process that ensures the best alignment of interventions with client needs and desired outcomes
Social Work 301
Professional Practice Paper Value: 40% Cummins, Sevel and Pedrick (2012) state that, “preparing for client treatment is an important step in the helping process that ensures the best alignment of interventions with client needs and desired outcomes†(p. 236). They also state that “treatment applications should vary from client to client†and that “the selection of intervention and treatment modalities should be in alignment with the goals and time frames set out in the contract with the client†(Cummins, Sevel & Pedrick, 2012, p. 236). Using the case scenario described below complete the assessment and contracting process with this client and choose a treatment modality that you believe will be effective in addressing this client’s situation. Selection of a treatment option does not need to be limited to only those discussed in Chapter 11 of your textbook (I WILL SEND YOU THIS). You are encouraged to explore other treatment interventions that reflect evidence-based practice informed by research. Use the following headings: Title (of paper – under which you would provide the introduction/intent of the paper) Assessment Problem Identification Contracting Treatment and Intervention Summary References Identifying Information Client Name: Kathy Claybourne Age: 45 years old Ethnicity: Caucasian Educational Level: B.S. degree in nursing Marital Status: Divorced Children: Tommy, age 14; Betty, age 12 Intake Information Kathy Claybourne is a 45-year-old single mother who contacted the Family Counseling Center concerning counselling for herself and perhaps, later, for her two children. She stated that she feels “very alone right now†and needs someone to talk to about “how my life is going.†She didn’t want to go into the reason for an appointment with a counsellor over the telephone. The intake worker scheduled an appointment for her with you, her counselor, for the following week. Kathy arrived on time for her appointment with you. Intake Interview Kathy presents as a polite, well-groomed, middle-aged woman who smiles and shakes hands with you in the waiting room. She says that she is very glad to have someone to discuss things with after spending much of her time talking to her children. Kathy indicates that she has been divorced for the past 3 years. She works as a nurse for four nephrologists in town who also have a kidney dialysis center connected to their practice. She has been a nurse for the past 20 years and loves her profession but lately has been feeling “burned out†on the job and has had difficulty concentrating on her work. She feels that since her divorce, her life has been going downhill. A year after her divorce, her mother died of liver cancer, and several months later, her father was diagnosed with prostate cancer. She took care of her mother during her illness and is currently caring for her father. Over the past 2 years, she has felt increasingly despondent, isolated and “blue†most of the time. She states that many of her “so-called friends†rejected her following the divorce because they were also friends with her ex-husband. She also feels that she hasn’t had much time for a social life since her part-time job became full-time following the divorce. When you ask her about her mood, she tells you it’s generally been “blue.†“I don’t seem to have any energy some days. It’s just hard to get up and face the day.†Kathy states that she feels lethargic most of the time and has difficulty doing everyday tasks that she once found easy to accomplish. “How has your sleeping been over the past year?†you ask. Kathy states that she has had difficulty falling asleep. She wakes up very early in the morning hours and is unable to get back to sleep. Approximately 6 months ago, Kathy reports “feeling so bad that I went to my physician to see if anything was really wrong with me.†She states that he found nothing physically wrong and recommended she get some exercise. At that time, she joined a health club and began working out. “I think I felt better for a while when I was going to the club, but after about 2 months, it became too much of an effort to get myself there to exercise.†She rubs her forehead and states that she probably should go back but doesn’t feel she has the energy. She also tells you that her biggest worry is that she’s not really “present†for her children. She has a hard time focusing on her children’s activities and has lost interest in what they are doing. “I just feel bored with everything – my children, my job, my life. I’m too tired to cook when I get home from work so I often stop at McDonald’s and get them hamburgers, which they’re happy with, but I don’t even feel like eating. I’ve lost about 20 pounds in the last year without even trying.†When you ask for background information, Kathy states that the problems she has been experiencing began shortly after her divorce from her husband approximately 2 ½ years ago. However, she suggests that she often struggled with feeling down and despondent throughout her 30s, prior to her divorce. She attributes those feelings to communication problems with her husband and states that she just couldn’t “give in to them because of the children.†“I got married right after I finished nursing school at the age of 21 and moved from my parents’ home to my husband’s home. He was 10 years older than I was and already had established business and social relationships that I was invited to participate in. At the time, it seemed great to me, and I thought the world revolved around him since he seemed older and wiser and could take care of me. I worked part-time as a nurse, not because I had to, but because I wanted to have a profession. Gradually, I began feeling like our relationship was falling apart. He began traveling a lot on business, and I was home with the children. He didn’t seem interesting in anything but work. We socialized with friends that he knew because of his business, and I felt that he just wanted me around to make him look good. This didn’t all happen overnight, you understand, but by my mid-30s I was having periods of utter despair over the kind of distant relationship I had with my husband and the total responsibility for my kids. His only goal in life was to make money, and he didn’t care about anything or anyone else.†Kathy states that from the age of 32 onward, she can’t really remember a time when she felt like her old self. “When I was a teenager, I was happy, outgoing, and enthusiastic about life. When I got into my 30s, everything seemed dreary most of the time.