SONDAI THE NEW EXPERIENCES Subject area: Practice: Children and Families Title: Sondai: The New Experiences Prepared by:Bernadette Cyrus

SONDAI THE NEW EXPERIENCES  Target Audience: Caregivers, Health Care Providers, Parents, HIV- AIDS, Social Workers  Key Transferable Lessons: (1) Many psychological issues affect parents/ caregivers of children living with HIV-AIDS, including grief and fear of death (2) This is exacerbated by social issues such as lack of social support and unemployment (3) Formal and informal support systems are necessary in dealing with psychosocial issues of HIV-AIDS

Abstract: This presentation represents two aspects of clinical practice: The strong feelings that the disclosure procedure evoked in student, and the method used to resolve these feelings. The group process and the impact on the group members.

AGENCIES  Prevention of Mother to Child Transmission Program-Mt. Hope Women's Hospital, Mt. Hope.  The Pediatric Special Clinic – Eric Williams Medical Sciences Complex, Mt. Hope.

Role of the Student To assess psychosocial needs of client group. To plan and implement appropriate social work interventions. To investigate the issue of adherence to treatment.

Description of the Population HIV Infected/Exposed HIV Affected Lower socio-economic level Unemployed/Minimum wage earners

Psychosocial Issues of Client Group PARENT/CAREGIVER o Fear of disclosure to family members o Fear of developing AIDS o Inadequate financial and material resources o Lack of social support o Unemployment

Psychosocial Issues of Client Group Child Care Death and Dying Treatment Adherence Multiple grief

Psychosocial Issues of Client Group CHILD o Separation and loss o Interrupted Schooling o Delayed development o Illness and hospitalization

Needs of the Client Group The need to be treated as an individual – not a HIV positive patient but as a patient with a HIV positive diagnosis The need to be heard – the client needs to tell his/her story expressing the unique life experiences and worldview The need to have HIV/AIDS information clarified and reinforced in order to make an informed decision. The need to be given formal and informal social support to effectively manage his/her life

Needs of the Client Group The need to develop problem solving and coping skills to deal with the related challenges of HIV/AIDS The need to be linked to appropriate services and resources The need to have all interaction with health care providers be treated with confidentiality The need to have resiliency factors identified and strengthened

Prevention of Mother to Child Transmission Program The most challenging experience: HIV+ post test counseling Informing client of the HIV positive test result. o The task evoked strong feelings of sadness, since student saw herself as bearer of bad news. o The supervisory consultation with long-arm practice teacher and peer was used to discuss feelings and address issues of self. o The feedback allowed student to see herself as “Bearer of bad news brings hope”

Prevention of Mother to Child Transmission Program Major Issues o Repeat pregnancies o Discordant couples( one HIV+ & one HIV-) o Treatment adherence

The Pediatric Special Clinic The most rewarding experience: The Psychoeducational Group The Planning Phase o Interviews – to gather data on the needs of the clients – this informed the intervention. o Dynamic environment – the clinic main focus was on medical treatment, so innovative strategies were adopted for the psychoeducational group to become part of the clinic activities.

The Pediatric Special Clinic Sponsorship – The National AIDS Coordinating Committee funded the meals. Sessions – four two-hour sessions on clinic dates. Topics – Self-care and Child-care

The Pediatric Special Clinic Implementation Phase Group discussion on the following: o Session one – The Social Self o Session two – The Emotional Self o Session three – The Physical Self o Session four – The Intellectual Self

The Pediatric Special Clinic Termination o Emotional ending – group members tearful during final session disappointed that group had come to an end. o Continuity – student sought and obtained commitment for the continuation of group.

The Pediatric Special Clinic Evaluation The following areas of the group session were evaluated: Delivery of information Topics Needs/Interests in support group

The Way Forward Following discussions with the Coordinator of the Prevention of Mother-to-Child Transmission Unit, it was seen as important to continue the valuable work started at the antenatal clinic. Two Social Work students have been placed at the Unit for the academic year 2006/07.

The Way Forward (cont’d.) The psychoeducational group will continue. The plan is to establish a team of Social Work practitioners to take the group forward. The vision is to promote group leadership within the membership so that the group can become self-regulating and fully owned by the participants.

Thank You