offices and centre in other places. This solved the problem of not enough place for the services.

Difficulties and Solutions to the integration4. There will be hesitation for the target groups of PP

and PDS to go to the centre combined with ICYSC to attend the groups. They may not want to show their identity to go for the

service with different and uncommon reasons from the others.

The parents of the other youths may also afraid about their children to meet with some “bad” youths when using the ICYSC’s service. This can be barrier for the delivery of the services.

SolutionsPhysically separation of the services to different locality can avoid to negative influence of the participation of the activities.

Difficulties and Solutions to the integration5. There are confusion of the administrative representative

for the youth service and the youth at risk service. Did the centre in-charge of ICYSC represented all the services, including the PP and PDS? Solutions: There was clearer division of administrative

representation. The issues that concern about the overall youth services will be managed by the centre in-charge of ICYSC.

The issues concerned about PP and PDS will be managed by the coordination officer of CSSS of MC, which managed the services of PP, PDS and MC Urban Renewal Social Service Team.

Our comment in PP & PDS

ICYSC VS Project Phoenix, Project Dawn and Project SolarNature are different. PP+PDS and ICYSC:

are involved in different community activities have different target group have different intervention methods

Integration of Family Service

(Tuen Mun East IFSC as an example)

Process in the arise of Integrated Family Welfare Service In 1970’s

Government starting develop the Family Service in HK

In 1980’s

Family Service is under higher specialization development.

In 2000’s

Government had evaluated on Family Service and starting to implement the integration

Integrated part of IFSC

In the past:--Community Centre (CC)--Family Service Centre (FSC)--Family Life Education Centre

In present:--From 2005, all of the FSC in HK had integrated into

Integrated Family Service Centre (IFSC)--40 IFSC are under Social Welfare Department and 21

IFSC are NGO

Structure of IFSC

非政府機構

推行整筆

撥款計劃，使

資源運用更

加靈活和更具

成本效益

非政府機構

推行整筆

撥款計劃，使

資源運用更

加靈活和更具

成本效益

社署

重整社署架

構，加強以社

區為本的服務

規劃和提供

社署

重整社署架

構，加強以社

區為本的服務

規劃和提供

社署

重整社署架

構，加強以社

區為本的服務

規劃和提供

第三層：專門服務和危機介入：如家庭暴力、虐兒和自殺

第三層：專門服務和危機介入：如家庭暴力、虐兒和自殺

第二層：一系列的支援服務：由發展計劃至深入輔導

第一層：預防問題和危機：

舉辦宣傳、教育、自助活動及早識別問題家庭

第一層：預防問題和危機：

舉辦宣傳、教育、自助活動及早識別問題家庭

Service/ worker-oriented Integration

--IFSC integrate the Community Centre, Family Life Education Centre and Family Service Centre etc. units into IFSC.

--Worker in different units in previous day now integrated in the same working environment and unit---IFSC.

Example: --In the past, there are one community center, family life ed

ucation center and FSC in Tuen Mun. Nowadays, these centres had integrated into the 4 IFSC in Tuen Mun: Tuen Mun East IFSC, Tuen Mun West IFSC, Tuen Mun South IFSC and Caritas IFSC. In the IFSC, it already provide different services, such as Family education group and the community group.

Profession-oriented Integration

--When dealing some serious cases in IFSC, social worker, police, doctor, teacher or psychologist may joined to held a case conference in order to discuss a case.

Example:

Suspected child abuse case need to call a case conference which include the joining of police, doctor, teacher, psychologists etc.


--In the past, Family Service Centre always concentrate on remedial and intervention focused on the family unit. Workers are usually more experienced in micro skills.

--Worker in the community centre mainly organize some support group and program in the community

---After integration had implement in IFSC, the worker in IFSC need to have multiple intervention skills, that is ability on handling case, group and program. Under the service agreement funding, every IFSC needs to achieve a standard number of the case, group and program.

