Case Note Reading Skills, Prioritising Guidelines & 12 Life Domains
WELF2019: 2021
Case Note Reading Skills, Prioritising Guidelines & 12 Life Domains
Service users rarely present with one or two clearly or neatly defined presenting concerns, but rather with a complexity of issues and multiple concerns across a number of different life domainsrather than just having poor mental health; hence the need to understand and exercise good case note reading skills and core prioritising principles. This document has been created to support you to address the case study assignment.
Case note reading skillsPlanning to work with a service user requires mindful case note reading skills.
First, it is important to read through the case study notes several times be mindful of what stands out for you, and why? You also need to be aware of any assumptions you might be making as you read through the case study notes. Being aware of your assumptions is the basis of good self-reflective practice.
Second, write down all of the concerns and issues you have noted in the case study notes. Here it would be good to take note of:
Socio-biographical information either highlighted in the persons case study notes or that you believe would need to be considered (e.g. age, gender, sexuality, marital status, number of children, the persons cultural heritage, spiritual and/or religious beliefs, living arrangements and socio-economic status)
Key socio-environmental aspects either highlighted in the persons case study notes or that you believe would need to be considered (e.g. factors to do with social withdrawal & isolation, bullying, outside pressures from peers or parents, issues to do with homelessness, experiences of violence, exposure to traumatic events, financial stress, addiction etc)
The mental health concerns outlined specifically or more indirectly in the case study notes
Any legal and/or ethical professional duty of care factors
Any further information that may not be clearly stated in the case study notes but that you believe is also an important key issue to follow-up with the person/people in the case study.
Third, ensure that you do some research on these concerns and issues before you meet with the person so that you are ready to present and discuss possible options with them.
Prioritising guidelines
Workers in the field of human services need to take into consideration key aspects in a service users case notes that may raise any legal and/or other professional duty of care issues and address them in order of priority. To do this effectively requires balancing these legal/duty-of-care aspects alongside the use of respectful and collaborative service-user centred practices (e.g. about what the service user wants to prioritise, and why). The following are four core prioritising principles:
Immediate Safety & Wellbeing
Consideration of any issues to do with the persons safety and well-being and/or anybody elses safety that appears at risk.
Be mindful that these safety concerns may not always be directly written in the case study notes (for example with regards to the safety of children involved in situations of domestic violence)
An understanding of appropriate and responsive risk assessment practice is critical here.
Immobilising Distress
Helping the person to immobilise and stabilise high levels of distress so they can return to normal functioning levels.
An understanding of the practice model of crisis intervention is critical here.
Basic Human Needs
Ensure that you take into consideration the persons basic human needs and their human rights.
Begin by looking at essential human rights which are connected to the persons physiological and safety needs (for example: housing, financial security, ongoing safety from abuse or violence, immediate physical health concerns).
Once you have addressed the essential needs, you can then focus on factors related to a persons self-esteem and supporting their ability to reach their fullest potential.
Addressing basic human needs requires respectful exploration of these factors in collaboration with the service user.
Levels of Support
Exploring the persons level of support within their immediate environment and across broader social services as described in the case study.
Here you are looking at a persons support systems from family, friends and the community more broadly, as well as from professional human services. If the supports seem minimal, provide some useful suggestions that you might explore with the service user.
12 Life Domains
The following 12 life domains break down a broad range of areas within a persons life that are often impacted in different ways by the ongoing struggle of coping with and managing the effects of a significant mental health concern or range of mental health concerns. While working on this section, keep in mind that you are expected to be working using a recovery-oriented approach and from a social work perspective. This means looking holistically at all aspects of a persons lived experience; not just that of the mental health concern itself in isolation from the rest of the persons life. For example:
personal response to mental health concerns
social, emotional and mental well-being
familys response to loved ones illness
friendships and social relationships
personal safety and the safety of others
daily living skills
managing/dealing with stress
physical health issues
financial concerns
housing issues
work, leisure and education
human rights and advocacy
Information taken from: Bland, R, Renouf, N & Tullgren, A 2015, Social work practice in mental health, (2nd Edition), Allen & Unwin, Crows Nest, NSW:
*See Appendix 11, pp. 291-294
WELF2019 Case Study Assignment
Your task: Respond to a case study following the prompts and suggested word counts provided. We will engage with those cases during tutorials across the semester. 1800-1900 words 40%
Where to start
Choose one of the case studies from those provided and respond to the prompts
Before you start, read the supporting document and the marking rubric
Use the 5 headings set out below to structure your paper
Suggested word counts do not need to be exact, but they should guide the balance of the amount of writing required for each section.
