Discussion Help – Tiffany Case

Discussion Help – Tiffany Case

Discussion: Using Research to Select a Therapeutic Modality

Imagine that some of your colleagues mention using cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, and reality therapy. Your colleagues continue to say that based on their experiences, they really like these therapies and that they appear to work. Your instincts also tell you that perhaps they might be helpful for your client in your case study. However, from Week 1, you recall that experiences and instincts as sources of knowledge are quite limited because they are biased. Instead, it is important to utilize existing research and data to support your choices of interventions. Theory helps inform the evidence-based practice process that should guide social workers’ practice.

In this Discussion, you examine the research related to a therapy based on cognitive or cognitive behavior theory to determine its effectiveness.

To prepare:

  • Recall the client from the case study you have been using in this course. You will apply your research for this Discussion to that client.
  • Select one therapy from the following: cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, or reality therapy.
  • Conduct a search in the Walden Library for one peer-reviewed research study about the effectiveness of the therapy you selected.
    • Note: You must select a study that has not already been used by a colleague in the Discussion. Each student is required to identify a unique research study.
  • Remember when looking for studies to take into account your client’s age and developmental stage and presenting problem.

By Day 3

Post:

  • Provide the reference for the study you found using APA guidelines.
  • Briefly paraphrase, in 2 to 3 sentences, the methodological context (i.e., research method, how data was collected, and the instruments used) of the study and the findings.
  • Evaluate the findings in terms of its applicability or appropriateness for the client in your case study.
  • Determine whether you would use or not use the therapy you selected for the client in your selected case study (consider how culturally relevant it is, how aligned it is with social work ethics, etc.)

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Theory Into Practice: Four Social Work Case Studies

 

 

In this course, you select one of the following four case studies and use it throughout the entire course. By doing this, you will have the opportunity to see how different theories guide your view of a client and that client’s presenting problem. Each time you return to the same case, you use a different theory, and your perspective of the problem changes—which then changes how you ask assessment questions and how you intervene.

 

These case studies are based on the video- and web-based case studies you encounter in the MSW program.

 

 

 

 

Table of Contents

 

Tiffani Bradley ………………………………………………………………………………………………….. 2

 

Paula Cortez ……………………………………………………………………………………………………. 9

 

Jake Levey …………………………………………………………………………………………………….. 10

 

Helen Petrakis ………………………………………………………………………………………………… 13

 

 

 

Tiffani Bradley

 

Identifying Data: Tiffani Bradley is a 16-year-old Caucasian female. She was raised in a Christian family in Philadelphia, PA. She is of German descent. Tiffani’s family consists of her father, Robert, 38 years old; her mother, Shondra, 33 years old, and her sister, Diana, 13 years old. Tiffani currently resides in a group home, Teens First, a brand new, court-mandated teen counseling program for adolescent victims of sexual exploitation and human trafficking. Tiffani has been provided room and board in the residential treatment facility for the past 3 months. Tiffani describes herself as heterosexual.

 

Presenting Problem: Tiffani has a history of running away. She has been arrested on three occasions for prostitution in the last 2 years. Tiffani has recently been court ordered to reside in a group home with counseling. She has a continued desire to be reunited with her pimp, Donald. After 3 months at Teens First, Tiffani said that she had a strong desire to see her sister and her mother. She had not seen either of them in over 2 years and missed them very much. Tiffani is confused about the path to follow. She is not sure if she wants to return to her family and sibling or go back to Donald.

 

Family Dynamics: Tiffani indicates that her family worked well together until 8 years ago. She reports that around the age of 8, she remembered being awakened by music and laughter in the early hours of the morning. When she went downstairs to investigate, she saw her parents and her Uncle Nate passing a pipe back and forth between them. She remembered asking them what they were doing and her mother saying, “adult things” and putting her back in bed. Tiffani remembers this happening on several occasions. Tiffani also recalls significant changes in the home’s appearance. The home, which was never fancy, was always neat and tidy. During this time, however, dust would gather around the house, dishes would pile up in the sink, dirt would remain on the floor, and clothes would go for long periods of time without being washed. Tiffani began cleaning her own clothes and making meals for herself and her sister. Often there was not enough food to feed everyone, and Tiffani and her sister would go to bed hungry. Tiffani believed she was responsible for helping her mom so that her mom did not get so overwhelmed. She thought that if she took care of the home and her sister, maybe that would help mom return to the person she was before.

 

Sometimes Tiffani and her sister would come downstairs in the morning to find empty beer cans and liquor bottles on the kitchen table along with a crack pipe. Her parents would be in the bedroom, and Tiffani and her sister would leave the house and go to school by themselves. The music and noise downstairs continued for the next 6 years, which escalated to screams and shouting and sounds of people fighting.

Tiffani remembers her mom one morning yelling at her dad to “get up and go to work.” Tiffani and Diana saw their dad come out of the bedroom and slap their mom so hard she was knocked down. Dad then went back into the bedroom. Tiffani remembers thinking that her mom was not doing what she was supposed to do in the house, which is what probably angered her dad.

 

Shondra and Robert have been separated for a little over a year and have started dating other people. Diana currently resides with her mother and Anthony, 31 years old, who is her mother’s new boyfriend.

 

Educational History: Tiffani attends school at the group home, taking general education classes for her general education development (GED) credential. Diana attends Town Middle School and is in the 8th grade.

 

Employment History: Tiffani reports that her father was employed as a welding apprentice and was waiting for the opportunity to join the union. Eight years ago, he was laid off due to financial constraints at the company. He would pick up odd jobs for the next 8 years but never had steady work after that. Her mother works as a home health aide. Her work is part-time, and she has been unable to secure full-time work.

 

Social History: Over the past 2 years, Tiffani has had limited contact with her family members and has not been attending school. Tiffani did contact her sister Diana a few times over the 2-year period and stated that she missed her very much. Tiffani views Donald as her “husband” (although they were never married) and her only friend. Previously, Donald sold Tiffani to a pimp, “John T.” Tiffani reports that she was very upset Donald did this and that she wants to be reunited with him, missing him very much. Tiffani indicates that she knows she can be a better “wife” to him. She has tried to make contact with him by sending messages through other people, as John T. did not allow her access to a phone. It appears that over the last 2 years, Tiffani has had neither outside support nor interactions with anyone beyond Donald, John T., and some other young women who were prostituting.

 

Mental Health History: On many occasions Tiffani recalls that when her mother was not around, Uncle Nate would ask her to sit on his lap. Her father would sometimes ask her to show them the dance that she had learned at school. When she danced, her father and Nate would laugh and offer her pocket change. Sometimes, their friend Jimmy joined them. One night, Tiffani was awakened by her uncle Nate and his friend Jimmy. Her parents were apparently out, and they were the only adults in the home. They asked her if she wanted to come downstairs and show them the new dances she learned at school. Once downstairs Nate and Jimmy put some music on and started to dance. They asked Tiffani to start dancing with them, which she did. While they were dancing, Jimmy spilled some beer on her. Nate said she had to go to the bathroom to clean up. Nate, Jimmy, and Tiffani all went to the bathroom. Nate asked Tiffani to take her clothes off and get in the bath. Tiffani hesitated to do this, but Nate insisted it was OK since he and Jimmy were family. Tiffani eventually relented and began to wash up. Nate would tell her that she missed a spot and would scrub the area with his hands. Incidents like this continued to occur with increasing levels of molestation each time.

 

The last time it happened, when Tiffani was 14, she pretended to be willing to dance for them, but when she got downstairs, she ran out the front door of the house. Tiffani vividly remembers the fear she felt the nights Nate and Jimmy touched her, and she was convinced they would have raped her if she stayed in the house.

 

About halfway down the block, a car stopped. The man introduced himself as Donald, and he indicated that he would take care of her and keep her safe when these things happened. He then offered to be her boyfriend and took Tiffani to his apartment. Donald insisted Tiffani drink beer. When Tiffani was drunk, Donald began kissing her, and they had sex. Tiffani was also afraid that if she did not have sex, Donald would not let her stay— she had nowhere else to go. For the next 3 days, Donald brought her food and beer and had sex with her several more times. Donald told Tiffani that she was not allowed to do anything without his permission. This included watching TV, going to the bathroom, taking a shower, and eating and drinking. A few weeks later, Donald bought Tiffani a dress, explaining to her that she was going to “find a date” and get men to pay her to have sex. When Tiffani said she did not want to do that, Donald hit her several times. Donald explained that if she didn’t do it, he would get her sister Diana and make her do it instead. Out of fear for her sister, Tiffani relented and did what Donald told her to do. She thought at this point her only purpose in life was to be a sex object, listen, and obey—and then she would be able to keep the relationships and love she so desired.

 

Legal History: Tiffani has been arrested three times for prostitution. Right before the most recent charge, a new state policy was enacted to protect youth 16 years and younger from prosecution and jail time for prostitution. The Safe Harbor for Exploited Children Act allows the state to define Tiffani as a sexually exploited youth, and therefore the state will not imprison her for prostitution. She was mandated to services at the Teens First agency, unlike her prior arrests when she had been sent to detention.

 

Alcohol and Drug Use History: Tiffani’s parents were social drinkers until about 8 years ago. At that time Uncle Nate introduced them to crack cocaine. Tiffani reports using alcohol when Donald wanted her to since she wanted to please him, and she thought this was the way she would be a good “wife.” She denies any other drug use.