Example:A community development activities called “Mid-Autumn festival celebration” had been carried out by Tuen Mun East IFSC. A support group which will held in the Tuen Mun East IFSC

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Agency-oriented Integration

Recently, case conference within different IFSC had increase. In the conference, different IFSC may carry out their difficult case in the conference and discuss in the meeting in order to seek professional exchange.

Example: 4 Tuen Mun IFSCs and Yuen Long IFSC always join togeth

er to have a conference per month. Each conference may focus on one topic and every IFSC had their chance to share their difficult case and seek for others opinion.


IFSC had enlarge their responsibilities on the community service provision. So they need to cooperate with others agency in their own district.

Example:--Worker always need to have meeting with the DO-- “ 中秋耀屯門” in Tuen Mun had organized under the cooperation of

Tuen Mun East IFSC and The Neighbourhood Advice-Action Council .-- For some indecent assault, police setting, District Council, Sam Shing

Est Moon Yu Hse Mutual Aid Community etc may carry out some conference to discuss their assault.

--District councilor in the district always refer some cases to the IFSC and sometimes may join IFSC to carry out some project.


IFSC had provided a one stop service for our client. Client can get different demands and needs such as case counseling, group and program in IFSC.

Example:

Client can get the different services such as group, case counseling and community activities within one centre.


Client perspective: Client can receive the one stop service in stead of the fragmentized

service in different location, it is more convenience for them Under service funding agreement (SFA) , IFSC need to carry out

several therapeutic group, client may benefit from it. Worker perspective: It is more easy for different specialist worker to exchange and share

their opinion on working. It is more easy for worker to build up relationship with client as more

type of intervention had input.

Agency perspective: Arrangement of the human resources will be more flexibl

e More connection with other agency in the same district, s

o the resources may not easily repeated.Government perspective: Easy for managing and supervise by government Cost effective due to they believe group work is more eff

ective than case work. So cost can be saved.

Disadvantages of IntegrationWorker perspective:

Worker did not have enough time to adjust on using different skills

Traditionally, a family service worker’s main duty is to help our clients and their family members to handle their problems. The service is mainly remedial and intervention focused on the family unit. Workers are usually more experienced in micro skills. After the integration, worker need to be multiple skills with case work, group work and community work. It is difficult for the worker to equip the skills immediately. It may influence the program quality.

Worker load is heavier As the worker in FSC only specialist to handle the case, they seldom

need to organize some group.

Client perspective:

Service may not have enough quality

As some of the worker may not specilist in handling of the group work, they may feel difficult on handling the group. The quality may affected.

Our comments

After the integration, we had found many advantages that government reports showed us. However, in the reality implementation, we found that is was difficult to fulfill the rationale.

There is lack of the supporting and resources for the staff to adjust their workload and work nature. They lack of the channel to strengthen their multiple skills.

In addition, after integration, the service achieved area should be enlarge. For example in Tuen Mun, as there are four IFSC had formed, the service provision had enlarge into different location to serve 10 to 15 thousands population per centre. However, the funding put in the Family Service did not increased. The lack of funding may affect the service or program quality.

Integration in Rehabilitation

Objective:

Rehabilitation services aim to acknowledge the equal rights of people with disabilities to be full members of the community by assisting them in developing their physical, mental and social capabilities to the fullest possible extent and by promoting their integration into the community.

People with disabilities would want to lead as normal a life as possible and to contribute to society as much as they can.


The rehabilitative welfare services in Hong Kong are mainly provided by around 50 voluntary agencies and funded by the Social Welfare Department.

Client –oriented integration in rehabilitation The definition of client –oriented

integration is provide One –Stop service and emphasis the clients’ needs as the primary target. Therefore, the clients as the most important factor in this integration.

Client –oriented integration

The purpose is helping them re-construct their lives as a normal person and help them re-integrate to the society.

