Case Study – Social Work and Visual Difficulties

Case Study 1 – Source: Sapey, B. et al. (2004). Access to Practice: Overcoming the Barriers to Practice Learning for Disabled Social Work Students. SWAP LTSN.

J, who has a visual impairment, was working as a social work assistant in the team from whom she also had received services as a disabled person. She was interviewed for the social work course and had the requisite ability. Unusually she was also asked what she envisaged doing for her work placements. Placement choice normally took place once students were on the course.

J said that she wanted to work with disabled children and this caused concern for the partner local authority who was the main placement provider. There were concerns that in the event of any suspicion of child abuse, J would not be able to observe the visible signs.

There was a protracted discussion with the local authority who continued to maintain that they would not be able to offer J a placement which could be seen as ‘safe’ both for her and for service users.

Ultimately, during this process, J withdrew her application saying that she had decided not to become a social worker but to train as a counsellor instead. This was interpreted positively as the discussion of her difficulties led her to realise that she had chosen an inappropriate career path and helped her to choose another one.

Several months after this, in a meeting held to discuss and evaluate the selection process, the following points were raised by several people representing the Higher Education Institution’s staff group, the partner LA and the service users:

  • Why was a prospective placement discussed with J when this is not the usual procedure for other students? Given that she had fully stated the nature of her impairment, this appeared inappropriate and discriminatory and there would have been ample time to discuss suitable placements with her once she was on the course as regularly happens with students.
  • Why was consideration only being given to LA placements and a lack of creative ideas raised for how the barriers could be removed for J?
  • The positive construction of J’s decision may indeed be valid but another explanation could be that she was being led to believe that she would face insurmountable obstacles on a social work course.

A decision was made to write to J explaining that, with hindsight, the Higher Education Institution/LA had acted inappropriately in querying placement suitability.

The reflection and review that took place after the event indicates that both the Higher Education Institution and the local authority were attempting to change their practice.

Whilst it is important to ensure equity in the selection process, it is also important not to let equality become a barrier. Some flexibility about giving applicants the opportunity to discuss impairment and placement issues during the admission process may be helpful.

There is a tendency to exclude disabled students from certain areas of practice and to assume that disabled students would be best suited to working with disabled people. This is contrary to the Disability Discrimination Act – disabled people should not be excluded from any employment unless the adjustments necessary would be unreasonable for the employer to make.

Case Study 2 – Source: Irvine, J. & Taylor, N. (2002). Case Study 14: Practice Placements for Disabled Students. University of Central England IN Herrington, M. & Simpson, D. (eds). (2002). Making Reasonable Adjustments for Disabled Students in Higher Education: Staff Development Materials: Case Studies and Exercises. University of Nottingham.

Designing for Diversity

Each year six to ten disabled students undertake the Diploma in Rehabilitation Studies (Vision Impairment) programme at UCE. Most, but not all of these students have a vision impairment. The remainder experience some other form of disability such as physical, hearing or neurological impairments. Provided that applicants with a disability are able to demonstrate their ability to manage their disability effectively on a day-to-day basis, and can meet the academic and professional requirements of the course, they receive equal access to the course. Indeed, individuals with a disability can often enhance the experience of all students undertaking the programme.

Planning and Organising Placements

In common with many courses which lead to a “professional” qualification a significant proportion of students’ learning during the Diploma programme occurs in a work-based practice placement. These placements usually occur in social services departments, voluntary organisations or educational establishments which provide services to adults and/or children who are blind or partially sighted. Given the importance of practice placements to the programme as a whole, considerable amounts of time are devoted to locating, planning, supporting and monitoring this aspect of the programme.

All students are involved in the process of identifying and preparing for placements from the outset, regardless of ability and disability. Several reasons exist for this. Firstly, students are expected to take control of their own learning at all stages of the programme, including the identification of appropriate placement agencies. Secondly, as students are recruited from all parts of the United kingdom they are given the opportunity to complete their practice placement in a setting of their choice, including their home area.