 

Medical History: During intake, it was noted that Tiffani had multiple bruises and burn marks on her legs and arms. She reported that Donald had slapped her when he felt she did not behave and that John T. burned her with cigarettes. She had realized that she did some things that would make them mad, and she tried her hardest to keep them pleased even though she did not want to be with John T. Tiffani has been treated for several sexually transmitted infections (STIs) at local clinics and is currently on an antibiotic for a kidney infection. Although she was given condoms by Donald and John T. for her “dates,” there were several “Johns” who refused to use them.

 

Strengths: Tiffani is resilient in learning how to survive the negative relationships she has been involved with. She has as sense of protection for her sister and will sacrifice herself to keep her sister safe.

 

Robert Bradley: father, 38 years old

Shondra Bradley: mother, 33 years old

Nate Bradley: uncle, 36 years old

Tiffani Bradley: daughter, 16 years old

Diana Bradley: daughter, 13 years old

Donald: Tiffani’s self-described husband and her former pimp

Anthony: Shondra’s live-in partner, 31 years old

John T.: Tiffani’s most recent pimp

   

Paula Cortez

 

Identifying Data: Paula Cortez is a 43-year-old Catholic Hispanic female residing in New

York City, NY. Paula was born in Colombia. When she was 17 years old, Paula left Colombia and moved to New York where she met David, who later became her husband. Paula and David have one son, Miguel, 20 years old. They divorced after 5 years of marriage. Paula has a five-year-old daughter, Maria, from a different relationship.

 

Presenting Problem: Paula has multiple medical issues, and there is concern about whether she will be able to continue to care for her youngest child, Maria. Paula has been overwhelmed, especially since she again stopped taking her medication. Paula is also concerned about the wellness of Maria.

 

Family Dynamics: Paula comes from a moderately well-to-do family. Paula reports suffering physical and emotional abuse at the hands of both her parents, eventually fleeing to New York to get away from the abuse. Paula comes from an authoritarian family where her role was to be “seen and not heard.” Paula states that she did not feel valued by any of her family members and reports never receiving the attention she needed. As a teenager, she realized she felt “not good enough” in her family system, which led to her leaving for New York and looking for “someone to love me.” Her parents still reside in Colombia with Paula’s two siblings.

 

Paula met David when she sought to purchase drugs. They married when Paula was 18 years old. The couple divorced after 5 years of marriage. Paula raised Miguel, mostly by herself, until he was 8 years old, at which time she was forced to relinquish custody due to her medical condition. Paula maintains a relationship with her son, Miguel, and her ex-husband, David. Miguel takes part in caring for his half-sister, Maria.

 

Paula does believe her job as a mother is to take care of Maria but is finding that more and more challenging with her physical illnesses.

 

Employment History: Paula worked for a clothing designer, but she realized that her true passion was painting. She has a collection of more than 100 drawings and paintings, many of which track the course of her personal and emotional journey. Paula held a fulltime job for a number of years before her health prevented her from working. She is now unemployed and receives Supplemental Security Disability Insurance (SSD) and Medicaid. Miguel does his best to help his mom but only works part time at a local supermarket delivering groceries.

 

Paula currently uses federal and state services. Paula successfully applied for WIC, the federal Supplemental Nutrition Program for Women, Infants, and Children. Given Paula’s low income, health, and Medicaid status, Paula is able to receive in-home childcare assistance through New York’s public assistance program.

 

Social History: Paula is bilingual, fluent in both Spanish and English. Although Paula identifies as Catholic, she does not consider religion to be a big part of her life. Paula lives with her daughter in an apartment in Queens, NY. Paula is socially isolated as she has limited contact with her family in Colombia and lacks a peer network of any kind in her neighborhood.

 

Five (5) years ago Paula met a man (Jesus) at a flower shop. They spoke several times. He would visit her at her apartment to have sex. Since they had an active sex life, Paula thought he was a “stand-up guy” and really liked him. She believed he would take care of her. Soon everything changed. Paula began to suspect that he was using drugs, because he had started to become controlling and demanding. He showed up at her apartment at all times of the night demanding to be let in. He called her relentlessly, and when she did not pick up the phone, he left her mean and threatening messages. Paula was fearful for her safety and thought her past behavior with drugs and sex brought on bad relationships with men and that she did not deserve better. After a couple of months, Paula realized she was pregnant. Jesus stated he did not want anything to do with the “kid” and stopped coming over, but he continued to contact and threaten Paula by phone. Paula has no contact with Jesus at this point in time due to a restraining order.

 

Mental Health History: Paula was diagnosed with bipolar disorder. She experiences periods of mania lasting for a couple of weeks then goes into a depressive state for months when not properly medicated. Paula has a tendency toward paranoia. Paula has a history of not complying with her psychiatric medication treatment because she does not like the way it makes her feel. She often discontinues it without telling her psychiatrist. Paula has had multiple psychiatric hospitalizations but has remained out of the hospital for the past 5 years. Paula accepts her bipolar diagnosis but demonstrates limited insight into the relationship between her symptoms and her medication.

 

Paula reports that when she was pregnant, she was fearful for her safety due to the baby’s father’s anger about the pregnancy. Jesus’ relentless phone calls and voicemails rattled Paula. She believed she had nowhere to turn. At that time, she became scared, slept poorly, and her paranoia increased significantly. After completing a suicide assessment 5 years ago, it was noted that Paula was decompensating quickly and was at risk of harming herself and/or her baby. Paula was involuntarily admitted to the psychiatric unit of the hospital. Paula remained on the unit for 2 weeks.

 

Educational History: Paula completed high school in Colombia. Paula had hoped to attend the Fashion Institute of Technology (FIT) in New York City, but getting divorced, then raising Miguel on her own interfered with her plans. Miguel attends college full time in New York City.

 

Medical History: Paula was diagnosed as HIV positive 15 years ago. Paula acquired AIDS three years later when she was diagnosed with a severe brain infection and a Tcell count of less than 200. Paula’s brain infection left her completely paralyzed on the right side. She lost function in her right arm and hand as well as the ability to walk. After

a long stay in an acute care hospital in New York City, Paula was transferred to a skilled nursing facility (SNF) where she thought she would die. After being in the skilled nursing facility for more than a year, Paula regained the ability to walk, although she does so with a severe limp. She also regained some function in her right arm. Her right hand (her dominant hand) remains semi-paralyzed and limp. Over the course of several years, Paula taught herself to paint with her left hand and was able to return to her beloved art.

 

Paula began treatment for her HIV/AIDS with highly active antiretroviral therapy (HAART). Since she ran away from the family home, married and divorced a drug user, then was in an abusive relationship, Paula thought she deserved what she got in life. She responded well to HAART and her HIV/AIDS was well controlled. In addition to her HIV/AIDS disease, Paula is diagnosed with Hepatitis C (Hep C). While this condition was controlled, it has reached a point where Paula’s doctor is recommending she begin a new treatment. Paula also has significant circulatory problems, which cause her severe pain in her lower extremities. She uses prescribed narcotic pain medication to control her symptoms. Paula’s circulatory problems have also led to chronic ulcers on her feet that will not heal. Treatment for her foot ulcers demands frequent visits to a wound care clinic. Paula’s pain paired with the foot ulcers make it difficult for her to ambulate and leave her home. Paula has a tendency not to comply with her medical treatment. She often disregards instructions from her doctors and resorts to holistic treatments like treating her ulcers with chamomile tea. When she stops her treatment, she deteriorates quickly.

 

Maria was born HIV negative and received the appropriate HAART treatment after birth. She spent a week in the neonatal intensive care unit as she had to detox from the effects of the pain medication Paula took throughout her pregnancy.

 

Legal History: Previously, Paula used the AIDS Law Project, a not-for-profit organization that helps individuals with HIV address legal issues, such as those related to the child’s father . At that time, Paula filed a police report in response to Jesus’ escalating threats and successfully got a restraining order. Once the order was served, the phone calls and visits stopped, and Paula regained a temporary sense of control over her life.

 

Paula completed the appropriate permanency planning paperwork with the assistance of the organization The Family Center. She named Miguel as her daughter’s guardian should something happen to her.

 

Alcohol and Drug Use History: Paula became an intravenous drug user (IVDU), using cocaine and heroin, at age 17. David was one of Paula’s “drug buddies” and suppliers. Paula continued to use drugs in the United States for several years; however, she stopped when she got pregnant with Miguel. David continued to use drugs, which led to the failure of their marriage.

 

Strengths: Paula has shown her resilience over the years. She has artistic skills and has found a way to utilize them. Paula has the foresight to seek social services to help her and her children survive. Paula has no legal involvement. She has the ability to bounce back from her many physical and health challenges to continue to care for her child and maintain her household.

 

David Cortez: father, 46 years old

Paula Cortez: mother, 43 years old

Miguel Cortez: son, 20 years old

Jesus (unknown): Maria’s father, 44 years old

Maria Cortez: daughter, 5 years old

 

 

 

       

Jake Levy

 

Identifying Data: Jake Levy is a 31-year-old, married, Jewish Caucasian male. Jake’s wife, Sheri, is 28 years old. They have two sons, Myles (10) and Levi (8). The family resides in a two-bedroom condominium in a middle-class neighborhood in Rockville, MD. They have been married for 10 years.