Expected word count approx. 1800-1900 words (this includes in-text references, but does not include the reference list)
It is expected that you will use a minimum of 8 peer reviewed academic sources to support your paper. The first place to look for these academic sources is within the course readings (a priority should be the course textbook) as it is expected that you will engage with the ideas in these readings in your written work as a demonstration of your learning in this course.
While you can simply respond to the prompts below, the best papers will incorporate their case study as an example throughout the paper
How to structure the assignment
In this assignment I will be focusing on this case study
Recovery-Oriented Approach (Approximate word count 200-250 words)
Succinctly outline your understanding of the core philosophies & key principles of using a recovery-oriented approach, drawing on relevant academic research to support what you write.
*Purpose: To demonstrate a clear theoretical understanding of the ROA taught throughout this course as it applies to social work practice
Pre appointment planning considerations (Approximate word count 300-350 words)
Identify and briefly discuss a minimum of three planning factors that you would need to consider BEFORE meeting with the person/people in your chosen case study - in keeping with: -
specific information outlined in your case study
information covered in Chapter 6 of the course textbook, Assessment for Social Work Practice (Bland et al, 2015, pp. 145-180)
further independent research work on these planning factors
* Purpose: To demonstrate an understanding of the importance of planning considerations: these considerations could include the Politics of the persons Referral; Self-Reflective Practice; what stood out for you when reading the case notes and why?
Prioritising Problems / Using Life Domain Sub-Headings (Approximate word count 600-650 words)
Outline and discuss the prioritisation of all of the concerns outlined in your chosen case study notes.
Select four appropriate Life Domains or combinations of Life Domains Sub-Headings for your case-study in this section
Support the priorities you chose with relevant academic sources
*See the supporting document for this assessment and the course textbook - particularly Chapters 2,6 and 7 for support with this section.
Social Work Theories/Models of Practice (Approximate word count 300-350 words)
Succinctly outline key features of one social work theory that you might use to guide your approach to working with your chosen case study families and explain why that theory may be relevant. e.g. Feminist Theory, Crisis Intervention, Ecological Systems Theory, A Trauma Informed Approach etc.
In this course we will NOT accept materials simply copied from your work in previous course. You can however elaborate upon a theory used in a previous course
Provide clear examples of how this theory/practice model could be applied in practice to specific aspects from your chosen case study scenario
Ethical and Legal Implications (Approximate word count 200-250 words)
Discuss any possible ethical and/or legal factors in relation to your chosen case study scenario that would need to be taken into account & why.
For example: the AASW Code of Ethics, relevant Mental Health Policy & Legislation, DOA Policy and Legislation & Human Rights Documents
WELF2019: Mental Health & Mental Wellbeing: Case Study Assignment Marking Rubric
Marking Criteria Fail 2
(39-0%) Fail 1
(40-49%) Pass 2
(50-54%) Pass 1
(55-64%) Credit
(65-74%) Distinction
(75-84%) High Distinction
(85-100%)
Does the submission respond to each of the 5 components in the case study?
Articulating a Recovery Oriented Approach (ROA) using the framework drawn upon in this course.
No connection made with the meaning of ROA as it has been discussed in this course.
No obvious connection made with the meaning of ROA as it has been discussed in this course.
Author attempts but does not convincingly respond to the section about ROA.
Author has attempted to engage with the meaning of ROA although this is not always successful.
Author shows that they have a solid understanding of the meaning of ROA. Author has explored most components of ROA and demonstrates a strong understanding of ROA.
Author has responded to this section in a sophisticated manner.
Pre-appt Planning considerations.
No sense of any appropriate pre-appointment planning.
Little sense of any appropriate pre-appointment planning. Author attempts to demonstrate pre-appointment planning but has missed some obvious aspects Author demonstrates some pre-appointment planning has taken place Author demonstrates a solid understanding of pre-appointment planning. Author demonstrates a strong understanding of a variety of pre-appointment planning factors. Author has responded to this section in a sophisticated and sensitive manner.
Prioritising problems
Submission demonstrates no sense of prioritising problems Little demonstrated understanding of prioritising problems Author attempts to demonstrate prioritising problems but has missed some obvious aspects Author demonstrates some understanding of how to prioritise problems. Author demonstrates a solid understanding of how to prioritise problems. Author demonstrates a strong understanding of how to prioritise problems Author has responded to this section in a sophisticated and sensitive manner.
