The Sustainability of Care for Elderly with Depression: The Experience of the BLESSED Project
Dr Sandra Oi-Ngor Cheung PhD,MASW
Dr Tabitha Yin-Ling Ng, PhD, MA (SW), RSW
Hong Kong Shue Yan University Louisa Wai-Man Yip RSW
Baptist Oi Kwan Social Service
Wai Shan Fong
Baptist Oi Kwan Social Service
In Hong Kong, depression is popular in the elderly but given less attention as the depressive symptoms among elders are understood as ‘normal’. The BLESSED Project – a pioneer integrated day care programme is specifically for discharged elderly depressed patients and their caregivers starting from the pre-discharge stage. It aims at meeting the public health challenge from a void of tailor-made community day care service for the discharged elderly with depression. This medical-social collaborative project accommodates users’ medical, psychological, and social needs. Individual interviews for the users and focus group interviews for the caregivers, and staff involved in this project were conducted. Evidences showed that the users enhanced a sense of capability of managing physical health and happiness resulting from the commencement of a structured life pattern. They expanded their social engagement through the activities with volunteers, staff, and other users. The project also released the family members’ stress and caring duties. It allowed them both the mental space and time to deal with personal affairs and join self-nurturing activities. The caregivers regarded their relationship with the elders improved and family conflicts reduced. The family engagement increased accordingly. The users were aware of the pros of changing and intended to change, hence, at the stage of Contemplation. However, due to financial constraint, some users quitted or reduced the number of service day after having completed the 6-month funded project. Through the follow-up calls, some found boredom and powerlessness due to the absence of a structured life schedule and peers. The caregivers reported an increase in stress since they gave more time to accompany the elders. The six-month intervention could not support the elderly with depression to progress to further stages of change. The authors argue the substantiality of care for supporting them involve in one’s family, peer group, and community.
Keywords: sustainability, elderly with depression, stages of change, caregivers
Symposium on Gender-based Violence and Gender Equality Education
Linda Wong MA, RSW
Dr Raymond Tam PhD, MASW, BASW
Hong Kong Polytechnic University
Doris Yuen-Hung Fok MSW, RSW
Association Concerning Sexual Violence Against Women
Dr Raees Begum Baig BSW, PhD
The Chinese University of Hong Kong
#metoo campaign around the world in 2017 has exposed a big loophole in the legal help-seeking situation for sexual violence victims, for example, disbelief and lack of knowledge of sexual violence in the complaint system, endured myths towards rape and sexual violence and more to come – in which victims turn to unconventional way to tell their stories. The symposium include 4 studies, the first one will illustrate some essential service data, which RainLily frontline workers collected from our service users, which is also the richest data in Hong Kong in revealing the landscape of sexual violence in Hong Kong in the past 18 years. The second one is an evaluation project focused on the outcome of a Prevention and Empowerment Project for Girls & Boys, a set of pre-workshop questionnaires and post-workshop questionnaires was designed to measure the changes within the students. The third study focuses on the influence of six social locations including gender, race, culture, religion, migration status and education, on shaping gender and GBV perceptions of minority girls in a transnational social system. The last study aims to gain more knowledge about the girls of the ethnic groups’ understanding of and experiences on gender-based violence in Hong Kong. Based on the above findings and discussion, the following recommendations are proposed for combating the GBV. (1) To provide gender education in schools and communities. (2) To construct a supportive environment for women and girls. (3) To render cultural sensitivity training to service providers, police and prosecutors, etc. (4) Specialized teams for handling GBV for ethnic groups.
Social Worker-led Holistic Interdisciplinary Community-based End-of-life Care: Development, Implementation and Evaluation
Dr Amy Yin-Man Chow BsocSc, MSocSc, RSW, CT
The University of Hong Kong
Funded by the Hong Kong Jockey Club Charities Trust, the Jockey Club Community End-of-Life Care Project developed, implemented and evaluated three different models of community end-of-life care between 2016 and 2018. These three models were led by social workers and supported the psychosocial needs of patients with advanced illnesses as well as their families. This symposium will describe three different models of community EoLC programmes by non-profit social service agencies in Hong Kong as well as the evaluation of these models. All organizations collaborated with hospital partners to provide community-based EoLC to families with older people with advanced illnesses, with unique foci. While emphasizing the partnerships with the health care system, these social care units strengthen psychosocial care in the community. Models include the volunteer-based model, assisted family-care model and patient empowerment model. A standardized comprehensive outcome and impact evaluation were carried out. Adopting mixed methods, assessments with older adults, family caregivers, and volunteers are implemented through pre-post-followup questionnaires as well as post-service qualitative interviews. Changes in symptoms, mental health, caregiving burden, quality of life, general health and complicated grief are assessed. Based on the experiences in the first three years, an integrated model was introduced for further testing. The symposium will also include the sharing of this new integrated model.
