This thesis deals with the theme of possibilities to develop communication skills of health social workers in Prague hospitals. The aim of the study is to find out what are the possibilities of education available for health social workers in hospitals. It also discuss whether health social workers are actively interested in the development of their communication skills and what resources are used most often. The thesis describes the basic concepts and the competence of health social worker. Next part is about education and laws which oblige to lifelong learning. The thesis also focuses on self-reflection and supervision from the perspective of other sources of education - self-knowledge. Practical part of the thesis deals with the research between health social workers in Prague hospitals. The aim of the research is to find out, whether these workers are actively educated in communication skills. The paper includes analysis and interpretation of results, discussion and conclusion of whole thesis. Keywords Communication, social work, health social work, conversation, education, self-reflection, supervision.

The diploma thesis is focused on the main activities of the social workers at the hospitals in Prague, the regional hospitals, and one former district hospital. Within the theoretical section of the abstract there are clearly defined fundamental concepts of social work in health care and its historical transformation. The chapters consist of four sections: ethics code, the quality of social work at the hospital, valid legislation, as well as interdisciplinary collaboration within the hospital. The theoretical part focuses on job description, competencies, skills or personality characteristics of the social worker in the hospital. The last section describes social work in the hospitals by different target groups with whom the social workers can come into contact. The empirical part of this diploma thesis is acquired by the semistructured interviews. The main research question tries to find out the role of the social worker at the hospital. The research targets three surveyed areas: The first examines the qualification skills of the social worker at the hospital. The second refers to the job description of the social worker at the hospital's core business activities. The last part of the research is dedicated to interdisciplinary collaboration among hospital staff. The discussion consists of compared...

本研究探討心理衛生社會工作者與精神病患照顧者工作之中相互期待的角色內涵、影響角色期待之因素或歷程，以及相互期待之認知、行動如何修正與調整。本研究採質性研究深度訪談法，採立意抽樣選取研究對象，對三十九位受訪者（二十六位心理衛生社會工作者、十三位精神病患照顧者）進行半結構式訪談，主要研究發現如下： 1. 精神病患照顧者的照顧內容和與角色立場： （1）照顧內容：症狀因應、社區生活 （2）照顧態度：積極主動、合理期待、自我照顧 （3）與其他家屬互動：聚會交流、自助助人、權益倡導 2. 照顧者樣態與社會工作者對照顧者之角色期待： （1）所見樣態：積極參與、消極參與、不當期待、家庭動力不穩 （2）對照顧者之角色期待：配合服務、適度支持、個別化期待、如個案需要協助 （3）影響因素：社經認知條件、家庭文化因素、疾病照顧經驗、社區環境、社工接觸經驗 3. 社會工作者與照顧者之工作方法，與照顧者對社會工作者的角色期待： （1）工作方法：傾聽陪伴支持、協作釐清期待、衛教家屬團體、家庭動力工作、社區資源連結、權益倡導協調 （2）指導原則：聚焦正向改變、以個案為中心、重視家庭經驗、尊重照顧知識、抱持覺察開放的態度 （3）照顧者對社會工作者之角色期待：教育引導、家庭陪伴、權益倡導 （4）影響社會工作者角色因素：個人因素、專業教育、組織因素、結構因素 4. 照顧者與社會工作者關係：夥伴關係、工作關係、彈性關係 5. 照顧者與社會工作者相互角色期待調整方式： （1）照顧者對社會工作者期待調整：接受現況、調整期待、自立自強 （2）社會工作者對照顧者期待調整：接納現況、調整期待、擇善固執 （3）社會工作者挫折因應方法：經驗回饋、自我照顧、團隊支持 最後，研究者結合上述研究結果，嘗試繪製出心理衛生社會工作者與照顧者相互角色期待內涵與影響因素之概念架構圖，並提出本研究限制與建議，提供照顧者、心理衛生社會工作者和政策制定者、未來研究者參考，期冀本研究有助於減少照顧者可能產生的失望，甚至進而奠定一個基於夥伴關係的服務方式。 / The purpose of the study was to explore the content of mutual role expectation for mental health social workers and caregivers, the factors influencing role expectation, and the adjustment process of role expectation. This study used purposive sampling to select thirty-nine participants (twenty-six mental health social workers and thirteen caregivers), conducting in-depth interviews by using a semi-structured interview outline. The major results of the study include: 1. Care content and role of caregivers: (1) Care content: symptom management, community life promotion. (2) Care attitude: proactive, reasonably expected, self-care. (3) Interaction with other caregivers: family support group and gathering, help others and self-help, advocacy. 2. Caregiver pattern and role expectation of caregivers: (1) Caregiver pattern: actively participated, passively participated, improperly expected, unstable family dynamics. (2) Role expectation of caregivers： service adherence, moderate support, individual expectation, potential client. (3) Factors influencing role expectation: socioeconomic and cognitive conditions, family and cultural factors, caring experience, community environment, the experience of contacting social worker. 3. Working methods and role expectation of social workers: (1) Working methods: listening and accompanying, cooperating to clarify expectation, group psychoeducation, family systems therapy, mobilizing community resources, advocacy and negotiation. (2) Guiding principles: focus on positive changes, case-centered, attention to family experience, respect for caring knowledge, open-mindedness and self-awareness. (3) Role expectation of social workers: educator and guide, family supporter, advocate. (4) Factors influencing role expectation: personal factors, professional education, organizational factors, structural factors. 4. Professional relationship: partnership, working relationship, elastic relationship. 5. Adjustment process of role expectation for caregivers and social workers： (1) Role expectation of caregivers adjusted by social workers: accepting the status quo, adjusting expectation, self-reliance. (2) Role expectation of social workers adjusted by caregivers: accepting the status quo, adjusting expectation, persisting. (3) Frustration coping methods: experience feedback, self-care, team support. Based on above findings, researcher drew out the depiction of mutual role expectation for mental health social workers and caregivers, as well as the factors influencing role expectation, proposing the study restrictions and suggestions on policy making, partnership-based approach for mental health social workers and caregivers, and further research.