 

Presenting Problem: Jake, an Iraq War veteran, came to the Veterans Affairs Health Care Center (VA) for services because his wife has threatened to leave him if he does not get help. She is particularly concerned about his drinking and lack of involvement in their sons’ lives. She told him his drinking has gotten out of control and is making him mean and distant. Jake reports that he and his wife have been fighting a lot and that he drinks to take the edge off and to help him sleep. Jake expresses fear of losing his job and his family if he does not get help. Jake identifies as the primary provider for his family and believes that this is his responsibility as a husband and father. Jake realizes he may be putting that in jeopardy because of his drinking. He says he has never seen Sheri so angry before, and he saw she was at her limit with him and his behaviors.

 

Family Dynamics: Jake was born in Alabama to a Caucasian, Eurocentric family system. He reports his time growing up to have been within a “normal” family system. However, he states that he was never emotionally close to either parent and viewed himself as fairly independent from a young age. His dad had previously been in the military and was raised with the understanding that his duty is to support his country. His family displayed traditional roles, with his dad supporting the family after he was discharged from military service. Jake was raised to believe that real men do not show weakness and must be the head of the household.

 

Jake’s parents are deceased, and he has a sister who lives outside London. He and his sister are not very close but do talk twice a year. Sheri is an only child, and although her mother lives in the area, she offers little support. Her mother never approved of Sheri marrying Jake and thinks Sheri needs to deal with their problems on her own. Jake reports that he has not been engaged with his sons at all since his return from Iraq, and he keeps to himself when he is at home.

 

Employment History: Jake is employed as a human resources assistant for the military. Jake works in an office with civilians and military personnel and mostly gets along with people in the office. Jake is having difficulty getting up in the morning to go to work, which increases the stress between Sheri and himself. Shari is a special education teacher in a local elementary school. Jake thinks it is his responsibility to provide for his family and is having stress over what is happening to him at home and work. He thinks he is failing as a provider.

 

Social History: Jake and Sheri identify as Jewish and attend a local synagogue on major holidays. Jake tends to keep to himself and says he sometimes feels pressured to be more communicative and social. Jake believes he is socially inept and not able to develop friendships. The couple has some friends, since Shari gets involved with the parents in their sons’ school. However, because of Jake’s recent behaviors, they have become socially isolated. He is very worried that Sheri will leave him due to the isolation.

 

Mental Health History: Jake reports that since his return to civilian life 10 months ago, he has difficulty sleeping, frequent heart palpitations, and moodiness. Jake had seen Dr. Zoe, a psychiatrist at the VA, who diagnosed him with post-traumatic stress disorder (PTSD). Dr. Zoe prescribed Paxil to help reduce his symptoms of anxiety and depression and suggested that he also begin counseling. Jake says that he does not really understand what PTSD is but thought it meant that a person who had it was

“going crazy,” which at times he thought was happening to him. He expresses concern that he will never feel “normal” again and says that when he drinks alcohol, his symptoms and the intensity of his emotions ease. Jake describes that he sometimes thinks he is back in Iraq, which makes him feel uneasy and watchful. He hates the experience and tries to numb it. He has difficulty sleeping and is irritable, so he isolates himself and soothes this with drinking. He talks about always feeling

“ready to go.” He says he is exhausted from being always alert and looking for potential problems around him. Every sound seems to startle him. He shares that he often thinks about what happened “over there” but tries to push it out of his mind. Nighttime is the worst, as he has terrible recurring nightmares of one particular event. He says he wakes up shaking and sweating most nights. He adds that drinking is the one thing that seems to give him a little relief.

 

Educational History: Sheri has a bachelor’s degree in special education from a local college. Jake has a high school diploma but wanted to attend college upon his return from the military.

 

Military History: Jake is an Iraqi War veteran. He enlisted in the Marines at 21 years old when he and Shari got married due to Sheri being pregnant. The family was stationed in several states prior to Jake being deployed to Iraq. Jake left the service 10 months ago. Sheri and Jake had used military housing since his marriage, making it easier to support the family. On military bases, there was a lot of social support and both Jake and Sheri took full advantage of the social systems available to them during that time.

 

Medical History: Jake is physically fit, but an injury he sustained in combat sometimes limits his ability to use his left hand. Jake reports sometimes feeling inadequate because of the reduction in the use of his hand and tries to push through because he worries how the injury will impact his responsibilities as a provider, husband, and father. Jake considers himself resilient enough to overcome this disadvantage and “be able to do the things I need to do.” Sheri is in good physical condition and has recently found out that she is pregnant with their third child.

 

Legal History: Jake and Sheri deny having criminal histories.

 

Alcohol and Drug Use History: As teenagers, Jake and Sheri used marijuana and drank. Both deny current use of marijuana but report they still drink. Sheri drinks socially and has one or two drinks over the weekend. Jake reports that he has four to five drinks in the evenings during the week and eight to ten drinks on Saturdays and Sundays. Jake spends his evenings on the couch drinking beer and watching TV or playing video games. Shari reports that Jake drinks more than he realizes, doubling what Jake has reported.

 

Strengths: Jake is cognizant of his limitations and has worked on overcoming his physical challenges. Jake is resilient. Jake did not have any disciplinary actions taken against him in the military. He is dedicated to his wife and family.

 

Jake Levy: father, 31 years old

Sheri Levy: mother, 28 years old

Myles Levy: son, 10 years old

Levi Levy: son, 8 years old

 

Helen Petrakis

 

Identifying Data: Helen Petrakis is a 52-year-old, Caucasian female of Greek descent living in a four-bedroom house in Tarpon Springs, FL. Her family consists of her husband, John (60), son, Alec (27), daughter, Dmitra (23), and daughter Althima (18). John and Helen have been married for 30 years. They married in the Greek Orthodox Church and attend services weekly.

 

Presenting Problem: Helen reports feeling overwhelmed and “blue.” She was referred by a close friend who thought Helen would benefit from having a person who would listen. Although she is uncomfortable talking about her life with a stranger, Helen says that she decided to come for therapy because she worries about burdening friends with her troubles. John has been expressing his displeasure with meals at home, as Helen has been cooking less often and brings home takeout. Helen thinks she is inadequate as a wife. She states that she feels defeated; she describes an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. Helen reports feeling overwhelmed by her responsibilities and believes she can’t handle being a wife, mother, and caretaker any longer.

 

Family Dynamics: Helen describes her marriage as typical of a traditional Greek family. John, the breadwinner in the family, is successful in the souvenir shop in town. Helen voices a great deal of pride in her children. Dmitra is described as smart, beautiful, and hardworking. Althima is described as adorable and reliable. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintaining the family’s cars. Helen believes the children are too busy to be expected to help around the house, knowing that is her role as wife and mother. John and Helen choose not to take money from their children for any room or board. The Petrakis family holds strong family bonds within a large and supportive Greek community.

 

Helen is the primary caretaker for Magda (John’s 81-year-old widowed mother), who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. Six months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Helen and John hired a reliable and trusted woman temporarily to check in on Magda a couple of days each week. Helen would go and see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. Helen would go food shopping for Magda, clean her home, pay her bills, and keep track of Magda’s medications. Since Helen thought she was unable to continue caretaking for both Magda and her husband and kids, she wanted the helper to come in more often, but John said they could not afford it. The money they now pay to the helper is coming out of the couple’s vacation savings. Caring for Magda makes Helen think she is failing as a wife and mother because she no longer has time to spend with her husband and children.

 

Helen spoke to her husband, John (the family decision maker), and they agreed to have Alec (their son) move in with Magda (his grandmother) to help relieve Helen’s burden and stress. John decided to pay Alec the money typically given to Magda’s helper. This has not decreased the burden on Helen since she had to be at the apartment at least once daily to intervene with emergencies that Alec is unable to manage independently. Helen’s anxiety has increased since she noted some of Magda’s medications were missing, the cash box was empty, Magda’s checkbook had missing checks, and jewelry from Greece, which had been in the family for generations, was also gone.

 

Helen comes from a close-knit Greek Orthodox family where women are responsible for maintaining the family system and making life easier for their husbands and children. She was raised in the community where she currently resides. Both her parents were born in Greece and came to the United States after their marriage to start a family and give them a better life. Helen has a younger brother and a younger sister. She was responsible for raising her siblings since both her parents worked in a fishery they owned. Helen feared her parents’ disappointment if she did not help raise her siblings. Helen was very attached to her parents and still mourns their loss. She idolized her mother and empathized with the struggles her mother endured raising her own family. Helen reports having that same fear of disappointment with her husband and children.

 

Employment History: Helen has worked part time at a hospital in the billing department since graduating from high school. John Petrakis owns a Greek souvenir shop in town and earns the larger portion of the family income. Alec is currently unemployed, which Helen attributes to the poor economy. Dmitra works as a sales consultant for a major department store in the mall. Althima is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant. During town events, Dmitra and Althima help in the souvenir shop when they can.

 

Social History: The Petrakis family live in a community centered on the activities of the Greek Orthodox Church. Helen has used her faith to help her through the more difficult challenges of not believing she is performing her “job” as a wife and mother. Helen reports that her children are religious but do not regularly go to church because they are very busy. Helen has stopped going shopping and out to eat with friends because she can no longer find the time since she became a caretaker for Magda.  

 

Mental Health History: Helen consistently appears well groomed. She speaks clearly and in moderate tones and seems to have linear thought progression—her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. More recently, Helen is overwhelmed by thinking she is inadequate. She stopped socializing and finds no activity enjoyable. In some situations in her life, she is feeling powerless.

 

Educational History: Helen and John both have high school diplomas. Helen is proud of her children knowing she was the one responsible in helping them with their homework. Alec graduated high school and chose not to attend college. Dmitra attempted college but decided that was not the direction she wanted. Althima is an honors student at a local college.