Although the process of finding and setting up placements begins shortly after the commencement of the Diploma programme, the course team (including our Secretary) are already quite well informed about the abilities and needs of each student in relation to information requirements, independent mobility and personal management skills. This is achieved by a continual process of individual student consultation meetings with all students undertaking the programme. When a student with a disability is being place, additional planning and preparation is routinely performed. For example, disabled students are required to attend a pre-placement meeting with the programme’s Placement Co-ordinator and their prospective Practice Teacher in order to engage in the process of preparation and negotiation to identify and eliminate actual or potential disabling barriers. This process requires a degree of forethought and knowledge, but does not require excessive amounts of additional time relative to that given to non-disabled students.

Underpinning Philosophy

The philosophy which underpins the Diploma programme is strongly influenced by the “Social Model of Disability”. A key principle of the programme asserts that professionals who work with vision impaired people should enable and empower individuals and groups to challenge and overcome barriers caused by social and institutional structures which fail to take account of the need of disabled people. For example, all learning materials and documentation provided by the programme’s teaching and administration staff is provided in an accessible format to disabled students. Most frequently, this is on computer disk, but it may also be in large print or Braille.

The “Social Model” approach is applied to all aspects of the programme, including placements. It is not viewed as being confrontational; rather it is achieved through informed debate, negotiation and persuasion. For example, when arranging placements administrative and record-keeping systems within the placement agency need to be made accessible and/or manageable. This may, for example, involve awareness training for students of data recording systems relevant to the placement agency before the placement begins, or perhaps during the induction period. This enables students to have adequate time to prepare their equipment and materials, and to arrange personal assistance if necessary. Furthermore, Practice Teachers and their colleagues are also given time to prepare appropriate cases and types of work to be completed by students during placement, taking into account information, mobility and transport requirements.


The contribution any disabled student makes to a given placement should be measured on the basis of the levels of competency and professionalism by which any student is assessed. Accordingly, assessments of students’ competence should not be undermined by disabling barriers and environments. The involvement of disabled students, therefore, in the identification of, and planning and preparation for appropriate placements is viewed by all parties as essential. In this way impediments to learning and service delivery are usually minimised or eliminated completely. Additional benefits often come by way of enhanced student enjoyment of practice learning, increased learning for Practice Teachers and their colleagues, and perhaps most importantly, the development of good “disabled” role models within the profession for service users.

Case Study 3 – Source: Debby Hill, M.S.W. Social Worker, Mental Health and Substance Abuse.

I chose this career because…

I chose to become a social worker, because of two interests that I developed. In grade school, I became very interested in medicine. At the time, I wanted to be a doctor or a nurse. When I grew older, I decided that it was not practical for me to pursue that dream, since I am blind. (Later, I discovered that there are doctors who are blind and nurses with partial vision.) But despite that decision, my interest in medicine remained.

My second interest developed when I was working in Harrisburg, PA, in the early 1980s. I became a volunteer for a telephone hotline. I was trained in supportive listening, crisis intervention and making referrals to various community services. I enjoyed helping people, working with them to solve problems, and giving them a friendly and safe means to express their concerns. Because I found the position so fulfilling, I decided to go back to school for a master’s degree in social work. While researching this choice, I discovered that social workers provided services to patients and families in hospitals and clinics. That was the clincher: I resolved to become a medical social worker.

After receiving my master’s degree, I joined the NIH as a research social worker, and got my wish to work in medicine.

My typical workday involves…

My typical workday is not very structured. It varies depending on the current research programs NIAAA has underway.

My major tasks are to:

  • Recruit program participants – In NIAAA’s alcoholism research and treatment program, patients receive an average of four weeks of treatment and participate in medical research on alcoholism. My job is to recruit patients for the program and perform eligibility interviews by telephone. To recruit patients, I oversee the placement of advertisements in local newspapers, maintain contact with staff members in hospitals and detox centers, and speak to groups about the program. When a potential patient calls, I give them all of the information about the program and then conduct a telephone interview which takes approximately 30 to 45 minutes to complete. After gathering the information, I talk with the NIAAA doctors to determine if the patient qualifies for any of their research studies. I also recruit healthy volunteers using a similar interview process. Healthy volunteers are people who do not have alcoholism, and they serve as control subjects for the research.
  • Coordinate admissions – If a person qualifies for the program, I work with the nursing staff to schedule the patient’s admission into the program. I provide information to the patient about what they need to bring to NIH and directions for getting to our facility.
  • Provide referrals and resources – If a patient does not qualify for the program, I give them contact information for other treatment options or area programs. I also act as a general resource to potential patients and their families. Many times a family member or a friend will call to inquire about our program for someone they know. We talk about the program and discuss any concerns they may have.
  • Handle daily correspondence and telephone calls – In the morning, I check my voice mail and my e-mail, and return calls and e-mails as soon as possible. I try to make sure that each person who contacts me receives a response in the same business day. Because effective communication is such an important aspect of my job, I maintain a log record of all e-mail and telephone interactions.
Equipment I use on the job…