E.g. The Hong Kong Society for Rehabilitation provided the services to the people who are disability, chronic illness, the elderly.

Client –oriented integration Services: 1. Accessible transport and travel 2. Education and advocacy 3. Wellness and community rehabilitation 4. Occasional rehabilitation and long-term care.

This five main categories of services is aimed at help the client re-integrate to the community and mainly focus on the clients’ needs . It includes different aspects , like have education , vocational training and long term services. It all is unique for every individual and depends on the client needs .

Source: The Hong Kong Society for Rehabilitation

Profession-oriented integration

To integrate the professions into the services. E.g. A shop called “Support the Employment

of People with Disabilities”

Integrated a Marketing Consultancy Office to plan the program for disabilities.

Profession-oriented integration The objective of the formation of

“Support the Employment of People with Disabilities” (“SEPD”) are to enhance the working capabilities and self-reliance of disabled persons through the provision of training from a real working environment, thereby preparing them for supported and open employment.


All the arts and crafts sold in “SEPD” are handmade by people with disabilities. “SEPD” is operated by disabled persons from varied welfare organization and managed by Marketing Consultancy Office (Rehabilitation) of Social Welfare Department.



Other example for profession-oriented integration

Physiatrist: - Providing rehabilitation services and planning

the body training for client in the centre

Nurses

Source: HCFC

Service/ Worker-oriented IntegrationDifferent service units or workers join together

E.g. The Hong Kong Council of Social Service To work in partnership with international rehabilitation

community and the counterparts in the Asian and Pacific region, including the China Disabled Persons Federation, to strive for greater development of the disability endeavors at large.

Source: The Hong Kong Council of Social Service

Method-oriented integrationCase E.g. counseling: deal with economics, emotional, deal with economics, emotional,

interpersonal, daily life problem…etc.interpersonal, daily life problem…etc.

Groups E.g. support group, developmental group, volunteer

group

Programs E.g. Community education, workshop

Source: HCFC

Networking & Case management

Working through referring and linking up clients with different services so that clients can receive multiple kinds of services.

E.g. Standardized Assessment Mechanism for Residential Services for People with Disabilities + Different resident


Build up an referring system

Give assessment → referring

E.g. Starting from January 2005, all mentally handicapped or physically handicapped applicants for residential service had to undergo a standardized assessment arranged by social workers.


Applicants assessed to have residential service need will be registered on the waiting list in accordance with the types of residential service matched.

For those assessed to have no residential service need, the referring social workers will refer them for other appropriate services, such as day training programs or community support services.

Advantages of integration in rehabilitation :

For client:One –stop services Integration center provide a

comprehensive services to the services target. E.g. Vocational, education and long term care service.

It take care all the needs of the client and effectively help them re-integrate to the community .

Advantages of integration in rehabilitation :More convenient for the client The client can enjoy the different services in one

organization, it is more optimum circumstance for the clients .

The connections within the organization can make a linkage during the transition period (from one service to another service ) of the client , it makes them more adaptable under a strong connections within the organization .

Advantages of integration in rehabilitation :

For agency:

More appropriate to use the resources Since it combines all the services together,

it can effectively distribute the resources in order to provide a better service .

And combine all the services together to held a bigger organization is easier to strive for the funding due to they mainly are non –profit organization .

Disadvantages of integration in rehabilitation : The comprehensive services within the

organization may benefit to the clients . The distinct boundaries between the services

also may lead to the negligence to the clients’ needs .

Too clear division of labor and work would lead to the unresponsiveness to the clients’ needs . Each services unit also finish their own task and the close relationship is absent .

Disadvantages of integration in rehabilitation :The workers are not capable to handle different tasks It become a serious issue if the finance status is not

good at all . The worker may responsible for more than one services , while they are not familiar with the services , it would deteriorate the services and eventually the service users becoming the victim of integration .

Extremely high work load also would made the worker felt frustrated in their working and had a poor performance on their work .