 

Medical History: Helen has chronic back pain from an old injury, which she manages with acetaminophen as needed. Helen reports having periods of tightness in her chest and a feeling that her heart was racing along with trouble breathing and thinking that she might pass out. One time, John brought her to the emergency room. The hospital ran tests but found no conclusive organic reason to explain Helen’s symptoms. She continues to experience shortness of breath, usually in the morning when she is getting ready to begin her day. She says she has trouble staying asleep, waking two to four times each night, and she feels tired during the day. Working is hard because she is more forgetful than she has ever been. Helen says that she feels like her body is one big tired knot.

 

Legal History: The only member of the Petrakis family that has legal involvement is Alec. He was arrested about 2 years ago for possession of marijuana. He was required to attend an inpatient rehabilitation program (which he completed) and was sentenced to 2 years’ probation. Helen was devastated, believing John would be disappointed in her for not raising Alec properly.

 

Alcohol and Drug Use History: Helen has no history of drug use and only drinks at community celebrations. Alec has struggled with drugs and alcohol since he was a teen. Helen wants to believe Alec is maintaining his sobriety and gives him the benefit of the doubt. Alec is currently on 2 years’ probation for possession and has recently completed an inpatient rehabilitation program. Helen feels responsible for his addiction and wonders what she did wrong as a mother.

 

Strengths: Helen has a high school diploma and has been successful at raising her family. She has developed a social support system, not only in the community but also within her faith at the Greek Orthodox Church. Helen is committed to her family system and their success. Helen does have the ability to multitask, taking care of her immediate family as well as fulfilling her obligation to her mother-in-law. Even under the current stressful circumstances, Helen is assuming and carrying out her responsibilities.

 

John Petrakis: father, 60 years old

Helen Petrakis: mother, 52 years old

Alec Petrakis: son, 27 years old

Dmitra Petrakis: daughter, 23 years old

Althima Petrakis: daughter, 18 years old

Magda Petrakis: John’s mother, 81 years old

 

 

Psychological Aspects of Aging

Psychological Aspects of Aging

Theories of successful aging explain factors that support individuals as they grow old, contributing to their ability to function. Increasing your understanding of factors that support successful aging improves your ability to address the needs of elderly clients and their families.

To prepare for this Discussion, review this week’s media. In addition, select a theory of successful aging to apply to Sara’s case.

Parker Family Episode 2 Program Transcript PARKER: Ever since my husband died, there’s been no one to talk to. It’s just, really, no one. And when Stephanie is home, I just feel so alone. FEMALE SPEAKER: What about the day center you go to? Isn’t that helping? PARKER: I don’t like it. What makes me really feel good, though, is when I go shopping, buying things. And my kittens. I love my cats. Oh, have you seen them? I have pictures. Just take a look. Look! These are so cute. My babies. FEMALE SPEAKER: Yes, they’re very cute. And wow, you have a lot of them.  PARKER: Oh, well, it’s their home, too, not just Princess Stephanie’s.  FEMALE SPEAKER: The day program you’re attending, are you seeing a  psychiatrist there?  PARKER: Yes. Dr. Lewin.  FEMALE SPEAKER: May I ask how that’s going?  PARKER: He says that I’m depressed.  FEMALE SPEAKER: In the pictures you showed me, you just talked about the  cats, but I also saw all the things you keep around you, the hoarding. I understand how depressed you been since your husband passed away. How alone you’ve felt. [SIGH] But I would like us to try and set up a plan to begin to address the hoarding. It’s very clear that that’s one of the big issues that’s affecting your relationship with Stephanie and your life together. Can we try that? PARKER: I don’t like it when we fight. She’s still my baby, too. Yes, I want to try.

References to use

 

Clark, E. (2018). Loss and suffering: The role of social work. Retrieved from

http://www.socialworker.com/feature-articles/practice/loss-and-suffering-the-role-of-social-work/

Fisher, C. (2018). Counseling connoisseur: Children and grief. Retrieved from

https://ct.counseling.org/2018/11/counseling-connoisseur-children-and-grief/

Zoll, L. (n.d.). A grief trajectory. Retrieved from https://www.socialworktoday.com/news/pp_063017_5.shtml

By Day 3

Post a Discussion in which you:

  • Explain key life events that have influenced Sara’s relationships. Be sure to substantiate what makes them key in your perspective.
  • Explain how you, as Sara’s social worker, might apply a theory of successful aging to her case. Be sure to provide support for your strategy.

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6210 Week 1 Discussion 2 Talia Case

6210 Week 1 Discussion 2 Talia Case

Discussion 2 – Week 1

Discussion 2: Resiliency

Perhaps you have observed a friend or family member after a tragedy and thought, “I’m not sure how they are managing” or “I wouldn’t be able to function.” Why do some individuals, despite overwhelming hardship, have the capacity to adapt and “bounce back,” whereas others, faced with similar circumstances, do not? The answer is resiliency, also referred to as resilience. Social workers help clients strengthen their resiliency as a protective factor against change and adversity across the life span.

Talia Johnson, whom you met briefly in HBSE I, is a young adult who has experienced a sexual assault. How might the concept of resiliency apply to her? For this Discussion, you explore resiliency and integrate it in social work practice using Talia’s case. As you progress through the course, continue to consider resiliency’s role in well-being across the life span.

To Prepare:

  • Review the Learning Resources      on resiliency.
  • Access the Social Work Case      Studies media and navigate to Talia.
  • As you explore Talia’s case,      imagine that you are her social worker, and consider how you might apply      the concept of resiliency to her case. Also think about how you might apply      the concept to social work practice in general.

APA 7 Edition Format

By Day 12/02/2021
Post a Discussion that includes the following:

  • An explanation of how you, as      Talia’s social worker, might apply the concept of resiliency to Talia and      her situation
  • Examples from Talia’s case      and the resources to support your strategy
  • An explanation of how you      might apply the concept of resiliency more generally to social work      practice

The Johnson Family ( Talia Case )

Talia is a 19-year-old heterosexual Caucasian female, who is a junior majoring in psychology and minoring in English. She has a GPA of 3.89 and has been on the dean’s list several times over the last 3 years. She has written a couple of short articles for the university’s newspaper on current events around campus and is active in her sorority, Kappa Delta. She works part time (10–15 hours a week) at an accessory store. Talia recently moved off campus to an apartment with two close friends from her sorority. She is physically active and runs approximately three miles a day. She also goes to the university’s gym a couple of days a week for strength training. Talia does not use drugs, although she has smoked marijuana a few times in her life. She drinks a few times a week, often going out with friends one day during the week and then again on Friday and Saturday nights. When she is out with friends, Talia usually has about four to six drinks. She prefers to drink beer over hard liquor or wine, but will occasionally have a mixed drink.

Talia has no criminal history. She reports a history of anxiety in her family (on her mother’s side), and on a few occasions has experienced heart palpitations, which her mother told her was due to nervousness. This happened only a handful of times in the past and usually when Talia was “very stressed out,” so Talia had never felt the need to go to the doctor or talk to someone about it until now. Talia is currently not dating anyone. She was in a relationship for years, but it ended a few months ago. She had since been “hooking up” with a guy in one of her English classes, but does not feel it will turn into anything serious and has not seen him in several weeks.

Talia’s parents, Erin (40) and Dave (43), and her siblings, Lila (16) and Nathan (14), live 2 hours away from the university. Erin works at a salon as a hairdresser, and Dave is retired military and works for a home security company. Erin is on a low-dose antidepressant for anxiety, something she has been treated for all of her life.

Talia came to see me at the Rape Counseling Center (RCC) on campus for services after she was sexually assaulted at a fraternity party 3 weeks prior. She told me she had thought she could handle her feelings after the assault, but she had since experienced a number of emotions and behaviors she could no longer ignore. She was not sleeping, she felt sad most days, she had stopped going out with friends, and she had been unable to concentrate on schoolwork. Talia stated that the most significant issues she had faced since the assault had been recurrent anxiety attacks.

Talia learned about the RCC when she went to the hospital after the sexual assault. She went to the hospital to request that a rape kit be completed and also requested the morning-after pill and the HIV prevention protocol (Post-Exposure Prophylaxis, or PEP). At that time, a nurse contacted me through the Sexual Assault Response Team (SART) to provide Talia with support and resources. I spent several hours with Talia at the hospital while she went through the examination process. Talia shared bits and pieces of the evening with me, although she said most of the night was a blur. She said a good-looking guy named Eric was flirting with her all night and bringing her drinks. She did not want to seem ungrateful and enjoyed his company, so she drank. She also mentioned that the drinks were made with hard liquor, something that tends to make her drunk faster than beer. She said that at one point she blacked out and has no idea what happened. She woke up naked in a room alone the next morning, and she went straight to the hospital. Once Talia was done at the hospital, I gave her the contact information for RCC. I encouraged her to call if she had any questions or needed to talk with someone.

During our first meeting at the RCC, I provided basic information about our services. I let her know that everything was confidential and that I wanted to help create a safe space for her to talk. I told her that we would move along at a pace that was comfortable for her and that this was her time and we could use it as she felt best. We talked briefly about her experience at the hospital, which she described as cold and demeaning. She told me several times how thankful she was that I had been there. She said one of the reasons she called the RCC was because she felt I supported and believed her. I used the opportunity to validate her feelings and remind her that I did, in fact, believe her and that the assault was not her fault.

