1. The role of the Social Worker in ARV Rollout Based on Social Work Practicum Experience at Sinikithemba Clinic, Mc Cord’s Hospital Durban, South Africa
Presented by Tracie Rogers
Social Work Unit
Department of Behavioural Sciences
UWI, St. Augustine

2. Social Work Practicum Social Work Unit
Behavioural Sciences/ Faculty of Social Sciences – University of the West Indies, St. Augustine
School of Social Work & Psychology, University of Kwazulu Natal, Durban, South African
Placement at Sinikithemba Clinic, McCord Hospital
ARV Roll out at Sinikithemba
Adult
Paediatric

3. Overview of Presentation
Role of the Social Worker in Pediatric ARV Treatment and Management
Role of the Social Worker in Adult ARV Treatment and Management
Group & Community Work
The Potential of the Social Worker

4. The Social Worker in Pediatric ARV Treatment and Management
Three Areas of Focus:
Psychosocial Assessments
Intervention
Evaluation

5. The Social Worker in Pediatric ARV Treatment and Management
1. Assessing the Child
2. Assessing the Family System
Psychosocial Assessments
3. Assessing the Support Structures

6. Making a Psychosocial Assessment:
1. The Child The Family
Personality & Adjustment to Living with HIV/AIDS
Level of Disclosure
Child’s Functioning & Developmental Stage
Education/ School Based Needs/ Peer Relations
CD4 Count %/ Medical issues & concerns
The present family structure
Regularity of the Care giver
Family’s capacity for supporting adherence to ARV regimen
Stability of the Family
Level of Disclosure among family members
Norms, Values, Beliefs, Socio-cultural Dynamics
Religion/ Spirituality
Financial Stability/ Welfare needs

7. Making a Psychosocial Assessment:
3. Assessing the Support Structures
The Extended Family Support System
The Environmental/ Community Support System
Institutional Support
Placement in a Children’s Home

8. Initial Interview Goals: Make psychosocial assessment
Identify and create initial care plan to target presenting problems
Evaluate ARV readiness
Protocol for child under age 14 – caregiver(s) is/are primary client(s); child is integrated where if developmentally mature enough to contribute to the interview; limited confidentiality for children
Protocol for children above age 14 – adolescent is primary client; caregiver(s) is/are integrated into the interview process; adolescents are interviewed individually as well as with caregiver(s)
Family/caregiver’s support structure or support system of the residential facility in cases where children are institutionalized are assessed specifically in terms of their capacity to provide for a child living with HIV

9. Disclosure Planning & Acceptance of Status
Is the Child aware of his/her status?
What is the caregiver’s attitudes towards disclosure
Assessment of the safety of disclosure for the child
Assessment of disclosure risks and benefits explained to the caregiver(s)
Where the child is under the age of 14 and the social worker’s assessment differs from the caregiver’s, the social worker clarify concerns and provide continuous support and information to the caregiver(s) in the interest of the child’s safety and wellbeing
Where the child is over age 14, the social worker advises caregiver of the legal ramifications for persons who are sexually active and HIV positive
Caregiver(s) encouraged to disclose to children and the social worker should work with them to disclose in a systematic and psychologically safe way

10. The Social Worker in Pediatric ARV Treatment and Management
Three Areas of Focus:
Psychosocial Assessments
Intervention
Evaluation

11. Intervention Formulating an Intervention Plan
Connection individual, family & community resources
Intervention in the Family System
Accessing social welfare
Family Testing & Counselling
Addressing stigma and discrimination
Direct Intervention with the Child
Counseling in specific issues identified e.g. coping, social skills
Making referrals

12. The Social Worker in Pediatric ARV Treatment and Management
Three Areas of Focus:
Psychosocial Assessments
Intervention
Evaluation

13. Evaluation Case Evaluation Continuous Case Management
Is the SW providing relevant, reliable and valid service
Is the SW meeting needs of clientele
Is the SW providing ethical service
Continuous Case Management
Adherence monitoring
Welfare needs
Advocacy

14. The Social Worker in Adult ARV Treatment and Management
VCT as the Gateway to Care and Treatment
Referrals to Social Work
Social Workers & Counsellors
The Social Work Intake Interview
The Social Worker as Enabler, Advocate, Resource Moblizer
Our primary concern is linking clients to comprehensive, holistic support services
Intervention & Evaluation:
Linking people to programmes

15. Group & Community Work at The Sinikithemba Clinic
Teenage Support Group
Playgroup
Grannies Support Group
Adult Support Group
Income Generation Projects
Youth Projects

16. The Potential of the Social Worker
The Professional Capacity of the Social Worker in HIV/AIDS Care and Treatment
Counsellor
Negotiator
Advocate
Activist and Coordinator
Administrator
Educator
Researcher & Programme Developer

17. Thank you for your attention