†Kathy states that she never was unable to function at her job or as a mother, but always felt sad and negative about the future. Kathy also tells you that she thinks her mother suffered from the same type of problem when Kathy was growing up. “If my mother could find a negative way to view a situation, she would find it.†She remembers her mother would often tell her and her sister that they had to go outside to play because her mother had to take a nap. “I always thought it was strange that she was sleeping in the middle of the day, but for my mother, it was normal for her to always be tired.†Despite the problems her mother may have had, Kathy states that she had a good childhood and often felt happy and full of life. “It seems like adulthood has ruined my mood,†Kathy says glumly. During your interview, Kathy often looks out the window, rather wistfully, when recalling the happier days of her childhood. She seems overwhelmed and obviously has difficulty coping with her feelings. She summarizes that she is requesting help with her overall mood and that she is able to function adequately but not up to the level that she has in the past. She seems concerned about not being an adequate mother for her children and the activities in which they are engaged. She spends most of the interview twisting the straps on her purse and only makes eye contact a few times throughout the session. She has apparently been experiencing these feeling for an extended length of time and is seeking help at this point because she worries about her job and her children. She doesn’t see the future as being very bright at the present time. You schedule another appointment for her in a week. She states as she leaves your office “I’m so glad I finally made the decision to get some help. That was the hardest thing to do.†Adapted from: Pomeroy, E. & Wambach, K. (2003). The clinical assessment workbook: Balancing strengths and differential diagnosis. Pacific Grove, CA: Brooks/Cole. Grading rubric: Topic Criteria Points/40 Assessment Includes (each with its own sub-heading under assessment) multidimensional assessment sub-headings: …physical functioning and well-being, cognitive functioning, spirituality and religious functioning, emotional functioning, behavioral functioning, family and social support functioning, suicide risk assessment. (With this last heading describe how you would assess for suicide risk using a suicide risk assessment tool or process that includes the tips on page 204 of your text; describe what you would do if suicide risk was assessed as high). Whether data in the case scenario is present or not, all of the above areas MUST be commented upon. Inclusion and comment on all multidimensional assessment areas and discussion of why each area is useful in “understanding the presenting problem, client, and situation so that the social worker, in collaboration with the client, can construct a plan of action to alleviate or at least mitigate the problem†(Cummins, Sevel & Pedrick, 2012, p. 180). Includes a discussion about the use of strengths-based and person-in-the-environment perspectives when conducting assessments (e.g. why both are important to consider). Briefly includes discussion on how the assessment approach may differ if Kathy were, instead: (a) a man, (b) a “blue collar†laborer, (c) elderly, (d) a member of an historically stereotyped, oppressed group (e.g. what biases can potentially enter that might influence the identification of the problem and its resolution)? HINT: when commenting, ensure you tie in to your course material from the textbook (esp. Ch 9) by using properly referenced quotes supporting your responses to each heading in the assessment phase. 10 Problem Identification Choose one main problem/issue that has been identified. Clearly outlined how the multidimensional assessment has led to the identification of the “real†problem to be addressed/treated and how this may be different from the presenting problem/symptoms (e.g. “I’m depressed – presenting problem; Unemployed – real problem); using the case scenario data, described the client interaction process leading to “real†problem identification (which subsequently informs the planning and contracting stages (see pgs. 214- 219 Cummins, Sevel & Pedrick, 2012). 5 Contracting Based on the problem identified proceed to discuss the steps you would take in the development of a service contract. Describes in detail the principles used in informing the contracting process as well as short and long term achievable goals with proposed activities; clearly identifies the process in choosing the intervention technique(s) to be used; describes the time frames and the summative evaluation process (how will we evaluate progress as we continue to move forward on the plan) see pgs. 225-232 (Cummins, Sevel & Pedrick, 2012) 5 Treatment/Intervention Choose a treatment/intervention technique you believe will effectively address the assessed problem. Has shown from the literature that this treatment intervention has been contextually appropriate and effective for this problem by citing no less than 5 different references from books and/or scholarly journals with publication dates no earlier than 1995. Demonstrates critical thinking in the process of selecting and applying the treatment modality. 15 (Scholarly Presentation) Summary References Not less than 15 and not more than 20 double spaced pages (inc. references); uses APA style precisely in the body of the paper as well as citations; correct grammar, spelling and sentence structure; easily readable with concise and logical ordering of ideas: provides an introduction for the reader that effectively describes the intent of the paper; provides a summary that is reflective of conclusions obtained about the effectiveness of the intervention chosen and implications for future research directed at resolving the identified problem. 5
File #1
Professional Practice Paper
Value: 40%
Cummins, Sevel and Pedrick (2012) state that, “preparing for client treatment is an important step in the helping process that ensures the best alignment of interventions with client needs and desired outcomes” (p. 236). They also state that “treatment applications should vary from client to client” and that “the selection of intervention and treatment modalities should be in alignment with the goals and time frames set out in the contract with the client” (Cummins, Sevel & Pedrick, 2012, p. 236).