Mental Health Social Work – Opportunities, Threats and Strategic Directions
Dr Siu-Man Ng RCMP, RSW, PhD
The University of Hong Kong
Angus Lam RSW; Hiu Ning Tai RSW; Peter Ho RSW
Mental Health Social Work Chapter, Hong Kong Social Workers Association
With a history of over a hundred years, mental health social work (MHSW) is one of the oldest specializations in the social work profession. Initially MHSW was largely hospital-based. Following the breakthrough in the pharmaceutical treatments for severe mental illnesses (SMI) in the 1960’s, community mental health services have been rapidly developing. In parallel, MHSW ventured into the community and pioneered many innovative service models. The scope of MHSW also gradually expanded to common mental disorders (CMD) and the promotion of mental well-being.
In Hong Kong, the development of psychiatric rehabilitation services for persons with chronic SMI took off in the 1960’s. Since the turn of century, more new resources were diverted to services for CMD. In 2010, the government reorganized the fragmented services into 24 Integrated Community Centres for Mental Wellness (ICCMW), with an ambitious aim of providing one-stop mental health service at the neighbourhood level. As a result of service expansion, the number of mental health social workers has been steadily increasing over the past few decades.
However, the specialization of MHSW in Hong Kong is lagging behind the rapid pace of service expansion. To drive the specialization of MHSW, the MHSW Chapter under the Hong Kong Social Workers Association was established in 2014. This symposium will critically examine the opportunities and threats ahead, and deliberate on the strategies to achieve our goal.
Application of Mindfulness-based Intervention in Elderly Depression, Substance Abuse Relapse Prevention, and Caregiver Burden for Early Psychosis
Dr Herman Hay-Ming LoPhD, MSW, AcounS, AFHKPCA
Sunny Ho-Wan ChanBSC(HONS)OT
Hong Kong Polytechnic University
Dr Cherry Hau-Lin Tam PhD, MSW, RSW
City University of Hong Kong
Recently more initiatives based on mindfulness-based intervention have been used in different social work settings. In these symposium three researchers shall present their recent projects about how mindfulness training has responded to the diverse service needs in social work practice. The first presentation is a pilot, randomized controlled study on elderly depression. 45 older adults aged 60 or above with depressive features were recruited and were randomly assigned to threedifferent conditions, Mindfulness-based Intervention group, Health Qigong group, and waitlist control group. Participants in the mindfulness group showed better improvements than other two groups in reducing depressive mood and most other outcome measures after the intervention. The second presentation is a randomized controlled trial on mindfulness approach in relapse prevention for young psychotropic substance abusers. The effectiveness of the Mindfulness-Based Relapse Prevention Programme (MBRP) was evaluated against the Cognitive Behavioural Based Programme (CBT). Assessments were conducted at the pre- and post-intervention, and the 4th month follow-up. Results found that the MBRP programme was significant
In reducing young drug abusers’ frequency of drug use and drug craving. Participants reported significant improvement in observing and describing their body sensations, feelings and thoughts. The third presentation is a pilot, mixed methods study on a mindfulness-based family psychoeducation for caregivers of young adults with psychosis. The study integrated a quasi-experimental group design with a participatory action research approach called Photovoice. 36 caregivers were recruited and significant improvements in caregiver perceived stress, positive caregiving experience, and emotional awareness as part of interpersonal mindfulness. The Photovoice approach provided additional insights about how caregivers encountered their stress, become more mindful of their pleasant moments, and their attachments to ideal conception of family and recovery. Implications to research and practice will be discussed in the symposium.
Social Work: A Helping Profession as an Emotional Labor, a Neglected Concept
Social welfare services are a range of human services aiming to fulfil the needs, enhance the strengths and potentials, and promote the social and emotional wellbeing of the service users. It is characterized by the intensive face-to-face and emotional interactions, which can be perceived as job demand rather than only as a medium to achieve work tasks between social work employee (employees) and their service users. In this regard, employees working in the welfare sector should be considered as physical, mental, intellectual as well as an “emotional labor’. Employees are required to face the work pressure from heavy workload, demands from service users/ families, and administrative requirements; they are also expected to induce positive emotion, express caring and empathy in their interactions with service users as well as to control emotions that conform to social and professional norms. While the wellbeing of the users and the quality of services are highly emphasized; little concern is paid on the impact of repeated emotional control/ suppression, the management of workplace emotions as well as organizations’ display rules for employees to manage their motional expression in order to achieve the service goals. In this workshop, speakers from family/casework, rehabilitation and elderly service settings will explore the concept of “emotional labor” and discuss its importance and consequences in service provision with the participants through lectures and group discussion. It aims at arousing the concern of “emotional labor” at different levels of social service management. Employees should acquire skills to regulate their emotions induced by work and maintain their emotional wellness; service unit should develop a mutual support network among the colleagues; agency management should provide regular training and support to the employees; and the concept of “emotional labor” should be further studied and discussed in professional development, agency management and social work education.
Energizing and Transforming Organizations through Positive Organizational Initiatives
Nancy Lo BSSc(SW), MSSc, MSSc, RSW
Four Dimensions Consulting Limited
Hong Kong Christian Service (HKCS) is the first organization pioneering Employee Assistance Programme (EAP) in Hong Kong. Since 1991, it has launched its Employee Development Service (EDS) to serve employees in their workplace. Over the years, EDS has built up extensive experience in EAP services including professional personal consultation and counseling, employee development and training, management consultation as well as critical incidents stress management. With the changing needs of the business environment, the service has evolved from an “assistance” nature to a “wellness” service model.