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I KNOW THIS ASSIGNMENT IS ALOT BUT PLEASE READ INSTRUCTIONS CAREFULLY! ITS ALOT OF INFORMATION TO ACHIEVE!
You are a high school social work intern who needs to summarize one of your clients experience. Throughout the past couple of weeks, you have been able to observe and sit in various sessions between your site supervisor and his caseload which are the students that attend the High School. The student you will write about is Grace, a 15 year old female with the following presenting concerns: anxiety, emotional distress, low self-esteem, and difficult time communicating. Your goal with grace is to work on her anxiety,communication skills and her emotional stress through different forms of interventions such as psychotherapy. Lastly, you and the supervisor came up with objectives such as developing self-calming strategies, identifying her triggers and identifying what is causing her emotional distress. Grace lives with both of her parents and has an older sister.
Things that need to be included: Identify and briefly describe your client (e.g., identifying characteristics such as age, race, ethnicity, gender, sexual orientation, marital status, health, employment, and/or school status, and living arrangements; if a group, such as task group or school group, briefly identify each group member using these categories of information). Include how your client(s) came to the attention of your agency or its social work unit. Identify the reason(s) for the referral (what happened in the present that motivated the referral now?). Identify whether the client or client system was mandated for services or voluntarily chose to receive services. Include a brief summary of relevant historical information, depending on your particular client, family, or client group and how much you know about the client. This section is primarily past tense. The amount of detail of a client’s history varies by practice setting and the specific client situation. If you do not have a lot of background information, you can include what you have
Discuss the presenting problems the client brought and then describe one problem-for-work for your client. (Note: there may be several presenting problems on which you can work; summarize the situation and problems generally, and then, focus on one or two for the purpose of your work with the client and for this analysis. Remember, a problem-for-work may not be the presenting problem (Hepworth et al., 2017, pp. 202-203). The problem-for-work may be an underlying issue that you both agree on, such as grieving a loss or history of trauma. Include an analysis of the problem as the client sees it, as significant others view it, and as other service providers see it). Be as non-judgmental as possible for this section, and avoid labels (Hepworth et al., 2017, p. 242). Focus on description. It is important to capture attitudes and perceptions as they impact relationships and behaviors.
Include observations you make regarding the client’s presentation to you of the problem(s) – this includes only what you see, hear or intuitively experience yourself (i.e., observations about your own reactions and the impact on the client) (Bisman, 2014, pp. 104-105). Observations are NOT opinions, but what you see, hear, or intuitively experience or observe about yourself that contributed to the engagement process, selection of the problem-for-work, and development of your case theory (Hepworth et al., 2017, p. 248).
For example, “every time I asked Maria about her relationship with her mother, she would change the subject, raising a bit of concern in me. She said she isn’t ready to address that. She did openly discuss how unhappy she was in her job, which led me to think that this may be where we can start.”
Here, change theory can be used to inform the case theory – she is in the pre-contemplation phase in terms of recognizing she has a problem with her mother. A discussion of tuning-in with the client (Shulman, 2009) is applicable here as well as it relates to the engagement process.
Provide at least 2 plausible hypotheses for the cause (etiology) and/or maintenance of the problem-for-work. Make sure that your hypotheses reflect a person-in-environment perspective and you identify and incorporate at least two practice theories we have covered in class that inform your hypotheses such as, cognitive behavioral, psychodynamic, trauma-informed practice. Your application of the theories MUST be explicit (name your theories and describe the principles and what they say about your client and why they are important to inform your hypotheses). You must include relevant references from the readings here. Remember, case theory can change as more information is obtained and/or you have more experience with the client. But it is important to be able to articulate your emerging hypotheses to yourself, your client, and colleagues as you will be continuously testing out your hypotheses or case theory through the assessment and intervention processes.
The clinical formulation is your working hypothesis for what is causing and/or maintaining the problem for work. This formulation is a theoretically-based explanation of the information obtained from a clinical assessment. Here is where you tie together the information you gleaned from the first integrative assignment with the case theory that you think best explains the problem for work. A clinical formulation contains the following components:
It describes all of the client or client systems challenges and strengths.
It proposes hypotheses about the mechanisms causing these challenges.
It proposes the recent triggers of the challenges.
The origins of the mechanisms.
Please structure your clinical formulation to include each of these components. Here is an example:
In childhood and adolescence, Jon was brutally teased and humiliated by his father (ORIGINS). As a result, Jon learned the schemas “I’m inadequate, a loser,” and “Others are critical, attacking, and unsupportive of me” (MECHANISMS). These schemas were activated recently by a poor performance evaluation at work (PRECIPITANT). As a result, Jon began having many automatic thoughts (MECHANISMS), including, “I can’t handle this job,” and experienced anxiety and depression (SYMPTOMS, PROBLEMS), with which he coped by avoiding (MECHANISM) important work projects and withdrawing from collegial interactions with both peers and superiors (PROBLEMS). The avoidance caused Jon to miss some deadlines (PROBLEM), which resulted in criticism from his colleagues and boss (PROBLEM) and led to increased sadness, feelings of worthlessness, self- criticism and self-blame, low energy, and loss of interest in others (SYMPTOMS, PROBLEMS). Jon’s low energy and hopelessness (PROBLEM) caused him to stop his regular program of exercise, which exacerbated his pre-diabetic medical condition (PROBLEM).
Based on your clinical formulation, please describe the indicated treatment approach. Justify why you have selected this approach over another. If an integrated approach is called for, explain which practice theories you will be using and why.
Finn writes that “We construct human difference in terms of cultural practices, gender identity and expression, racial/ethnic identification, social class, citizenship, sexual orientation, ability status, age, livelihood, education, and other forms of identification. Our positionality or location in the social work is shaped in terms of multiple identifications” (Finn, 2016: 26). Discuss how your client’s positionality impacts the presenting problem and the problem for work. ? How do issues of structure influence the presenting problem and the problem for work? How will you address issues of structure with your client? Further, please also reflect on how your positionality shapes your interpretation of the presenting problem and the problem for work. What steps can you take to ensure that your positionality does not overly influence your work with your client or your client system? Finally, please identify one mistake that you made during the course of your work with this client this semester. How do you understand this mistake? What did you learn from it?
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