SW theories/models of practice
No appropriate theory or model described A model or theory described but done so incorrectly Author demonstrates only a minimal understanding of a theory, or has chosen an inappropriate theory Author demonstrates some understanding of an appropriate theory, but Author demonstrates a solid understanding of an appropriate theory Author demonstrates a strong understanding of an appropriate theory Author has responded to this section in a sophisticated manner.
Ethical and legal implications
Author has not responded to this section appropriately No sense of understanding ethical or legal concerns Little obvious sense of understanding ethical or legal concerns Author demonstrates some understanding of ethical and legal implications Author demonstrates a solid understanding of ethical and legal implications Author demonstrates a strong understanding of ethical and legal implications Author has responded to this section in a sophisticated manner.
The following section sets out the expected standards of writing and editing
F2 F1 P2 P1 C D HD
Overall written expression, tone and language.
Often, the tone, language and expressions used do not meet the required standards.
Sometimes the tone, language and expressions used do not meet the required standards.
At times, the language and tone wavers away from expectations.
There are some structural inconsistencies in ordering the information.
Sometimes, but not always, the language is appropriate.
Sometimes the meaning of the writing is unclear.
Most of the time, author uses respectful tone and language.
Most of the writing is clear and easy to understand.
The author has used respectful tone and language throughout.
Clear and precise language and writing deployed throughout.
Author uses respectful tone and language throughout.
The use of language is simple and effective, the flow of writing is impressive and engaging.
Editing
The best writers spend as much time editing as they do writing. Numerous grammatical errors are present, affecting the readers ability to understand the meaning of what is said.
Submission appears rushed with little evidence of editing Many grammatical errors. At times the meaning of what is written is affected by these errors.
Submission appears rushed with little evidence of editing Often there are repeated grammatical errors.
More editing required Some repeated grammatical errors, although generally the meaning of what is written is clear.
Another round/s of editing advised.
Some minor grammatical errors.
More time spent editing may have enhanced this work Few grammatical errors.
Obvious that the author has spent time editing their paper No grammatical errors. The meaning of the work is always clear and easily understood.
Obvious that the author has spent time and care editing their paper thoroughly
The following section sets out the expected standards around referencing and Academic Integrity
Research informing the paper.
It is an expectation that you will include and engage with the readings and other resources curated for this course
No ideas, facts or opinions are referenced.
No evidence of engagement with any of the course texts
Few referenced ideas, facts or opinions.
A lot of inappropriate attribution of referenced material or references used which contradict the ROA approach taken in this course. Author has used the minimum of 8 peer reviewed references, although there is no engagement with course texts and resources.
There are large gaps in referencing and/or inappropriate attribution of referenced material. Author has used the minimum of 8 peer reviewed references-which includes the course text.
There are some gaps in referencing.
Sometimes there was inappropriate attribution of referenced material. Author demonstrates engagement with course texts and other resources
Author has exceeded the minimum requirement for peer reviewed sources and has engaged with their content.
Most ideas or facts are attributed.
Obvious that author has carried out independent research to support their work. Author demonstrates engagement with course texts and other resources throughout their work
Author has exceeded the minimum requirement for peer reviewed sources and has engaged with the content in a comprehensive manner.
References all of the appropriate ideas and facts within the essay.
Independent research has resulted in a rigorous paper, with all references incorporated into the paper. Author demonstrates engagement with course texts and other resources in a sophisticated manner
Author has greatly exceeded the minimum requirement for peer reviewed sources and has engaged with the content in a comprehensive manner.
Demonstrates a sophisticated use of referencing material, arguments and factual information, including synthesis of ideas from a number of sources.
These are combined seamlessly and flawlessly into the paper.
Reference List
You can use either UniSA Harvard or APA 7th however, you must be consistent
Sources should be relevant to the content of the course.
No reference list present.
Multiple errors in referencing with missing information and poor formatting
No engagement with course readings and resources Many references in the list are not used in the text or vice-versa.
Reference list is poorly presented and formatted.
Author does not utilise enough appropriate, peer-reviewed literature;
or relies too much on online sources;or does not use the course readings to support their work
Some references in the list are not used in the text or vice-versa.