Difficulties of implementation of integrated practice Require different professional for different

services A cohesion relationship is essential to

establish but have obstacles while implementation of integration

Solution

Hold a preparatory and detailed briefing and sharing before the service started

For workers Self-learning to equip themselves

Comments:

Comments (+ve): Client service excellence

- provide one-stop services

Maximize service output System efficiency effectiv

eness

Agency can well organize the resources.

Comments (-ve): Still need time to improve

the integration system Raise the burden for work

ers

Integration in NLCDP

Background of NLCDP

Introduced in the 1970s Aims: To serve the deprived and transient

communities where the provision of welfare services and facilities was inadequate or non-existent

Included areas: temporary housing areas, squatter areas, Mark III to VI public housing estates affected by the Housing Authority's five year Comprehensive Redevelopment Program

NLCDP in Shek Kip Mei

To serve the residents affected by the Housing Authority's five year Comprehensive Redevelopment Program

Profession-oriented Integration

SW & teachers: arrange students to have site visit in Shek Kip Mei People’s Museum (managed by NLCDP team) or visit the old public housing


Case: Counseling or practical assistance – deal with economic, emotional, adaptive, interpersonal, daily life problem etc

Group: Woman group, action group etc Community work: Social action, residents

meeting, attend District Council’s meeting


NLCDP + DECC + Family Service Networking Team case referral, cooperation, resources

NLCDP + Agency for Volunteer Service’s V-Care Volunteer Aid Campaign arrange space, and suitable elders for the volunteers


Redevelopment: Housing Department, Shek Kip Mei Estate Property Management Office, Welfare Department, Integrated Family Service Centre, District Elderly Community Centre, members of District Council, elderly centre


(a) Same client, different needs

Elderly: Community education program such as health and hygiene education

(b) Different clients, same need

Family & elder residents: residents meeting about redevelopment issues

Networking & case management

Refer and link up clients with different services: District Elderly Community Centre, Housing Department, Welfare Department (e.g. CSSA), Water Supplies Department, furniture companies etc


Promote community education Accelerate community’s welfare services

and facilities by linking with other agencies Connect clients together to tackle

community problems and fulfill community needs

Better worker-client relationship


Refer cases to other agencies need time to refer it and for others to follow up may not the best to the clients

Affected by the policy and restriction of Housing Department, e.g. redevelopment schedule

Difficulties and Solutions to the integration For Workers: Do not have comprehensive knowledge in

handling different needs and problems of the clients, e.g. fitment, cheapest furniture, the renewal of water bill etc

Solution – Use extra time to enrich themselves, seek help from other NLCDP teams or other relevant resources

Difficulties and Solutions to the integration For Agency: The overlapping of works with other

agencies in the same district, e.g. community education program, group works

Solution – Clear division of work through communicating with other service providers

Difficulties and Solutions to the integration For Clients: Residents VS Government different

expectations, needs, problems and difficulties encountered

Solution – Try to link them up and balance the benefits between two through negotiating and discussing

Comments in Integration in NLCDP

Pros – It really helps social construction because those elements of integration provides a better and comprehensive services for the residents even the whole community

Cons – The services are easily influenced by the outside factors e.g. the government’s sudden change in the sum of compensation for the affected residents

Integration in DECC

District Elderly Community Centre

DECC implemented since 2001/02 providing elders with a comprehensive package of support services

Upgraded from multi-service centres for the elderly

Service/ Worker-oriented Integration A worker is responsible to provide counseli

ng service, holding groups and programmes

Profession-orientated Integration Physiatrist: providing rehabilitation

services in the centre and home visit Nurses: home visit, consultation services

Both of the professions holding groups (exercises group) and programs (talks) together with the social worker