Le Plan d’action en santé mentale institué en 2005 marque le début d’une période de changements profonds qui auront un impact significatif sur les équipes de première ligne qui assurent la plupart des services au Québec. Le changement se manifestera sur deux fronts distincts. En premier lieu, le passage de services historiquement ancrés dans un modèle biomédical vers des services centrés sur le rétablissement. En second lieu, l’adoption de processus administratifs s’inscrivant dans une philosophie de gestion axée sur les résultats qui ont pour objectif de mesurer et d’assurer l’efficacité des services. L'objectif de cette étude est d’explorer le statu du développement des pratiques axées sur le rétablissement au niveau des travailleurs sociaux de première ligne dans le contexte administratif mentionné ci-haut. Le travail de recherche qualitatif et exploratoire est construit sur l’analyse de 11 interviews semi structurés avec des travailleurs sociaux et des gestionnaires dans des équipes de première ligne en santé mentale. Les entretiens m’ont non seulement permis d’identifier et d’examiner des actions concrètes s’inscrivant dans l’effort d’implantation du Plan d’action mais aussi de sonder et d’explorer la signification qui est donnée au rétablissement par les travailleurs sociaux de première ligne. Les résultats indiquent que certains facteurs relatifs à l'organisation du travail tels que la flexibilité, l'autonomie, la réflexivité et l’interdisciplinarité peuvent favoriser une pratique orientée vers le rétablissement. Aussi, les résultats démontrent que le modèle du rétablissement et la profession du travail social partagent des valeurs fondamentales mais que la signification et l'expression du rétablissement ont été profondément influencés par les modèles organisationnels et obligations administratives en vigueur. Il appert que les travailleurs sociaux sont confrontés, dans leur pratique, à des contraintes qui dépassent leur mandat professionnel et, à certains égards, leur savoir-faire. En somme, les résultats obtenus indiquent que le passage avec succès vers la pratique de services basés sur le rétablissement est compromis par les exigences d’un modèle de gestion axé sur les résultats. / Following the 2005 Mental Health Action Plan most mental health services are offered in primary care teams. This policy called for a paradigm shift away from a biomedical model of care toward a process-focused ‘recovery’ orientation in mental health. Concurrently, it called for the use of a results-orientation that is outcome-focused in order to ensure efficiency. The objective of this research project was to explore the development of recovery-oriented practices among social workers in first line mental health teams in Québec. To do this, I investigated the microprocesses of implementing recovery-oriented services and practices alongside results-oriented management techniques. In addition, this project explored the saliency of a recovery orientation specifically for first line mental health social workers. This qualitative, exploratory study consisted of 11 semi-structured interviews with social workers and managers in first line mental health teams. The results indicate that certain aspects of work organization, such as flexibility, autonomy, reflexivity, training, and interdisciplinarity can foster a practice that is recovery-oriented. In addition, the results show that the foundations of both the recovery orientation and the social work profession share common values. However, social workers face constraints to practice that go beyond their know-how and professional base. Our exploratory study leads us to contemplate the influence of work organization on changing practice. The results suggest that practicing from a recovery orientation was a shared ideal among the participants but that the meaning and expression of this ideal was profoundly shaped by practice contexts. The implications of these results are that recovery-oriented systems will be difficult to develop in a result-oriented paradigm.

