al., 2009). Part 5 -- Use of reframing

Reframing refers to the manner in which something is said, or the actions one takes in introducing certain elements to clients -- perhaps a new way of looking at an old problem, of themselves, of a clinical issue. In the case of Mrs. O., we would ask that she look to the expansion of her universe through developing language abilities, or helping to find her translation assistance. The reframing stage would also be indicating that her cultural privacy issues about the effects of her medical problems might be contributing to her pain and suffering over them. Instead, reframing the issue would allow us to find a way to solve the problem, while still slowly moving within Mrs. O's comfort zone. Reframing, in fact, is applicable when the fixed attitude constitutes a fundamental part of the issue -- in this case, a cultural bias against sharing certain aspects of medical history with men. If reframed correctly, and using the appropriate communication skills, we may be able to free Mrs. O. from the dogmatic position of feeling helpless (Coumoyer, 2008).

Part 6 -- Use of strengths based approach/anti-oppressive approach, crisis intervention and systems theory approaches.

Approach

Basic Issue

Use with Mrs. O.

Strengths Based

Holistic assessment into how clients work within stressful situations.

Possibly not as useful in this case, this model assumes clients have the necessary interpersonal skills to cope; Mrs. O. clearly does not.

Anti-Oppressive Approach

Social justice approach, assumes cultural heritage is guiding principle.

Culture is a guiding principle in Mrs. O's case; it is culture that is keeping her illness private, and therefore uncontrolled.

Crisis Intervention

Handling acute crisis using triage, other resources that are complimentary, and intervention strategies.

Mrs. O. is not currently in complete crisis mode, but if she does not receive adequate treatment, that is the path toward which she is headed.

Systems Theory

Looking at the client or issue within the ecological framework of their social system.

This is a relational theory, uses the environment and environmental messages to change and alter perception. Could be combined with Mrs. O's issue in order to accentuate solutions (transportation, integration into the community).

O., is one of transcultural barriers and a feeling of helplessness, loneliness and lack of resources that understand and can effectively deal with her issue. Culture is an important factor that can make the greatest difference in promoting wellness, preventing illness, restoring health, facilitating the coping mechanism, and even enhancing the quality of life for all individuals, families, and communities. Out of a needed response to this trend comes transcultural care, quite relevant in the contemporary world in any area in which there is an immigrant or divergent population base. With a transcultural focus, the social or healthcare professional must think about differences and similarities among people regarding their special needs and concerns -- and develop a different rubric to assist clients. The transcultural model asks the professional to look beyond the surface of the client and try to uncover what may be hidden because of cultural values and norms. This model focuses more in removing barriers to communication in order to improve care. Ironically, this uncovering also has the added benefit of uncovering insights about their own specific cultural issues and needs (Narayanasamy, 2007; Papadoupolos, 2006).
The social work plan for Mrs. O. is threefold: 1) Investigate translation services for medical care; 2) Help with transportation training through Turkish speaking social workers; 3) Engage as a liaison with medical care to provide transcultural care paradigms.

REFERENCES

Coady, N. And Lehman, P. (2008). Theoretical Perspectives for Direct Social Work Practice.

New York: Springer.

Cournoyer, B.R. (2008). The Social Work Skills Workbook. Belmont, CA: Thompson

Higher Education.

Green, R. And Kropf, N. (2009). Human Behavior Theory: A Diversity Framework. New Brunswick, NJ: Transaction Publications.

Grinnell, R.M. And Unrau, Y.A. (2011). Social Work Research and Evaluation: Foundations

Of Evidence-Based Practice. New York: Oxford University Press.

Hepworth, D., et.al., (2009). Direct Social Work Practice: Theory and Skills. Belmont, CA:

Cenage/Brooks Cole.

Narayanasamy, A. (2007). "Palliative Care and Spirituality." Journal of Palliative Care.

13(2): 32-41.