Advantages: more professional services are provided to the clientsDisadvantages: medically treats clients’ problem ( 醫療主導 ), Other professionals substitute the role of social workers power gap between clients and professional may be wid

ened disempoweredDifficulties: The medical professions need social work skills in holdin

g groups and programsSolutions: Cooperation and communications between social worker

and other professionals needed

Method-oriented /Integration

Case (counseling: deal with economics, deal with economics, emotional, interpersonal, daily life problem…emotional, interpersonal, daily life problem…etc.etc.),

Groups (support group, developmental group, volunteer group)

Programs (community education)

Advantages: deal with clients’ needs by different intervention

at the same time more holistic and efficientDisadvantages: Work load of Social workers ↑Difficulties: Social workers need to be versatileSolutions: More training given to social workers


School/ Youth work agency + DECC (volunteer programs, Home visits organized cooperatively by school and DECC)


DECC acts as a coordinator between elderly centres in a district, communication will be done through meetings with other centres. There will be discussion on popular topics/ problem in the district and have division of labour.


One stop-servicesSame client, different needs: e.g.: Elderly: need- tangible, counseling (counsel

ing services), developmental, social network (groups), health education (Community education programmes)

Different client, same needs: e.g. carers+ elders+ community at large need

educations on health issues (caregivers group, programs)

Networking & Case Management

DECC: Provision of information on community resources and referral services

Refer to hospitals, Social Security department

Refer from hospitals, IFSC, other agencies

Advantages

Link up client with community Provide clients with more holistic services Division of labour

Disadvantages

過度分工 e.g. divided the responsibilities by streets and street nos. clients feel confused where they can get the servicessolution for this: some individual services are divided by region, but for some mass program, elders can join freely so an elder can be member of more than one centre same services provided to the same group of clients in different centers

Difficulties

Limited resources (spaces, workers, knowledge of workers)

Division of labour sometimes is difficult, only divided by region but not the case nature

Whole group comments

Advantages of integrations

For Service users: One centre obtain different types of

services (fulfill their needs and more convenience)

Integrate with different services =>

Not only focus on individual change but also the systems that interfere them


For Workers: Develop more network between other

professionals or specialists (increase knowledge and skills)

More insights from cooperation More mutual supports between workers


For Service Unit: Better working atmosphere ( increase

communication between workers to get more insights)

More flexible in allocation of resources (man power, $, spaces, services) to deal with different needs in the communities


For government Better and easier in management, monitor and

supervise different agencies (more efficient) Better understanding in the needs and services

provided in different districts Easier to implement new social services policies More clear structural => better image in the

social welfare

But,

There are difficulties in achieving the goal of integrations

Difficulties in integration

Workers are not a supermen and have limited (should focus on their strength)

1+1>3 (ideal) 1+1<2 (in some realities, problems in resources allocation)

Government policy => FSA Different field communication problems

(Locality) (e.g. IFSC and ICYSC) Worker values and attitude

~The End~

References:

Lo Tit Wing, Wong Sing Wing, Ma Kun, Chan Wing Tai (1997) Evaluation on the Implementation of the Review Report on Children and Youth Centre Services

HCFE http://www.hcfc.org.hk/

The Hong Kong Jockey Club. http://www.hkjc.com/english/news/enews_20001121a.htm

The Hong Kong Council of Social Service: http://www.hkcss.org.hk/download/folder/rh/rh_eng.htm

The Hong Kong Society for Rehabilitation http://www.rehabsociety.org.hk/483.html

Social welfare Department http://www.swd.gov.hk

St. James’ Settlement http://www.sjs.org.hk/tc/publication/172/172-2.pdf

青年高峰會　 http://www.hkcss.org.hk/cy/2006%20youth%20summit.pdf

http://www.hkcss.org.hk/cy/er/cyservice_ref_c.dwt

Documents

SS4115 Integrated Social Work Practice Au Yin Ting (50577048) Chan Ho Chit Alson (50558114) Chan Oi Wah (50465179) Chan Sin Ting (50568906) Chow Ching