Some errors in referencing with missing information and poor formatting
Minimal engagement with course readings and resources
Author relies on online sources, when peer reviewed sources would have been appropriate
All references in the paper are present in the reference list, although there are some formatting errors and/or information missing.
Author has used one or two readings from the course to support their position.
Some errors in referencing with missing information and poor formatting
A relevant set of sources used to support the paper.
A good reference list, but there is still room for improvement.
Evidence that author has engaged with some course resources and readings to inform paper.
Reference list utilises appropriate references throughout, with some coming from the course readings.
The reference list is almost perfect, with all details included, contains only minor formatting errors Reference list includes a wide range of appropriate references, many are from the course readings and resources.
The reference list is perfectly constructed and formatted with all details included.
Academic Integrity
Clear evidence that material has been directly copied and pasted from another source, with or without acknowledgement Poor attention paid to properly acknowledging sources used to support the argument Well done, your paper is respectful of academic integrity throughout
Meeting deadlines Your paper was submitted x days late, therefore x marks have been deducted as per policy
Well done on submitting your work on time
General Comments and Mark:
Dear
Grade Notion Descriptor
High Distinction HD 85 100 Exemplary competency in all criteria
Distinction D 75 84 Higher level competency all criteria PLUS exemplary competency on most criteria
Credit C 65 74 Basic competence all criteria PLUS demonstrates higher level competency on some criteria
P1 55 64 Basic competence in all criteria.
P2 50 54 Basic competence on most criteria. Some requirements for pass may be reached and others widely missed.
F1 40 49 Insufficient competence on some criteria. Deficiencies in meeting Pass requirements
F2 Below 40 Competence not demonstrated on most criteria. Requirements for Pass clearly not met.
WELF2019 Assignment Case Studies
Choose 1 of the following Case Studies as your focus for Assignment 1 and Assignment 3.
Unless you are given explicit permission by your tutor to do otherwise, you will use the same case study to inform both assignments.
Case Study 1: Parker
Parker is 19, they left school early because they struggled with reading and felt anxious in large classes. The school counsellor worked well with Parker providing useful strategies to manage their anxiety, and connected Parker with a friend, Anna who owned a caf who was looking for a worker. Anna had a knack for creating a space for people who did not seem to fit in elsewhere, she was accepting of diversity, patient and gentle. Parker was nervous at the interview but impressed Anna by offering to do a shift for free as work experience. At the end of the shift, Parker was offered a steady job, and worked for 6 months as a kitchen hand. In that role Parker learned the ropes of what happens behind the scenes in a caf, got on well with other staff, got to know the delivery drivers and impressed Anna by being reliable, punctual and courteous. Parker was offered a front of house role to learn to serve tables and was loving it so much that they were about to enrol in a hospitality management course at TAFE. During this time, Parker found stable accommodation at Common Ground and was learning to live well with their mental health challenges.
However, early in 2020 the Caf had to close due to COVID, Anna lost her business and Parker became unemployed. During lockdown, Parkers anxiety and depression became incredibly difficult to manage and at times, Parker seemed to have lost hope. Even after restrictions were lifted, Parker rarely went out and was becoming increasingly isolated. It was only when Parkers former school counsellor phoned to see how Parker was getting on that anyone else knew about Parkers mental health. The counsellor has referred Parker to Headspace. You are a counsellor at Headspace and will be seeing Parker for the first time on Friday.
Case Study 2: Amir
Amir, his wife Ferhana and their two young children fled their home country Afghanistan in 2014 seeking asylum in Australia. They arrived with little money, limited English and with limited knowledge of the social context of Australia. They spent the first 4 years being held in offshore immigration detention facilities, and another 2 years on community detention, they are now on a bridging visa.
Amir and Ferhana have found work picking fruit and vegetables in Virginia, not far from where they live. They also grow what they can in the small yard attached to their rented accommodation, however, they are essentially living in poverty. While Amir and his family are eligible to access Medicare, they are not eligible to access a Healthcare Card despite being their low income. They have been supported by a few charities since being in the community, and Ferhana volunteers with Uniting Communities Hopes Caf twice a month.
Although Amir and his family hoped to find a better life in Australia, the last 8 years have been more difficult than he could have ever imagined when he first thought about seeking asylum in Australia. Amir worries for the safety and well-being of his relatives and friends in Afghanistan, and for the people of Afghanistan more generally. This fear escalates whenever reports on violence happening in Afghanistan makes the news. Often Amir feels helpless.
