Definition of 'holistic'
For a worker to respond holistically to a client’s issues, they need to:
- appreciate the complexity of the person’s situation/issues and the environment in which that situation/issue occurs
- understand how this issue/situation affects the client in all aspects of their functioning – physical, emotional, spiritual, and mental
- establish an effective and trusting relationship with the client to explore their options with them so they can resolve their issues
- liaise with other significant people or organisations in the client’s life to facilitate the client’s goals and action plans.
This section looks at evaluating the range of issues impacting on the client and on the delivery of appropriate services, including:
- identifying the indicators of harm, neglect, abuse or risk of harm
- using observations, assessment tools and questioning to identify possible presenting issues
- seeking information to determine the range of issues that may be affecting the client, within the organisation's policies and procedures regarding autonomy, privacy and confidentiality
- applying organisational procedures for collecting and analysing client information
- examining all client information to determine the degree to which other issues may impact on the possible services that can be provided by your organisation.
Holism is a term from the Greek word holos, meaning whole. Thousands of years ago Aristotle encapsulated the principle of holism when he wrote, ‘The whole is more than the sum of its parts’ (from Aristotle’s Metaphysics). When we apply this concept to human beings, it brings awareness that we cannot really know a person without learning about all aspects of their life and understanding the impact of the interrelationships between those aspects.
This has been most clearly seen in the area of health care, where the concept of holistic health care has replaced the more traditional medical model. The traditional approach of treating the illness and not the person failed miserably to improve the overall wellness of patients. In addition the medical model raised the status of the medical profession to that of a divinity and effectively removed the right and responsibility of the patient to be a decision maker or even a participant in their own care.
However, the concept of holistic care is not restricted to the field of medicine and health care. It is now the guiding principle in all forms of community and disability service work. Workers in all sectors (e.g. domestic violence work, youth work, and disability services work) need to adopt an approach that emphasises the need to look at the whole person and consider their physical, environmental, emotional, social, spiritual and lifestyle situation. To achieve this, you attempt to understand the interplay of personal, relationship and social factors that affect the current situation for each client. This approach recognises that people need resources, support and knowledge so they can make choices that will better enable them to function in their environment (Berger, RL, McBreen, JT, & Rifkin, MJ 1996).
Hence holistic care focuses on educating the person so that they can take responsibility for achieving balance and wellbeing in their life. It promotes a belief in the ability of clients to control or at least participate in the planning of their lives if given the necessary knowledge, skills and support.
Working with clients in an holistic approach requires you to look at the person from a whole-of-life perspective, including:
- emotional support
- health and mental health
- legal issues.
People and the situations in which they find themselves are very complex. Clients are likely to present with multiple issues. They may be referred to the agency you work for, or contact the agency themselves, because of one presenting problem but it is very likely that this presenting problem is only one issue relating to a broader range of problems that the client is experiencing. A client’s social, emotional, spiritual and physical wellbeing needs to be seen within the broader context of their world.
Case study: Support worker situation
Read the case study below and then the reflection that follows.
You are a support worker in a youth accommodation service. A young person comes in one night who you suspect is under the influence of drugs. She is highly agitated, displaying physical and emotional indicators of extreme distress. In your first few minutes with her, she reveals that she has been working as a prostitute in order to support her drug habit and that one of her regular clients has begun stalking her and threatening her if she doesn’t ‘drop all those others and come with me ’.
Reflect on how you might deal with this situation and make some notes in your reflective journal. As you work through this unit, you may like to add strategies and methods used to deal with this and other situations.
In order to appreciate the complexity of an issue that a client is confronted with/presents with, some form of assessment of the situation is made. You, as a youth worker, are likely to be involved in this process at some level as it relates to your role and the agency’s policies and procedures.
Most agencies cannot possibly meet every need in helping their clients to achieve their goals. However, workers who adopt an holistic approach will be more in tune with the areas of assistance a client needs and can achieve a comprehensive and integrated service delivery, using a referral network of appropriate local and accessible professionals, services and community groups.
Clients often present with multiple issues. The situations in which they find themselves can be extremely complex. For this reason multi-agency support is often considered the best approach to support the client. Multi-agency support (sometimes referred to as multidisciplinary case management) is a collaborative approach that assumes that all service providers are committed to providing an optimal service to clients to maximise their potential for change.
In some agencies where there are clients with highly complex needs, multidisciplinary teams and inter-agency workers meet together regularly to support a client’s planning and progress.