We talked briefly about how Talia had been feeling over the last 3 weeks. She was very concerned about her classes because she had missed a couple of assignment deadlines and was fearful of failing. She told me several times this was not like her and she was normally a very good student. I told her I could contact the professors and advocate for extensions without disclosing the specific reason Talia was receiving counseling services and would need additional time to complete her assignments. Talia thanked me and agreed that would be best. I introduced the topic of safety and explained that she might possibly see Eric on campus, something that might cause her emotional distress. We talked about strategies she could use to protect herself, and she agreed to walk with a friend while on campus for the time being. She also agreed she would avoid the gym where she had seen Eric before.

The Johnson Family

Erin Johnson: mother, 40

Dave Johnson: father, 43

Talia Johnson: daughter, 19

Lila Johnson: daughter, 16

Nathan Johnson: son, 14

During our second meeting, Talia seemed very anxious. We talked about how she had been feeling over the last week, and she indicated she was still not sleeping well at night and that she was taking long naps during the day. She had missed days at work, something she had never done before, and was in jeopardy of losing her job. Talia reported experiencing several anxiety attacks as well. She described the attack symptoms as feeling unable to breathe, accompanied by a swelling in her chest, and an overwhelming feeling that she was going to die. She said that this was happening several times a day, although mostly at night. I provided some education about trauma responses to sexual assault and the signs and symptoms of post-traumatic stress disorder (PTSD). We went over a workbook on trauma reactions to sexual assault and reviewed the signs and symptoms checklist, identifying several that she was experiencing. We practiced breathing exercises to use when she felt anxious, and she reported feeling better. I told her it was important to identify the triggers to her anxiety so that we could find out what exactly was causing her to be anxious in a given moment. I explained that while the assault itself had brought the attacks on, it would be helpful to see what specific things (such as memories, certain times of the day, particular smells, etc.) caused her to have anxiety attacks. I gave Talia an empty journal and asked her to record the times of the episodes over the next week as well as what happened right before them. She agreed.

We met over several sessions and continued to address Talia’s anxiety symptoms and feelings of sadness. She told me she was unable to talk about what happened on the night of the rape because she felt ashamed. She said that it was too difficult for her to verbalize what happened and that the words coming out of her mouth would hurt too much. I reassured her that we would go at her pace and that she could talk about what happened when she felt comfortable. We practiced breathing and reviewed her journal log each week.

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It had become clear that the evenings seemed to be the peak time for her anxiety, which I told her made sense as her assault had occurred at night. I described how sleep is often difficult for survivors of sexual assault because they fear having nightmares about what happened. She looked surprised and said she had not mentioned it, but she kept having dreams about Eric in which he was talking to her at the party. The dreams ended with him holding her hand and walking her away. She said she also thought about this during the day and could actually see it happening in her mind. We talked about the intrusive thoughts that often occur after trauma, and I tried to normalize her experience. I told her that often people try to avoid these intrusions, and I wondered if she felt she was doing anything to avoid them. She told me she had started taking a sleep aid at night. When I asked about her exercise habits, she said that right after the assault she had stopped running and going to the gym. We set a goal that she would run one to two times a week to help her with anxiety and sleeping. I also suggested that now would be a good time to start writing her feelings down because journaling is a very useful way to express feelings when it is difficult to verbalize them. Talia mentioned that she had decided not to go to the police about the sexual assault because she did not want to go through the process. I informed her that if she wanted to, she could address the assault in another way, by bringing it to the campus judicial system. She said she would think about this option.

During another session weeks later, Talia came in distraught. She said she had been feeling better overall since working on her breathing and doing the journaling, but that a few things had happened that were making her more and more anxious and that her attacks were increasing again. Talia said her parents were pushing her to drop out of school and to come home. She said they had been calling and texting her often, something she found annoying but understandable. They were very upset about what had happened, although they were more upset with her that she had waited for weeks to tell them about “it.” Her father threatened to come and beat the guy up, and her mother cried. She avoided talking with them, but they had become relentless with the calls. Her mother had shown up with her sister unannounced the previous weekend and had treated Talia like she had a cold—making chicken soup and rubbing Talia’s feet. The pressure from her parents was weighing on her and upsetting her. Talia was also distressed by a friend who kept pushing her to talk about what happened. When Talia finally relented, her friend asked her why she had gone upstairs with him. Talia said this made her feel terrible, and she started to cry. This friend also told her that Eric had heard she had gone to the hospital and was telling people that she had wanted to have sex. Eric had been telling people she was “all over him” and that she had taken her own pants off. This made Talia very angry and upset.

Key to Acronyms

HIV: Human Immunodeficiency Virus Infection

PEP: Post-Exposure Prophylaxis

PTSD: Post-Traumatic Stress Disorder

RCC: Rape Counseling Center

SART: Sexual Assault Response Team

We talked about how there are certain myths in society around sexual assault and that the victim is often blamed. We also talked about how the perpetrator often blames his or her victim to make himself or herself feel better. Talia said she has felt some sense of blame for what happened and that she should not have drunk so much. She started to cry. I gently reminded her that she was not at fault for Eric’s actions, and her drinking was not an invitation to have sex. I reminded her that he should have seen how incapacitated she was and that she could not have consented to sex. Talia continued to cry. She clearly had a number of emotions she wanted to express but was having difficulty sharing them, so I offered her some clay and asked her to use it to mold representations of different areas in her life and how she felt about them. We spent the rest of the session talking about the shapes she made and how she felt. Toward the end of the session she told me she had decided to put in a complaint with the campus judicial system about the assault. She worried that Eric would assault another woman and she would feel responsible if she did not alert the university. I offered my support and told her I would be there for her through the process.

References

Laureate Education (Producer). (2013). Johnson family: Episode 5 [Video file]. Retrieved from https://class.waldenu.edu

Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Sessions: Case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader]. The Johnson Family (pp. 11–13).

Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA: Cengage Learning.

Initial Posting: Content

14.85 (49.5%) – 16.5 (55%)

Initial posting thoroughly responds to all parts of the Discussion prompt. Posting demonstrates excellent understanding of the material presented in the Learning Resources, as well as ability to apply the material. Posting demonstrates exemplary critical thinking and reflection, as well as analysis of the weekly Learning Resources. Specific and relevant examples and evidence from at least two of the Learning Resources and other scholarly sources are used to substantiate the argument or viewpoint.

Readability of Postings

5.4 (18%) – 6 (20%)

Initial and response posts are clear and coherent. Few if any (less than 2) writing errors are made. Student writes with exemplary grammar, sentence structure, and punctuation to convey their message.

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The Complexity of Eating Disorder Recovery in the Digital Age

The Complexity of Eating Disorder Recovery in the Digital Age

Post a 300- to 500-word response in which you address the following:

  • Provide the full DSM-5 diagnosis for the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
  • Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
  • Explain why it is important to use an interprofessional approach in treatment. Identity specific professionals you would recommend for the team, and describe how you might best utilize or focus their services.
  • Explain how you would use the client’s family to support recovery. Include specific behavioral examples.
  • Select and explain an evidence-based, focused treatment approach that you might use in your part of the overall treatment plan.
  • Explain how culture and diversity influence these disorders. Consider how gender, age, socioeconomic status, sexual orientation, and/or ethnicity/race affect the experience of living with an eating disorder.

The Case of Diamond

Intake Date: August 2019

DEMOGRAPHIC DATA: This was a voluntary intake for this 28-years-old single African American female. Diamond lives with a 24-years-old female roommate in New York City. She has a bachelor’s degree in Art History and is employed by a major New York museum. Diamond was born and raised in Virginia and moved to New York 4 years ago for employment.

CHIEF COMPLAINT: “My roommate suggested I go to therapy.  I do not agree. I can handle my life, but she threatened to move out and I cannot afford the apartment by myself.”

HISTORY OF PRESENT ILLNESS:  Diamond admitted to purging and frequent use of laxatives to try and keep her weight down.  Diamond reported her weight was being monitored by a nutritionist and she had lab work done to be sure she remained healthy. Diamond reports that she was much heavier as a teenager and wants to confirm she doesn’t get like that again.

Diamond reported that she has a very stressful job. She stated that approximately one month ago she started to have difficulty concentrating at work.  She had several altercations with coworkers as well. Several weeks ago Diamond reported that a coworker “said something nasty and I lost it.” Diamond reported that she was angry and “hit everything I knew I could—but that did not help.” Diamond also reported being under stress due to applying for her master’s degree in art history and difficulties with her boyfriend.

Diamond complained of depression with insomnia and sleeping only a few hours per night, feeling confused, decreased concentration, irritability, anger, and frustration. She admitted to suicidal ideation. She complained of feeling paranoid over the past few weeks and believed the police were after her and that she heard them outside her door. This was another reason her roommate wanted her to seek treatment.  Diamond reported she was emotionally abused as a child and suffered from post-traumatic stress disorder, but she denied a history of flashbacks or nightmares or any avoidance of the person who she says emotionally abused her.

Diamond noted that at times over the past year she has very strange experiences of being overwhelmed with fear.  At these times she begins sweating, has chest pains and chills, and thinks she is going crazy.  It concerns her terribly that these may happen at inappropriate times.   Reluctantly, Diamond admitted to bingeing several times per month since she was 17-years-old.

PAST PSYCHIATRIC HISTORY:  Diamond denies any history of psychiatric problems in the past.  Diamond admits to using alcohol periodically but rarely to excess.

MEDICAL HISTORY: Diamond is allergic to penicillin and has a lactose intolerance. She wears glasses for reading.