Amir recently presented at the GP (his local doctor) at the insistence of Ferhana because of trouble sleeping at night and of fear around leaving his house. Amir has lost his appetite, he has stopped playing with his children when they get home from school and has stopped attending the Mosque near his home. Amir told the GP that he has this nagging fear that something terrible will happen to him or his family. This has become worse since the time he had a panic attack on the train coming home from the city.
Amir is becoming withdrawn. He sleeps badly, often waking in the early hours and is then unable to get back to sleep. He talks and thinks a lot about his sister and her family who fled Afghanistan the same time he did, but he has lost contact with them and does not know if they are alive or dead. You are a mental health worker at Uniting Communities and have been approached by Ferhana hoping that you will be able to meet with Amir. You will be seeing Amir tomorrow.
Case Study 3: Arden and Merritt
Arden and Merritt are in their late 60s, have been a couple for over 30 years and identify as part of the LGBTQI community. The referral notes say that Merritt has developed a chronic health condition and it looks like they will be needing to move to live in an aged care facility soon. Both Arden and Merritt have experienced a lifetime of homophobia and they still experience micro-aggressions.
They are wary of entering aged care, especially as many are owned and operated by religious groups, some of whom actively campaigned against same sex marriage in Australia. They are also concerned about the enormous financial outlay of entering an aged care facility and the stress that could create. For example, for two people the outlay can be more than $800,000. They are worried that they may only be able to pay for Merritt and that Arden will have to go on a waiting list for a hardship position and are fearful for the impact on their relationship because of the possibility they will get separated in different facilities. Arden has mentioned feeling anxious and depressed and is worried about what will happen in the future. Arden has sought your support and will be seeing you tomorrow. You work for Switchboard.
Case Study 4: Josh
Josh is in his late thirties and a year ago he was medically discharged from the Australian army with symptoms of post-traumatic stress disorder. The referral information says that Josh had completed 2 tours of duty into conflict zones. Josh also remembers the bullying he both witnessed and experienced in his early army training. Since his discharge, Josh often talks about having lost his sense of purpose. Josh and his partner Melanie are not communicating well with each other, he is drinking excessively and often does so alone. You are a mental health worker at Open Arms, and Josh and his partner Melanie will be seeing you for the first time today, however, you received a phone call from Joshs partner Melanie last week where she expressed concerns for Joshs welfare and is worried about leaving him alone.
Case Study 5: Karen
Karen is in her late twenties. She has a daughter who is 4 and also has a 12-week-old baby. During her recent pregnancy, she left her partner, Mick due to increasing levels of control and abuse. Recently her GP diagnosed her with post-natal depression. Mick has used this diagnosis as evidence to argue that Karen is not capable of parenting, as he is mounting a case in the Family Court wanting to be granted full-time custody of their children. Karen is scared of losing her children but is also struggling with day to day demands of parenting 2 children while living in her friends garage. You work at SA Healths Womens Health Service and today, Karen will be coming to see you for the first time. When you phoned Karen to organise the appointment, she mentioned that she would need to bring her children with her.
Case Study 6: Justin
Since he started playing touch football at the age of 7, Justin has excelled at playing sport. He is physically gifted and does well at any sport he puts his mind to. For the last few years Justin has dreamt of becoming an elite athlete. At age 17, Justin began doing weight-training with his football team. He loves lifting heavier and heavier weights, and by the age of 19 he had built an impressive physical presence and had made it to the finals in a number of local bodybuilding competitions. Building his physique and doing well at a competitive level has almost become an addiction. About a year ago Justin suffered an injury while playing football and became frustrated with the slow recovery. He met a man through an online bodybuilders group who suggested that he use steroids to speed up his recovery. Not only did they work, but he soon noticed that he felt stronger and was getting bigger. However, Justins partner Erica has noticed that Justin is becoming aggressive and lashes out at the slightest things not going his way, she has also noticed physical changes in him that she believes puts him at risk of long-term health problems. Erica has told Justin he needs to get help or she will leave him and go back to live with her parents. Erica has made an appointment for Justin to see you. You are a worker at Centacare Drug & Alcohol Service and will be meeting Justin for the first time tomorrow.
