I start my week off with supervision. We spend the time discussing my most complex cases, as well as having a long discussion about certain difficulties particular to my role and my service user group. I have a long waiting list, and as such I can feel the pressure of wanting to assess people as quickly as possible. However, the needs of my service user group – autistic adults without learning disabilities – often require me to put relationship-based practice at the centre of my work, building trust and developing a true picture of someone’s (often masked) needs over time. The conflict between these two opposing principles is ongoing.
I work through my lunch break before visiting a new client with their mother at home. He is socially isolated, spending the majority of the time in his room on his phone browsing fashion websites. They tell me that they have so far only been let down by education and adult social care, who have not understood his needs or how to best support him.
My health condition flares up and so I am forced to work from home. A blessing in disguise, I spend the morning catching up on overdue paperwork, and the afternoon finishing two support plans that I have been co-producing with my clients. One of them is relatively expensive; they require a year’s support to help with their hoarding behavior, support to become a self-employed photographer from a specialist autism employment service, and ongoing support from a personal assistant. After all the work put into developing the plan, I worry about whether the funding panel will agree to the final cost.
I visit a young man at his college in the morning to begin his social care assessment. It is envisaged that his assessment will take around four to five meetings as his needs are complex and he can have difficulties keeping focus during meetings. He is intelligent, funny and articulate, but struggles immensely with anxiety, intrusive thoughts and anger, which are getting in the way of him achieving the grades he needs to attend his desired university course. Later in the day, while on a bus to a home visit, I receive a call from his younger sister’s social worker from children’s services. She tells me there is violence occurring at home.
This morning I receive a referral for a young man with autism who is to be evicted from his private tenancy the following week. Whilst previously functioning at a higher level, he is currently mute and non-communicative, neglecting to eat and drink, and has a history of financial exploitation from others. We desperately try to find him a safe placement to safeguard him from the risks that would be posed by homelessness or temporary accommodation.
I spend the morning making arrangements to take my client’s children out for the day over the Christmas holidays, giving her some much needed respite to prevent a “meltdown” from having the children at home full time for two weeks.
During my lunch break I participate in a working group for evaluating and improving the local authority’s support to autistic residents in regards to education, training and employment.
Later in the afternoon I visit a young adult who was referred to me by a GP concerned that they are isolated, living in unsuitable accommodation and have been taking prescription drugs purchased from the internet. The flat smells overwhelmingly of damp, and the walls are visibly black with mould in places. We speak in their corridor for 45 minutes and they tell me they feel shy meeting new people. We have a strange and wonderful conversation – they know absolutely everything about autism, but refuse to say the word “autism” itself.
Despite obvious support needs, they are ambivalent about receiving any assistance from me. We agree that I will come back to visit again. I hope that building a relationship with them will form the foundation for them accepting positive support in the future.