PSYCHOSOCIAL AND DEVELOPMENTAL HISTORY: Diamond’s parents were married when her mother was 19-years-old, and Diamond was born the following year. Two years later, Diamond’s sister was born.  Diamond reports her mother stated Diamond’s personality changed; she became stubborn and difficult. Diamond’s mother said that Diamond began biting, having temper tantrums, and has been moody since then. Diamond states she “adores her father” because he was never the disciplinarian. When Diamond was 12-years-old, her parents separated for 2 weeks. Diamond reported her mother quit college after Diamond’s birth and returned to college after her sister’s birth. She said her father worked all the time, and there was a housekeeper who cared for the children.

Diamond reports that when she was in high school, her maternal aunt, who was dying of cancer, came to live with the family and this was very stressful for the family. During those years, Diamond told the school counselor that her mother was abusive, and school officials visited the family. During the visit, Diamond had a temper tantrum and there was no further investigation.

Diamond reports she was always an above-average student who rarely studied. She said she was always hyperactive and had difficulty sitting in school. Diamond stated that in college she had a 3.8 GPA and was on the Dean’s list. Diamond is currently applying for admission to graduate school and has taken some courses toward her master’s degree.

Currently, Diamond is friendly with her roommate but does not have many other friends. “I don’t trust anybody.” Diamond states that when she lived in Connecticut during college, she had many friends.

Diamond worked during summer vacation while in high school. She baby sat during college and worked as a graduate assistant. Since graduating from college, Diamond has been employed by a museum. Diamond reports she currently has financial problems due to living in New York.

MENTAL STATUS EXAMINATION: Diamond presented as a slightly overweight, somewhat disheveled, African-American female. She was relaxed but very restless during the interview. Her facial expression was mobile. Her affect during the initial interview was constricted and her mood dysphoric. Diamond’s  speech was pressured, and she spoke in a loud voice. At times, her thinking was logical; and at other times, it was illogical. Diamond denied hallucinations but complained of hearing policemen outside her sometimes. She denied homicidal ideation. She initially admitted to suicidal ideation but then denied it.

Diamond was oriented to person, place, and time. Her fund of knowledge was excellent. Diamond was able to calculate serial sevens easily and accurately. Diamond repeated 7 digits forward and 3 in reverse. Her recent and remote memory was intact, and she recalled 3 items after five minutes. Diamond was able to give appropriate interpretations for 3 of 3 proverbs. Her social and personal judgment was appropriate. Diamond’s three wishes were: “To be skinny, to have a big house where I can take in all the stray cats, and for a million more wishes.” When asked how she sees herself in 5 years, Diamond replied, “Hopefully graduating from graduate school.” If Diamond could change something about herself, she would “make myself thin.”

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media and sexism

media and sexism

Many marketing efforts perpetuate the gender stereotypes that are steeped in our culture. Two examples at attempts to maintain these stereotypes through advertising are the Bic Critsal For Her and the Easy Bake Oven. These two conceivably innocuous items triggered a flood of articles, petitions, and videos, denouncing their perceived underlying messages.

The first controversy that erupted surrounded the Bic Cristal For Her pen. This pen was created and packaged specifically for women to use. Several groups lashed out at Bic, calling their attempt to target women with “lady pens” sexist and demeaning. Its detractors felt the campaign was degrading and fed into stereotypes by highlighting the thin design and the use of pastel colors. The negative press was overwhelming, although the pens have remained on the market.

Consumers also targeted those responsible for marketing the Easy Bake Oven by sending a petition asking its parent company Hasbro to make the ovens in colors other than pink and purple. Thousands of individuals signed the petition asking for alternative oven colors after a teenage girl from New Jersey was angered that her younger brother would have no other option but to use an oven in the colors that are considered stereotypically female. It was argued that the colors supported the stereotypical view that only young girls would want to bake. The signers of the petition felt that young boys who might want to use the toy would be more likely to practice their baking skills if the color of the oven was gender neutral.

Consider these two stories and think about your own reactions to the responses to the advertising and merchandising of these items.

To prepare: View the assigned resources and reflect on your experience with gender.

Turn in by Sunday 9/15/19

Submit a 2- to 4- page paper, in which you: Please include all questions below in APA. From required readings  Adams, M., Blumenfeld, W. J., Castaneda, C., Catalano, D. C. J., DeJong, K., Hackman, H. W,… Zuniga, X. (Eds.). (2018). Readings for diversity and social justice (4th ed.). New York, NY: Routledge Press.

  • Identify specific messages about gender presented in the mass media.
  • Discuss messages about gender you have received from your family or cultural group.
  • Analyze how these messages have influenced your experience with gender.
  • Explain how you might address issues related to sexism in the mass media and diverse cultural beliefs about gender and gender roles in your social work practice.

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Medical Social Work in Chronic Illness Care and Management

Medical Social Work in Chronic Illness Care and Management

Advances in medical technology have altered the trajectory of illness in our society. Many illnesses that were once considered acute or terminal are now considered chronic. The trajectory of advanced chronic illness, thus, has shifted from a brief period of time to longer periods with impaired quality of life. Patients and/or families living with chronic illnesses are often forced to adjust their aspirations and lifestyle. They also are vulnerable to protracted distress and developing psychiatric illness.

Optimal care and management of chronic illness is significant because it is likely to minimize distress, prevent psychiatric illness, and improve health outcomes and quality of life (Wagner, 2000). A professional team including a medical social worker can deliver optimal care for chronic illness (Wagner, 2013).

To prepare for this Discussion:

Review this week’s resources. Consider a chronic illness that is of interest to you. Think about how the following medical social work practice skills might apply to the illness you chose:

· Assessment

· Crisis intervention

· Case management

· Education and counseling

· Advocacy

· Team collaboration

· Community-level intervention

Assignment

Post a brief description of the illness you selected and the psychosocial effects of the illness on patients and families. Analyze the issues and concerns surrounding the care and management of the illness. Choose three medical social work practice skills, and explain how a medical social worker might implement them to improve the care and management of the illness. Explain challenges that might arise for families or caregivers caring for a patient with your chosen illness. Explain how you as a medical social worker might address the struggles or challenges experienced by families or caregivers.

Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

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Discussion Response week 7 for 6200 and 6051

Discussion Response week 7 for 6200 and 6051

SOCW 6051: Diversity, Human Rights, and Social Justice

Respond to at least two colleagues with recommendations of what skills social workers might employ to separate and/or reconcile personal values with professional responsibilities in the scenario presented. Discuss how the barriers to services identified by your colleagues can be overcome by a professional social worker working with LGBTQ clients.

SOCW 6200: Human Behavior and the Social Environment I

Discussion 1: Moral Development Theory and Bullying

Respond to a colleague’s post by offering an additional development theory and explaining its connection to the act of bullying. Please use the Learning Resources to support your answer.

Discussion 2: Bullying: Cycle of Events

Respond to a colleague’s post by expanding on how the act of bullying can affect the psychological development of both victim and observer. Then offer an additional social work intervention, skill, or practice that might change this cycle of events. Please use the Learning Resources to support your answer.

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SOCW 6051: Diversity, Human Rights, and Social Justice

 

Respond to at least two colleagues with recommendations of what skills social workers might employ to separate and/or reconcile personal values with professional responsibilities in the scenario presented. Discuss how the barriers to services identified by your colleagues can be overcome by a professional social worker working with LGBTQ clients.

 

Colleague Respond:  Diana Thorne 

RE: Discussion – Week 7

Top of Form

My scenario deals with a social worker, named Crystal, who works at a community agency that assists disadvantaged teens. The social worker is a devoted senior member of her Baptist church. Crystal is a teacher in her church’s teen ministry. Crystal and her husband of 25 years, Tom, who is a deacon in the church has two children both in college. One day while Crystal is working at the teen community agency, she interviews a new client. The new client, “Sharon”, is 17 years old female and 3 months pregnant. While interviewing the client, the social worker finds out that the client has a partner who is also female. The social worker has determined that Sharon is either lesbian or bi-sexual. The social worker is very religious and believes that any type of relationship that is not heterosexual is deviant and sinful. Crystal’s personal, ethical, and moral values clearly do not agree with her new client, Sharon’s personal, ethical, and moral values.

 

Social work is not a faith-based profession founded on any one religious tradition, and there are times when social work professional expectations differ from the personal beliefs of religious social work professionals (Dessel et al. 2017). Social workers are entitled and have the right to have their own personal beliefs and ethical values regarding sexual orientation. However, social workers have a professional responsibility to address their personal biases with cultural sensitivity and competence. In this scenario, Crystal, as a social worker is professionally bound by the NASW Code of Ethics which calls for culturally competent and non-discriminatory social work practice regardless of “sex, sexual orientation, gender identity or expression (Dessel et al. 2017).

 

Prejudice and bias might create barriers to fulfilling a social worker’s professional responsibility to the LGBTQ community. Social workers can fail to consider the client’s sexual orientation or gender identity and their world experiences. As a result, failing to provide professional guidance can lead to harmful and discriminatory practices based on person personal biases related to their sexuality and gender identity rather than informed, evidence-based policies and guidelines (Ryan, 2019). A social worker’s personal beliefs and values can cause tensions and negatively influence their ethical decision-making and practice if they do not practice self-reflection and cultural competence (Dessel et al. 2017).

 

References

 

Dessel, A. B., Jacobsen, J., Levy, D. L., McCarty-Caplan, D., Lewis, T. O., & Kaplan, L. E.