Case Study 7: Lisa
Lisa is in her early 20s. When she was around the age of 7 Lisa and her sister Eve, who was then 3 went to live with their aunt and uncle after their mother died. The sisters were sexually abused by their uncle, and when they found the courage to tell their aunt, she did not believe them. While Eve managed to move in with a friend early in high school and has since done very well, Lisa has spent most of her time since her late teens alternating between couch-surfing or living on the streets. She started using alcohol and drugs, and often did sex work to pay for them. At age 19, Lisa was doing street sex work she was arrested by an undercover police officer, and subsequently spent 6 months in the Adelaide Womens Prison. When she was released from prison, she left with just the possessions she had in a clear plastic bag. She had no home and no connections she felt she could trust; she does not know how to find her sister. You work at Relationships Australia in their MOSAIC Program, Lisa has been referred to you by her community corrections officer after being diagnosed as having Hepatitis C. During your phone call with the community corrections officer who referred Lisa you learned that Lisa has stated that although she wants to make changes in her life, she seems to be almost crippled with social anxiety, is worried about relapsing and has begun to indicate that perhaps life would be easier if she were back in prison.
Case Study 8: Dave
Dave is a farmer who grew up on Kangaroo Island and runs the farm started by his parents, who have both passed away. He lost a lot of his livestock and his home in the recent bushfires and he is devasted by the death of one of his neighbours who died trying to escape the fire. He is currently living in an old caravan on his property. Everywhere he looks and everywhere he goes he is reminded of the devastation that occurred during that dreadful time. Even though he was insured, he has not yet been able to rebuild due to scarcity of trades people and building supplies. You are a social worker with lived-experience of having mental health challenges and you work at Neami on Kangaroo Island Daves GP has suggested that he attend your service, during the referral phone call, Daves GP stated that he is worried that Dave is a risk of suicide, you will be seeing Dave this week. Case Study 9: Sandra
When Sandra was 26 one of her sons was killed when he was hit by a train on his way home from school. Sandra and her husband grieved for many years, and although they separated, they successfully shared the care of their 2 remaining children. On the weekends when the children stayed with their father, Sandra often walked around to the local hotel where she would have a few drinks and chat to the regulars at the bar. Even though she had many drinks, she never drove while she was drinking but sometimes, she did not remember how she got home. Once the children finished high school they were accepted into university, moving interstate to study. Sandra was very lonely once they left and spent more and more time at the pub. One day, her local hotel was having a promotion where people who played the pokies between 1-4pm on a weekday would be rewarded with heavily discounted alcoholic drinks. Sandra had never been interested in playing the pokies before this day but was so excited when the first $5 she put into the machine returned her almost $900. Since then, Sandra has spent more time playing the pokies, and, although some weeks she won money, other weeks she lost everything and often resorted to selling things (for example her jewellery and other household goods) to pay her bills. Two years ago, Sandras former husband passed away; he left Sandra a sizeable inheritance in a will that he had written not long after their children were born, with the intention that the money would be used to support them and Sandra comfortably for many years. After her late husbands estate was finalised, Sandra began to play the pokies every day, often staying until closing time. Last week, Sandras son asked if she could send him some money for a new laptop for his studies. But when Sandra checked her bank account, she had less than $300 left. She checked the recent transactions and could see that nearly all of them were withdrawals from an ATM in the Pokies Venue. Sandra attended a financial counsellor last week at Anglicare, where she broke down, saying that gambling is like a drug for her and she just cannot stop, that her sons will hate her when they find out what she has done and that she could see no way of repairing their relationship. The financial counsellor is deeply concerned about Sandras mental health. The financial counsellor has referred Sandra to you, a mental health worker within Anglicare, youll be seeing Sandra tomorrow.
Case Study 10: JaneYou are a community health worker at Baptist Care in Port Augusta, a small, regional centre in South Australia. You work with all manner of people and their social problems. Jane is a woman you know through her work (she works at the local hardware store) and you often stop for a friendly chat with her when you buy your gardening supplies. This is one of the things you love about living in regional areas, the slow and friendly pace of life. However sometimes that close proximity can be problematic in your work. One example is that often you are aware of aspects of a persons problems without them knowing and this is one such example. Recently Jane made an appointment to see you, seeking mental health support. When you phoned Jane for a quick chat before her appointment you learned that Jane believes that her partner is having an affair. Jane has been recently diagnosed with schizophrenia so when she challenged her partner about having an affair, he insisted that he is not having an affair, but that it must be due to her schizophrenia and that she should have her head read. However, once you heard her partners name you felt ill, because you not only know that he is having an affair, but that he is having the affair with one of your friends.