Using the case scenario described below complete the assessment and contracting process with this client and choose a treatment modality that you believe will be effective in addressing this client’s situation. Selection of a treatment option does not need to be limited to only those discussed in Chapter 11 of your textbook. You are encouraged to explore other treatment interventions that reflect evidence-based practice informed by research.
Use the following headings:
Title (of paper – under which you would provide the introduction/intent of the paper) Assessment
Problem Identification Contracting
Treatment and Intervention Summary
References
Identifying Information
Client Name: Kathy Claybourne Age: 45 years old
Ethnicity: Caucasian Educational Level: B.S. degree in nursing
Marital Status: Divorced Children: Tommy, age 14; Betty, age 12
Intake Information
Kathy Claybourne is a 45-year-old single mother who contacted the Family Counseling Center concerning counselling for herself and perhaps, later, for her two children. She stated that she feels “very alone right now” and needs someone to talk to about “how my life is going.” She didn’t want to go into the reason for an appointment with a counsellor over the telephone. The intake worker scheduled an appointment for her with you, her counselor, for the following week. Kathy arrived on time for her appointment with you.
Intake Interview
Kathy presents as a polite, well-groomed, middle-aged woman who smiles and shakes hands with you in the waiting room. She says that she is very glad to have someone to discuss things with after spending much of her time talking to her children. Kathy indicates that she has been divorced for the past 3 years. She works as a nurse for four nephrologists in town who also have a kidney dialysis center connected to their practice. She has been a nurse for the past 20 years and loves her profession but lately has been feeling “burned out” on the job and has had difficulty concentrating on her work.
She feels that since her divorce, her life has been going downhill. A year after her divorce, her mother died of liver cancer, and several months later, her father was diagnosed with prostate cancer. She took care of her mother during her illness and is currently caring for her father.
Over the past 2 years, she has felt increasingly despondent, isolated and “blue” most of the time. She states that many of her “so-called friends” rejected her following the divorce because they were also friends with her ex-husband. She also feels that she hasn’t had much time for a social life since her part-time job became full-time following the divorce.
When you ask her about her mood, she tells you it’s generally been “blue.” “I don’t seem to have any energy some days. It’s just hard to get up and face the day.” Kathy states that she feels lethargic most of the time and has difficulty doing everyday tasks that she once found easy to accomplish.
“How has your sleeping been over the past year?” you ask. Kathy states that she has had difficulty falling asleep. She wakes up very early in the morning hours and is unable to get back to sleep.
Approximately 6 months ago, Kathy reports “feeling so bad that I went to my physician to see if anything was really wrong with me.” She states that he found nothing physically wrong and recommended she get some exercise. At that time, she joined a health club and began working out. “I think I felt better for a while when I was going to the club, but after about 2 months, it became too much of an effort to get myself there to exercise.” She rubs her forehead and states that she probably should go back but doesn’t feel she has the energy.
She also tells you that her biggest worry is that she’s not really “present” for her children. She has a hard time focusing on her children’s activities and has lost interest in what they are doing. “I just feel bored with everything – my children, my job, my life. I’m too tired to cook when I get home from work so I often stop at McDonald’s and get them hamburgers, which they’re happy with, but I don’t even feel like eating. I’ve lost about 20 pounds in the last year without even trying.”
