SOWK 501 Psychosocial Biopsychosocial Family Assessment for Rosa Lee
SOWK 501 Psychosocial Biopsychosocial Family Assessment for Rosa Lee
Presenting Problem: The client (Rosa Lee) is a fifty-three-year-old African American woman who has been addicted to substance usage. Due to her substance abuse, the client has experienced seizures and drug-related illnesses. Currently Rosa Lee is HIV positive, and takes AZT and Folic acid. She also has Hepatitis and short-term memory loss. According to her doctor, these conditions can be attributed to her long-term use of heroine.
Rosa Lee Cunningham’s main complaint is addiction to substance use, which has led to chronic health issues such as malnutrition, a weakened immune system, and drug-related illnesses. The use of marijuana and other drugs has led to anxiety as well as a reduced ability to think clearly. The consequences of substance abuse seen in Rosa Lee are detrimental in the areas of health, social relations, employment and productivity.
Personal Status:
Rosa Lee Cunningham, a Black woman, is 53 years of age, the daughter of Earl Lee and Rosetta Wright. She was raised by her grandparents, Thadeous and Lugenia Lawrence. Rosa Lee had eight children by five different men, and her marriage ended years ago. First diagnosed with HIV in 1988, Rosa Lee was severely affected by AIDS and succumbed to AIDS-related pneumonia in July 1995. Her family was shocked after several children from the family died at a tender age, for instance, Bobby in 1993 and Patty in 2010, who succumbed to AIDS. Drug addiction, child abuse, and poor education were evident in Rosa Lee’s family cycle, and her childhood trauma put her at a disadvantage in being a good mother. During her teenage years she stole from the church’s collection plate, shoplifted, and broke into people’s homes. The opportunity of using the church as a resource was shown not to work. Instead of using it to change her life, Rosa Lee just used it as another scheme to get over in court by telling the Judge she had changed and had even been baptized. Despite such odds, she was very influential in her family – most of her children grew up, although some of them died while others got into adulthood with those challenges. Rosa Lee justified her illegal behaviors as modes of survival and doing what she had to do to support her family.
Drug History and Current Patterns of Use:
Rosa Lee started using drugs when she was 36 years old; she used Preludin (“bam”) while in a relationship with a same-sex partner, Lucky. Although she was selling heroine years prior. This worsened when her daughter Patty brought a packet of heroin into the house. Rosa Lee has shared needles with her children and continues to manage her addiction through methadone treatment. In the meantime, she has stopped for some time, her drug use has led to risky behaviors and health issues.
Substance Abuse Treatment History:
Rosa Lee has taken programs in methadone maintenance as part of her recovery from heroin dependency. She reveals high treatment motivation and compliance and a desire to remain abstinent by actively participating in treatment services. She has shown that she wants to stay engaged in outpatient substance abuse treatment, which shows how committed she is to her path to recovery and improved health.
Medical History and Current Status:
Rosa Lee was diagnosed as HIV-positive in 1988 and is on antiretroviral therapy, including azidothymidine (AZT) and folic acid. She also suffers from epileptic seizures, which require the use of another medication, so her situation is even more challenging. However, because she is illiterate, she has experienced some challenges in following through with proper set-down treatment regimens. Her health is worse due to the effects of drug taking and the lack of regular checkups. As a result, her health status is still compromised by poor attendance to essential medical services, which hinders appropriate disease control and management.
Family History and Current Relationships:
Rosa Lee’s childhood was characterized by poverty, fear, and lack of parental guidance and supervision. She grew up under the parental custody of her parents, Earl Lee and Rosetta Wright; her grandparents, Thadeous and Lugenia Lawrence, were also influential in her early years. Her father was an alcoholic, and she has strained relationships with her siblings, who received preferential treatment from their mother. Rosa Lee and everyone in her family have issues such as substance abuse, imprisonment, and failure to live healthy relationships. Rosa Lee tries to care for the children but encourages their negative actions instead.
Positive Support Systems:
Through her conversation / interview sessions with Leon Dash, Rosa Lee displays her desire for positive change by her active participation in methadone treatment and her high desire to improve her literacy. Her desire for positive change further reveals that all her efforts were meant to build a better life for herself and her family. She receives some assistance through social services and doctors for her substance use treatment and other health issues. However, Rosa Lee’s support is irregular, and she has no stable social support to help her consistently overcome these problems.
Crime or Delinquency:
Rosa Lee has been involved in shoplifting, prostitution, and drug-related activities and justifies these actions as survival tactics. These behaviors have been emulated by her children, most of whom are involved in criminal activities to satisfy their addictions.