Le Plan d’action en santé mentale institué en 2005 marque le début d’une période de changements profonds qui auront un impact significatif sur les équipes de première ligne qui assurent la plupart des services au Québec. Le changement se manifestera sur deux fronts distincts. En premier lieu, le passage de services historiquement ancrés dans un modèle biomédical vers des services centrés sur le rétablissement. En second lieu, l’adoption de processus administratifs s’inscrivant dans une philosophie de gestion axée sur les résultats qui ont pour objectif de mesurer et d’assurer l’efficacité des services. L'objectif de cette étude est d’explorer le statu du développement des pratiques axées sur le rétablissement au niveau des travailleurs sociaux de première ligne dans le contexte administratif mentionné ci-haut. Le travail de recherche qualitatif et exploratoire est construit sur l’analyse de 11 interviews semi structurés avec des travailleurs sociaux et des gestionnaires dans des équipes de première ligne en santé mentale. Les entretiens m’ont non seulement permis d’identifier et d’examiner des actions concrètes s’inscrivant dans l’effort d’implantation du Plan d’action mais aussi de sonder et d’explorer la signification qui est donnée au rétablissement par les travailleurs sociaux de première ligne. Les résultats indiquent que certains facteurs relatifs à l'organisation du travail tels que la flexibilité, l'autonomie, la réflexivité et l’interdisciplinarité peuvent favoriser une pratique orientée vers le rétablissement. Aussi, les résultats démontrent que le modèle du rétablissement et la profession du travail social partagent des valeurs fondamentales mais que la signification et l'expression du rétablissement ont été profondément influencés par les modèles organisationnels et obligations administratives en vigueur. Il appert que les travailleurs sociaux sont confrontés, dans leur pratique, à des contraintes qui dépassent leur mandat professionnel et, à certains égards, leur savoir-faire. En somme, les résultats obtenus indiquent que le passage avec succès vers la pratique de services basés sur le rétablissement est compromis par les exigences d’un modèle de gestion axé sur les résultats. / Following the 2005 Mental Health Action Plan most mental health services are offered in primary care teams. This policy called for a paradigm shift away from a biomedical model of care toward a process-focused ‘recovery’ orientation in mental health. Concurrently, it called for the use of a results-orientation that is outcome-focused in order to ensure efficiency. The objective of this research project was to explore the development of recovery-oriented practices among social workers in first line mental health teams in Québec. To do this, I investigated the microprocesses of implementing recovery-oriented services and practices alongside results-oriented management techniques. In addition, this project explored the saliency of a recovery orientation specifically for first line mental health social workers. This qualitative, exploratory study consisted of 11 semi-structured interviews with social workers and managers in first line mental health teams. The results indicate that certain aspects of work organization, such as flexibility, autonomy, reflexivity, training, and interdisciplinarity can foster a practice that is recovery-oriented. In addition, the results show that the foundations of both the recovery orientation and the social work profession share common values. However, social workers face constraints to practice that go beyond their know-how and professional base. Our exploratory study leads us to contemplate the influence of work organization on changing practice. The results suggest that practicing from a recovery orientation was a shared ideal among the participants but that the meaning and expression of this ideal was profoundly shaped by practice contexts. The implications of these results are that recovery-oriented systems will be difficult to develop in a result-oriented paradigm.

In my thesis I am going to focus on one of the areas of community care for people with mental illness and thus on the area of employment. The main focus of the thesis is on a description of current situation in the provision of the employment support for people with mental illness. The focus is also on the formulation of the specifics of the Employment Support Program for people with mental illness. Another part of my thesis contains empirical investigations focusing on the sustainability and the perspective of the Employment Support Program for people with mental illness. The goal of my thesis is to set up an updated oveview study on the issue of providing employment support for people with metal illness. Powered by TCPDF (www.tcpdf.org)