 

(2017). LGBTQ Topics and Christianity in Social Work: Tackling the Tough

 

Questions. Social Work & Christianity, 44(1/2), 11–30.

 

Ryan, C. (2009). Supportive families, healthy children: Helping families with lesbian, gay,

bisexual & transgender children. San Francisco, CA: Family Acceptance Project,

Marian Wright Edelman Institute, San Francisco State University. Retrieved from

http://familyproject.sfsu.edu/publications.

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Colleague Respond:  Ja’Sharee Bush 

RE: Discussion – Week 7

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Kathy is a 32-year-old bisexual female, she classifies as a Baptist, and her family is considered old school; they believe same-sex relationships and marriages are against the Bible and should be outlawed. Kathy believes that individuals should be able to express themselves and love whomever they choose. Kathy may encounter individuals like her family and be reluctant to receiving care.

 

These individuals will attempt to portray their beliefs on Kathy without knowledge of her preference and support for the LGBTQ community. Kathy will be placed in situations where she must place her beliefs aside to assist clients who are against her way of living. She will find individuals willing to change and she will provide information to broaden their perspectives.

 

The difference between professional ethics and values versus personal is when in a professional setting a social worker must understand they are there to provide a service, they are to prevent harm and understand diversity and oppression (Dessel et al., 2017). Personal ethics and values are the social worker’s limitations, and what they believe is right or wrong. In the scenario Kathy will have to distinguish between the two when working with clients, when working with those who oppose what she feels, she must put her professional ethics and values into place.

 

There will be individuals that feel supporting the LGBTQ community is wrong and will fight against progress. Prejudice and Bias will make individuals find a rebuttal towards efforts made for the LGBTQ but as a social worker, I must find a way to overcome their objectives to fulfill my role.

 

Dessel, A. B., Jacobsen, J., Levy, D. L., McCarty-Caplan, D., Lewis, T. O., & Kaplan, L. E. (2017). LGBTQ Topics and Christianity in Social Work: Tackling the Tough Questions. Social Work & Christianity, 44(1/2), 11–30.

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Follow Rubric

 

Responsiveness to Directions

8.1 (27%) – 9 (30%)

Discussion posting fully addresses all instruction prompts, including responding to the required number of peer posts.

 

Discussion Posting Content

8.1 (27%) – 9 (30%)

Discussion posting demonstrates an excellent understanding of all of the concepts and key points presented in the text(s) and Learning Resources. Posting provides significant detail including multiple relevant examples, evidence from the readings and other scholarly sources, and discerning ideas.

 

Competency Demonstrate Professional and Ethical Behavior-Values

1.35 (4.5%) – 1.5 (5%)

Student demonstrates an excellent understanding of social work values and ethical standards. Student demonstrates expert ability to apply professional value framework when working with a specific population.

 

Competency Demonstrate Professional and Ethical Behavior-Cognitive and Affective Processes

1.35 (4.5%) – 1.5 (5%)

Student demonstrates a high level of critical thought related to application of social work values and ethics. Critical thought may be demonstrated through the ability to consider multiple perspectives, ability to recognize personal values, and ability make the distinction between personal and professional values.

 

Peer Feedback and Interaction

5.4 (18%) – 6 (20%)

The feedback postings and responses to questions are excellent and fully contribute to the quality of interaction by offering constructive critique, suggestions, in-depth questions, additional resources, and stimulating thoughts and/or probes.

 

Writing

2.7 (9%) – 3 (10%)

Postings are well organized, use scholarly tone, contain original writing and proper paraphrasing, follow APA style, contain very few or no writing and/or spelling errors, and are fully consistent with graduate level writing style.

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Intervention Treatment Plan

Intervention Treatment Plan

According to the Counsel on Social Work Education, Competency 4: Engage in Practice-informed Research and Research-informed Practice:

Social workers understand quantitative and qualitative research methods and their respective roles in advancing a science of social work and in evaluating their practice. Social workers know the principles of logic, scientific inquiry, and culturally informed and ethical approaches to building knowledge. Social workers understand that evidence that informs practice derives from multi-disciplinary sources and multiple ways of knowing. They also understand the processes for translating research findings into effective practice.

The MSW program expects students in their specialization year to be able to:

· Critically evaluate evidence based and “best practice” treatment interventions.

· Compose clinical intervention plans that are grounded research-based knowledge

This assignment is intended to help students demonstrate the behavioral components of this competency in their field education.

To Prepare: Review the agency’s intervention/treatment plan used to engage clients. After reviewing the agency’s intervention/treatment plan, consult the literature and conduct extensive research, with the goal of finding best practices that supports or adds to the agency’s current intervention/treatment plan. The purpose of this assignment is to find research that supports or adds to the agency’s current intervention/treatment approach.

Assignment

Submit a 1-2-page paper in which you:

1. Briefly describe the agency’s intervention/treatment plan (Student agency is a short term inpatient mental health/substance abuse hospital. On the treatment plan the agency assess client strengths and deficits. The agency sets goals and interventions for each client’s treatment plan).

2. Briefly discuss best practices about interventions identified in the literature

3. Briefly discuss how the agency can incorporate those best practices into the current intervention/treatment plan

4. Provide a brief summary of the similarities and differences between the intervention/treatment plan used at the agency and the suggested practices in the literature

Note: If no formal process is used in the agency, discuss the agency’s current process and compare it to the suggestions in the literature. You are expected to present and discuss this assignment with your agency Field Instructor. Your field instructor will be evaluating your ability to demonstrate this competency in the field evaluation. 

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Planning a Needs Assessment II

Planning a Needs Assessment II

One of the many reasons social workers conduct needs assessment is to provide support for new programs. Social workers have many methods available to collect necessary data for a need’s assessment.

Social workers can use existing data from a wide range of sources, including local and national reports by government and nonprofit agencies, as well as computerized mapping resources. Social workers can gather new data through interviews and surveys with individuals and focus groups. This data can provide the evidence that supports the need for the program.

To prepare for this Assignment, review the needs assessment plans that you and your classmates generated for this week’s Discussion. Also, review the logic models that you created in Week 7 (problems affecting young mothers such as; depression)

and any literature on needs of caregivers that you used to generate them. Consider the following to stimulate your thinking:

  • Getting      information about the needs of the target population:
    • Who       would informants be?
    • What       is your purpose for interacting with them?
    • What       questions would you ask?
    • What       method would you use (interview, focus group, questionnaire)?
  • Finding      potential clients:
    • Who       would informants be?
    • What       is your purpose for interacting with them?
    • What       questions would you ask?
    • What       method would you use?
  • Interacting      with the target population:
    • Who       would informants be?
    • What       is your purpose for interacting with them?
    • What       questions would you ask?
    • What       method would you use?

Assignment

Submit a 2- to 3-page paper outlining a hypothetical needs assessment related to the support group program for caregivers. Include the following:

  • The      resources needed to operate this service
  • The      program activities
  • The      desired outcomes
  • A      plan for gathering information about the population served
  • Justifications      for your plans and decisions
  • A      one-paragraph conclusion describing how you might conduct a follow-up to      the need’s assessment at the implementation stage of the program evaluation
  • Resource

Dudley, J. R. (2014). Social work evaluation: Enhancing what we do. (2nd ed.) Chicago, IL: Lyceum Books.

  • (For review) Chapter 6, “Needs Assessment” (pp. 107–142)
  • Chapter 7, “Crafting Goals and Objectives” (pp. 144–164)
  • Also see attached resources

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Week7: Developing a Logic Model Outline Handout

 

Complete the tables below to develop both a practice-level logic model and a program-level logic model to address the needs of Helen in the Petrakis case history.

 

Practice-Level Logic Model Outline

 

Problem Needs Underlying Causes Intervention Activities  

Outcomes

         

 

Program-Level Logic Model Outline

 

Problem Needs Underlying Causes Intervention Activities  

Outcomes

         

 

Introduction to Research Proposals

Introduction to Research Proposals

Just because you thought of an interesting research question and have a desire to conduct research does not mean that your research will automatically be supported by faculty or funded by an organization. In order to gain stakeholder approval, you must submit a research proposal. Much like an outline of a paper or a treatment of a movie script, the research proposal contains several parts that begin with a research question and end with a literature review. For this Assignment, you compile a research proposal that includes a research problem, research question, and a literature review.

For this Assignment, choose between the case studies entitled “Social Work Research: Couple Counseling” and “Social Work Research: Using Multiple Assessments.” Consider how you might select among the issues presented to formulate a research proposal.

Be sure to consult the outline in Chapter 14 the Yegidis et al. text for content suggestions for the sections of a research proposal. As you review existing research studies, notice how the authors identify a problem, focus the research question, and summarize relevant literature. These can provide you with a model for your research proposal.

By Day 7

Submit a 5- to 6-page research proposal stating both a research problem and a broad research question (may be either qualitative or quantitative). Use 6–10 of the most relevant literature resources to support the need for the study, define concepts, and define variables relevant to the question. Include a literature review explaining what previous research has found in relation to your problem and question. The literature review should also include a description of methods used by previous researchers. Finally, be sure to explain how your proposed study addresses a gap in existing knowledge.

Cite from resources below

 

Yegidis, B. L., Weinbach, R. W., & Myers, L. L. (2018). Research methods for social workers (8th ed.). New York, NY: Pearson.