Education:
Rosa Lee had her first child when she was only 13 years old, and she did not go back to school to complete her education. Her early departure from school made her illiterate, which she considers one of her life’s biggest setbacks. Rosa Lee feels that her illiteracy has greatly hampered her chances of getting better jobs, improving her standards of living, and improving the quality of life of her family.
Employment:
Rosa Lee has been a waitress and a drug dealer and has engaged in other forms of casual work to cater to her family’s needs. Due to her lack of education and literacy skills, she can hardly attend to meaningful employment and has rarely found a better job. Such limitations have pushed her into a cycle of poverty, which has caused her to find temporary and sporadic sources of income that cannot support her and her family in the long term.
Readiness for Treatment:
Rosa Lee has shown some eagerness to go for treatment in that she goes for her HIV drugs through the AIDS clinic and has accepted to take phenobarbital and Dilantin for seizure control. However, her substance use disorder and high-risk behaviors, such as sharing needles and inconsistent follow-up, also suggest her need for more supervision, education on her condition, and strict medical compliance. Medicaid coverage assists in meeting the cost of medication.
Resources and Responsibilities:
Rosa Lee struggles to meet her family’s needs due to limited financial resources, reliance on low-paying jobs and lack of education, which hinders her ability to secure better opportunities or support. Continued poor economic decision-making coupled with her encouragement of her children’s drug addiction puts a lot of pressure on her scant financial resources. Her children are currently dependent on financial assistance from Rosa Lee without having a share in contributing to bills, making Rosa Lee solely responsible for managing the home and family, something that may not be sustainable.
Mental Status Exam Narrative and Mental Health History:
Rosa Lee does not have a record of any mental health intervention; however, her behaviors depict severe psychiatric illness. She displays symptoms of co-dependency and an enabling attitude, especially towards her children. Rosa Lee’s reported feelings of low self-esteem and a pervasive sense of failure point to potential underlying issues such as depression or anxiety. The conditions mentioned above may go undiagnosed but appear to affect her responses and decision-making processes, causing the struggles she goes through.
Goals:
- Get a formal education to increase the chance of getting a job and be more confident.
- Develop healthy boundaries with her children to foster independence.
- Maintain sobriety and improve health outcomes.
Strategies/Interventions:
- Counseling Approaches: Cognitive Behavioral Therapy (CBT) can help Rosa Lee address her enabling behaviors and develop healthier decision-making patterns. This will help her change any negative thinking that might be causing her difficulties. Motivational interviewing will continue to strengthen Rosa’s determination to change. It will consciously make her aware of the change process and provide her with the skills to make necessary improvements regarding her life condition.
- Practical Steps: Rosa Lee should take an adult literacy educational course to learn to read and be offered a better job. She should also attend family counseling sessions to manage the family issues that are lacking in her home and promote healthy relationships. Participating in a parenting skills workshop can also help her set boundaries and improve family stability.
- Health Management: Rosa Lee should continue with the methadone treatment for her to recover from substance use. Stable medical appointments would help her adequately control her HIV and seizure disorder. Routine appointments and medication management will enhance the quality of her life and guarantee she continues to get proper treatment for her ongoing medical needs.
Client’s Values and Attitudes:
Rosa Lee embodies resilience, showcasing determination to overcome her struggles and create a better future. Her decision to work towards enhanced literacy and education, along with abstinence, shows her concern for personal change. Despite her hardships, Rosa Lee’s willingness to seek help highlights her hope for positive change and a more stable life.
Counselor’s Values and Attitudes:
The counselor should adopt an empathetic and nonjudgmental approach, recognizing Rosa Lee’s resilience and strengths. This way, the counselor can guide her and ensure that she accepts healthier behaviors while setting achievable goals. Some key considerations when trying to empower Rosa Lee to make positive changes are to be tolerant, culturally sensitive, and supportive of the problems she is battling and the progress she is making.
Rosa Lee Genogram
References
Dash, L. (1996). Rosa Lee: A Mother and Her Family in Urban America. Basic Books; First Edition. Retrieved August 22, 1996.
McPhatter, A. R. (1991). Assessment revisited: A comprehensive approach to understanding family dynamics. Families in Society the Journal of Contemporary Social Services, 72(1), 11–22. https://doi.org/10.1177/104438949107200102
SOWK 501 Psychosocial Biopsychosocial Family Assessment for Rosa Lee
