Mental Retardation

This work examines the case study of a Taiwanese Family in which one of the children, Po-Sheng, 23 years of age, has mild mental retardation. This family is experiencing frustration and angst because Po-Sheng feels that he should be allowed more freedom and independence than his parents allow. This work takes a look at the values and principles in the social worker's practice that are relevant in view of this particular family which is the focus of this case study. "Social work knowledge is based on a range of perspectives and content areas derived from various schools of thought. Hepworth, Looney and Larsen (1997) note that the Council on Social Work Education (CSWE) categorized the knowledge base for social work practice into five content areas: Human Behavior and Social Environment; Social Welfare Policy and Services; Social Work Practices; Research; and Practicum. The National Association of Social Workers further identified 25 knowledge areas needed for effective social work practice. To become culturally competent, social workers must acquire technical and substantive knowledge in social work as well as cultural information" concerning their clients."

Berger, Federico and McBreen, 1991, Cross et al. (1989) Devore and Schlesinger (1996), Green (1995), Leight (1998), Lum (1994), and Wilson (1982) identified over 50 knowledge areas and attributes essential in developing cultural and ethnic competence." The following is a partial list of the knowledge areas:

1. Knowledge about human behavior including individual and family life course consideration of the family and the effect that bio-psycho-social, cultural and spiritual systems have on their behavior;

2. Knowledge about the family sub-culture;

3. Knowledge about the impact of class, ethnicity, dialects and speech communication patterns;

4. Knowledge about the perceived effectiveness of service providers and social services in meeting identifiable needs of their clients; and 5. Knowledge about the ways that professional values, knowledge and skills may clash with those of family members.

The NASW 'Code of Ethics' states that the core values of social work practice are inclusive of: (1) social justice; (2) dignity and worth of the person, (3) the importance of human relationships, (4) integrity; and (5) competence." Additionally stated is: "Within these values are ethical principles that social workers aspire to attain. Cultural Competence and Social Diversity are emphasized in the social work practice. Among these principles are the following values:

1) Value cultural diversity and cultural integrity with a genuine and open appreciation of inter and intra-group differences;

2) Value the social and historical contributions of the client in relation to their culture, community and the broader society.

3) Value the cultural resources and natural support system utilized by the family in problem-solving;

4) Respect the traditional beliefs, folk methods, and spiritual roles of the family members.

5) Value culture and ethnicity as interactive and emergent forces in the life of the client.

6) Validate the experiences (positive and negative) of the family members from a social, cultural, historical, political and spiritual perspective.

In the area of skills there are core skills which are a requirement for social work practice. The work of McMahon (1996) categorizes foundation skills into four key areas:

1) Relationship skills;

2) problem-solving skills;

3) Political skills; and 4) Professional skills subsumed under the overarching person in environment perspective."

This method of practice is inclusive of "micro or direct practice with individuals, families and groups, and macro practice with communities, organizations and policy planning arenas." There are 26 total skills and abilities identified by NASW that are essential in social work practice. Stated is that social work skills "reflect a broad range of interpersonal, technical, therapeutic and organizational skills that are comprehensive, complex and enable social workers to work with diverse populations and settings.

I. Purpose and rationale for the paper

The purpose of this paper is to examine the values and principles as set out by NASW in relation to the relevance of those values and principles to the case study that is the focus of this work.

II. Clear presentation of the client system

The objective of this work is to report a case study on a Taiwanese Family where one of the members has mild mental retardation. The Hsiang family is comprised of the father; Joseph Hsiang, 56 years of age; the mother; Helen Hsaing, 53 years of age, Po-Sheng the son who is 23 years of age and who has mild mental retardation and Andy, the brother who is 19 years of age. This family previously lived in a rented home but were evicted due to the problematic behaviors of Po-Sheng. Po-Sheng has been found trespassing in a neighbor's backyard and the police were called but no charges were filed. The Hsiang family has only recently emigrated from Taiwan two years ago and have not adjusted to the cultural life in the United States. Helen's sister sponsored the family to come to the United States because the family believed that Po-Sheng would received better services for those with mental retardation than in Taiwan. The Hsiangs speak Mandarin Chinese at home and have limited English-speaking ability except for their son Andy who currently attends university. The language barrier has greatly limited the family in assimilating into the American culture. Isolation is one problem experienced by this family. Po-Sheng does not believe that he is limited in any way and craves freedom and independence which is allowed the brother Andy, who is younger. Po-Sheng has been diagnosed with Attention Deficit Hyperactivity Disorder and Impulse Control Disorder due to his exposure to mercury poisoning when his mother was pregnant with him. Helen apparently ate some fish tainted with mercury. The effects of mercury poisoning have led to developmental delays with Po-Sheng and he was tested in the United States and had an IQ of 68 which meant he has mild mental retardation. Po-Sheng fell behind in school and refuses to attend in the U.S. stating the school is too loud. There is constant argument between Po-Sheng and his parents regarding not listening or doing his chores. This results in communications problems within the family and the self-worth and self-esteem of the family is very low. The family has sought help from the community mental retardation agency due to their limited English and lack of knowledge surrounding mental retardation. The Hsaing family is frustrated and confused with the services being provided and are skeptical of the relationship with the social services agency due to the language barrier. The family strengths include a constant love for one another and the family is financially stable having lived prudently due to their cultural background. Both Po-Sheng's mother and father are educated and hold bachelor degrees from Taiwan universities. The family is involved in church and receives a great deal of support from the church members. The cultural beliefs of the Asians people view mental retardation and mental illness as something evil and shameful to the family. (Smith and Ryan, 1987) Because of the language barrier Po-Sheng's parents are not fully informed and there is clearly a lack of language appropriate and culture-appropriate information relating to the nature of mental retardation and the course that intervention should take.

III. Social Policy

It is important that social policy take into account the diversity expressed in and among the many races and ethnicities that social policy is idealistically designed to serve and protect. Melvin Delgado writes that: "Culture represents humankind's master plan; it molds our way of explaining the world and charts the limits of allowable behavior." (2004) Furthermore Delgado writes that "Ethnicity is an equally significant concept in the ecological perspective with multiple definitions and relevance to service providers. In a sense, ethnicity refers to a sense of peoplehood, a psychological and social identity involving commonality and loyalty to race, religion, nationality and ancestry (Cos and Ephross, 1998; Devore and Schlesinger, 1996). It is distinguishable as categorical and transactional ethnicity (Gteen 1995)" (Delgado, 2003) Delgado states that "categorical ethnicity refers to specific predetermined traits or 'content' about a group such as color, food, music, dress and the like, believed to be descriptive and characteristic of a particular group." In contrast, transactional ethnicity focuses more on ethnic boundaries that define a group - the manner in which people behave, communicate and act upon their differences. The former is presumed to stigmatize and perpetuate existing stereotypes and preconceived notions about ethnic groups, while the latter views ethnicity as an emergency positive feature of human development (Green, 1995). (Children are often stigmatized when the have mental retardation even in its mildest form. The work of Jones 2006) states that:."..self-stigmatization - the internalizing of stigma - is one of the most significant barriers keeping people from accessing mental health treatment."

In fact Jones states that "Fifty-four million Americans - nearly one in five - have a mental health disorder and nearly two-thirds of them won't seek treatment because of stigma. That means the playground stereotypes that affect our attitudes have consequences - often fatal consequences."

Even within the American society the stigmatization of mental illness still exists due to…