My telephone and computer are very important tools that help me do my job effectively. I use a hands-free headset on my telephone. This helps prevent neck or shoulder problems that could result from extended periods of balancing a receiver on my shoulder. My computer is important because it’s where I store all of my phone logs and interview information. Because I am blind, I also use some special software and equipment that makes my computer more accessible.

Equipment and software I use:

  • DecTalk Express – A speech synthesizer that provides almost human-sounding speech output from my computer. Since I cannot see the screen, the synthesizer speaks what appears on the computer screen.
  • JAWS for Windows – A software package known as a screen reader that helps the DecTalk Express interpret the information to speak. It makes things like web pages and word processing in Windows much more accessible than if I had the speech synthesizer alone.
  • PowerBraille Display – This is a piece of hardware that provides output in Braille from the computer. It interfaces with JAWS and shows what is on the screen, 65 Braille characters at a time. It comes in very handy when I am interviewing someone on the telephone. By using the PowerBraille, I don’t have to listen to a caller talking in one ear and the DecTalk talking in the other.
  • VersaPoint Braille Printer and Duxbury Braille Translator Program – This hardware and software combination converts digital documents on my computer into Braille hard-copy documents. It comes in handy if I need to carry information from my computer to meetings.
  • BrailleNote – This is a portable note taker that I can use to take notes and to carry electronic files from my computer to meetings, lectures, and training sessions. It has both speech output and an onboard 32-character Braille display.
  • Scanner and Openbook Software – Sometimes I receive documents that are only in print. To make them more accessible, I use a scanner and the OpenBook software. Openbook is optical recognition software specifically written for people who are blind. It has many features for use when reading scanned printed material, such as formatting columnar text to make it easier to read. It also ignores pictures and graphics from the original so they don’t clutter up the text being read.
What I like best/least about my work…

What I like best about my work is that my job is very unpredictable. I never know when I answer the phone what life-story I am going to hear, or what request or problem may be posed. It challenges me all of the time.

What I like least about my work is when I have to tell callers that they don’t qualify for any of our research studies and so we cannot admit them into a treatment program. Many times people are very disappointed and that makes me feel sad. At those times, I support them the best way I can, and give them referrals to find other treatment programs.

My career goals are…

My career goals are to get involved in two projects in our institute. I would like to help design a computerized database for storing, saving and organizing the logs and interview information I collect. Also, I would like to be able to conduct the psychological interviews that are administered to each patient in our research program. Currently, the interview questions and answer sheets are only in print and are not available to me, even using my specialized equipment and software. In the future, I would like to make them accessible and expand my role in the NIAAA research.

In the future I would like to teach in some capacity. I haven’t decided what form that will take, but I always remain open to new opportunities.

Advice on facing challenges to succeed…

It can be very difficult for someone who is blind or who has other disabilities to have a career, but I have been quite lucky and always had an interesting work life. After graduating with a B.A. degree in mathematics, I worked for one year as a seventh grade math teacher. At that time, we didn’t have computers in the classroom, so it was very challenging, but also a great experience. Next, I worked for the Navy with computers in various positions such as a mathematician, computer specialist, and computer systems analyst. Since I am a fairly organized person, I really enjoyed all of the computer programming and database work I did during those years.

After 13 years with the Navy, I decided to go back to school and become a social worker. Upon graduation, I became a director of a telephone crisis hotline. At that job, I learned a lot about being a supervisor and working with budgets. When the program lost its funding, I began to look for another job and found my current position at NIH.

As my career path illustrates, I think it’s important to be persistent and work hard. You never know what experiences and opportunities may come your way.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.