  • Review Chapter 4, “Conducting the Literature Review and Developing Research Hypothesis” (pp. 71-99)

 

Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

  • Social Work Research: Couples Counseling
  • Social Work Research: Couples Counseling Social Work Research: Using Multiple Assessments

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  1. Social Work Research: Couples Counseling

Kathleen is a 37-year-old, Caucasian female of Irish descent, and her partner, Lisa, is a 38-year-old, Caucasian female with a Hungarian ethnic background. Kathleen reports that she has a long family history of substance use but has never used alcohol or drugs herself. She does not have a criminal history and utilized counseling services 10 years ago for family issues regarding her father’s alcohol use. Kathleen works as a nurse in a local hospital on the cardiac floor where she has been employed for 8 years.

 

Lisa reports experimenting with substances during college. She currently drinks wine on occasion. Lisa does not have a criminal history. Lisa has had many jobs and stated that she was unable to find her niche until recently when she took out a loan and opened a small Hungarian restaurant serving her grandmother’s recipes. Her restaurant has been open 1 year. Lisa reports that while she enjoys the work and has found her niche, she must work constantly to be successful, and she is worried the business might fail.

 

Kathleen and Lisa have been together for over 15 years. They have a close group of friends and see their families on major holidays. They came to outpatient counseling at a nonprofit agency to examine the possibility of starting a family together. They were both feeling ambivalent about it, and it had been the source of more than a few arguments, so they decided to come to counseling to address their concerns in a more productive way. They said they chose this agency because it was recognized as lesbian, gay, bisexual, and transgender (LGBT) friendly. They asked about my sexual orientation and my history because they were concerned about my level of experience working with the issues they were presenting.

 

I thanked Kathleen and Lisa for sharing this concern, and I informed them of various programs I had worked in within the agency, including supportive services for LGBT youth in schools and in the community. I also shared our agency philosophy and mission, which includes outcome measures and engaging clients in feedback to evaluate practice.

 

I explained the tools we used to measure outcomes. The first form measures how each of them are feeling with regard to their life and current circumstances. There are four different scales to measure aspects of their lives, such as social, family, emotional health, etc. I also provided the chart on which I score the scales and track progress. I explained that the purpose was to see where they began to demonstrate progress with the work we were doing.

 

The second form measures how well I am providing treatment. I demonstrated the four scales that measure if the client feels heard and understood and if we addressed in session what they wanted to. I explained that this should address their concern about my ability to assist them. Because we would be evaluating both how they felt and how the sessions were going each week, we could make adjustments on treatment and delivery style.

 

I informed Kathleen and Lisa that both measurement tools were obtained from the National Registry of Evidence-Based Programs and Practices. We use these tools in the agency to assess the experience of the client and whether the goals of treatment are being achieved. Lisa questioned how the information would be used, and I told them that this information would be shared with them weekly and would only be in their chart.

 

Lisa and Kathleen came every week for 15 weeks. In that time, we charted each week using both tools. The chart demonstrated significant progress and then began to level off. During that time, Kathleen and Lisa worked on effective communication strategies to discuss the presenting issues. The arguments had become less frequent and shorter in duration as both Kathleen and Lisa learned to appreciate the other’s perspective. They expressed that some members of their families of origin were not supportive of their sexual orientation, and this was the main challenge for them as a couple. They were able to identify their strengths and not let family or societal opinions inform how they wanted to live. They were able to see that this was their decision.

 

During treatment there were times when the measurement tool indicated that they felt we were not connecting on certain issues. As I could pinpoint when that was and the topic we discussed, we were able to address it in the next session to clarify and get back on track.

 

  1. Social Work Research: Using Multiple Assessments

Lucille is a 68-year-old, Caucasian female. Her husband of 43 years passed away 4 years ago after a long and debilitating illness during which Lucille was his primary caregiver. During their marriage, he worked at the sanitation department, and she was a homemaker. She continues to live in the house where she and her husband raised their three children. Lucille receives a limited income of approximately $2,100/month from her husband’s retirement pension and Social Security; she owns her home and has no major outstanding debts. She receives Medicare to cover her major medical expenses and a small supplemental health plan to cover any outstanding medical costs. Her physical health is good, and she has not had any major illnesses or surgeries, although she has not had a complete physical in over two years. Her favorite hobbies are gardening and cooking. Lucille has two sons and one daughter, each living away from home with their own families. Lucille’s daughter and one son reside in the local area; her other son lives in another state.

 

Lucille’s major concern is about her daughter, Alice (33), who has battled substance abuse and alcoholism since adolescence. At present, Alice is not employed and has had several encounters with law enforcement for drug possession and intent to sell illegal substances. Alice has admitted that she has used cocaine as well as other substances in the past. She has made several attempts to go into drug rehabilitation, but she has never completed a program. Her siblings have essentially disowned her. Alice has three children, Michael (6), Rachael (4), and Randy (18 months), who was recently diagnosed with fetal alcohol effects (FAE). Lucille is not certain who is the father of her grandchildren; it is a subject Alice refuses to discuss. Alice has repeatedly left her children alone for several hours in their tiny apartment, and once she was gone for several days. Child Welfare has interceded, but Alice continues to have custody of her children. Whenever Lucille visits her daughter and grandchildren, the living conditions are filthy, there is little food in the house, and there is talk of constant “visitors” to the house well into the night. Because of Alice’s instability, Lucille has taken physical custody of her grandchildren without any redress from Alice. Lucille’s family members are not aware of the stress Lucille is feeling about possibly having to spend the rest of her life raising her grandchildren, including one with a disability. This causes Lucille to often feel “down in the dumps,” resulting in overeating because, as she stated, “comfort food makes me feel better.” Within 2 months, she gained 15 pounds.

 

Lucille heard about a counseling program at the local community center for grandparents raising grandchildren. The program provides support, group meetings, parenting classes, individual counseling sessions with a social worker, and referrals for other supporting services. At first, Lucille was skeptical about attending the program. She was embarrassed to tell others about her family circumstances; she was particularly fearful that others would blame her for her daughter’s lifestyle and wonder how she could now care for her grandchildren if she could not raise her daughter properly. She already blamed herself for her daughter’s actions, which made her bouts of depression more frequent and difficult to overcome.

 

Eventually, Lucille came to the community center after some encouragement from her neighbor. Lucille is quite concerned about the fate of her daughter. Fearing the worst, she is constantly worried she will get a late night phone call that her daughter was found dead somewhere from a drug overdose or something related to her drug life. She once believed caring for her grandchildren was a temporary arrangement but more recently believes this will become permanent. Although Lucille loves her grandchildren, she is afraid that she will have to raise them alone and is angry with her daughter for putting her in this position. She does not know if she can do it at her age. Her youngest grandchild will need many resources over the years, and she does not even know where to begin to access them. She admits feeling overwhelmed and depressed frequently, but she does not have a wide circle of family or friends to talk to about her concerns. She spoke to her church minister once about her family circumstances but did not feel she got much out of it. “He just did not seem to understand what I was talking about,” she stated, “so I never went back.” She stated she was feeling unable to manage her family needs and that “I just want to get control of the ship again.”

 

After a thorough psychological assessment, the agency psychiatrist determined that medication was not necessary for her bouts of depression. After our initial talk, I administered a series of baseline measures on her emotional and physical functioning, specifically the Center for Epidemiologic Studies—Depressed Mood Scale (CES-D), Family Resource Scale, Family Support Scale, and the Medical Outcome Survey, SF-12v2. Our plan is to administer these measures at 3-month intervals for 1 year to assess her emotional functioning and social progress. Using a strengths-based approach to problem solving, I collaborated with Lucille on a biweekly basis to define personal goals that focused on helping her address feelings of depression and broaden her support network for managing family challenges. She attended monthly support group meetings with other grandparents who discussed their challenges and celebrated their triumphs. Lucille never missed a meeting. I made two home visits per month to observe Lucille in her home environment. Our individual sessions included assessing strengths, defining/redefining needs, targeting problems and goals, identifying resources to address needs, and monitoring goal progress. A nutritionist also conducted two home visits to help her with food options for herself and her grandchildren. Lucille is an excellent cook, and the nutritionist showed her how to reduce calories without sacrificing taste. Within four weeks, Lucille was able to make small changes in her everyday life. She began walking her grandchildren to the local park for playtime, preparing her front yard for spring flowers, and preparing Sunday dinners to reengage her family. She also visited her family physician and learned that she has high blood pressure, which can be controlled with proper diet and exercise, and she has asked her son and daughter-in-law for respite once per month so she can have some “down time.”

 

After 6 months, I facilitated a family group conference with Lucille and her sons and their wives. The focus of the meeting was to plan how the family would support Lucille as the primary caregiver for her grandchildren and to define the role other family members would play in assisting in raising Alice’s children. There was family agreement that it was in the children’s best interest for Lucille to seek legal counsel so she could establish temporary custody for her grandchildren, as well as learn the options for a more permanent relationship, such as adoption. She also applied for disability benefits for her youngest grandchild. Later, the family would meet to conduct permanency planning for the grandchildren. After 9 months, Lucille’s emotional health improved, and we decided to suspend individual counseling, but she continues to participate in the weekly support group meetings where she can have her blood pressure checked by the program nurse. After 12 months in the program, Lucille has a positive perception of her support network, including her family; familiarity with community resources and how to access them; a positive emotional state; and she has lost 10 pounds and her blood pressure is normal. Lucille has even initiated a grandparent mentoring service for new custodial grandparents who want to partner with a “seasoned” grandparent caregiver. Last week, Lucille found out her daughter Alice, who she has not seen in nearly a year, is 6 months pregnant.

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