When you ask for background information, Kathy states that the problems she has been experiencing began shortly after her divorce from her husband approximately 2 ½ years ago. However, she suggests that she often struggled with feeling down and despondent throughout her 30s, prior to her divorce. She attributes those feelings to communication problems with her husband and states that she just couldn’t “give in to them because of the children.”
“I got married right after I finished nursing school at the age of 21 and moved from my parents’ home to my husband’s home. He was 10 years older than I was and already had established business and social relationships that I was invited to participate in. At the time, it seemed great to me, and I thought the world revolved around him since he seemed older and wiser and could take care of me. I worked part-time as a nurse, not because I had to, but because I wanted to have a profession. Gradually, I began feeling like our relationship was falling apart. He began traveling a lot on business, and I was home with the children. He didn’t seem interesting in anything but work. We socialized with friends that he knew because of his business, and I felt that he just wanted me around to make him look good. This didn’t all happen overnight, you understand, but by my mid-30s I was having periods of utter despair over the kind of distant relationship I had with my husband and the total responsibility for my kids. His only goal in life was to make money, and he didn’t care about anything or anyone else.”
Kathy states that from the age of 32 onward, she can’t really remember a time when she felt like her old self. “When I was a teenager, I was happy, outgoing, and enthusiastic about life. When I got into my 30s, everything seemed dreary most of the time.”
Kathy states that she never was unable to function at her job or as a mother, but always felt sad and negative about the future. Kathy also tells you that she thinks her mother suffered from the same type of problem when Kathy was growing up. “If my mother could find a negative way to view a situation, she would find it.” She remembers her mother would often tell her and her sister that they had to go outside to play because her mother had to take a nap. “I always thought it was strange that she was sleeping in the middle of the day, but for my mother, it was normal for her to always be tired.” Despite the problems her mother may have had, Kathy states that she had a good childhood and often felt happy and full of life. “It seems like adulthood has ruined my mood,” Kathy says glumly.
During your interview, Kathy often looks out the window, rather wistfully, when recalling the happier days of her childhood. She seems overwhelmed and obviously has difficulty coping with her feelings.
She summarizes that she is requesting help with her overall mood and that she is able to function adequately but not up to the level that she has in the past. She seems concerned about not being an adequate mother for her children and the activities in which they are engaged.
She spends most of the interview twisting the straps on her purse and only makes eye contact a few times throughout the session. She has apparently been experiencing these feeling for an extended length of time and is seeking help at this point because she worries about her job and her children. She doesn’t see the future as being very bright at the present time.
You schedule another appointment for her in a week. She states as she leaves your office “I’m so glad I finally made the decision to get some help. That was the hardest thing to do.”
Adapted from: Pomeroy, E. & Wambach, K. (2003). The clinical assessment workbook: Balancing strengths and differential diagnosis. Pacific Grove, CA: Brooks/Cole.
Grading rubric:
Topic Criteria Points/40
Assessment Includes (each with its own sub-heading under assessment) multidimensional assessmentsub-headings:
…physical functioning and well-being, cognitive functioning, spirituality and religious functioning, emotional functioning, behavioral functioning, family and social supportfunctioning, suicide risk assessment. (With this last heading describe how you would assess for suicide risk using a suicide risk assessment tool or process that includes the tips on page 204 of your text; describe what you would do if suicide risk was assessed ashigh).
Whether data in the case scenario is present or not, all of the above areas MUST be commented upon. Inclusion and comment on all multidimensional assessment areas and discussion of why each area is useful in “understanding the presenting problem, client, and situation so that the social worker, in collaboration with the client, can construct a plan of action to alleviate or at least mitigate the problem” (Cummins, Sevel & Pedrick, 2012, p. 180). Includes a discussion about the use of strengths-based and person-in-the-environment perspectives when conducting assessments (e.g. why both are important to consider). Briefly includes discussion on how the assessment approach may differ if Kathy were, instead: (a) aman,
(b) a “blue collar” laborer, (c) elderly, (d) a member of an historically stereotyped, oppressed group (e.g. what biases can potentially enter that might influence the identification of the problem and its resolution)?
HINT: when commenting, ensure you tie in to your course material from the textbook (esp. Ch 9) by using properly referenced quotes supporting your responses to each heading in the assessment phase. 10
Problem Identification Choose one main problem/issue that has been identified. Clearly outlined how the multidimensional assessment has led to the identification of the “real” problem to be addressed/treated and how this may be different from the presenting problem/symptoms (e.g. “I’m depressed – presenting problem; Unemployed – real problem); using the case scenario data, described the client interaction process leading to “real”problem identification (which subsequently informs the planning and contracting stages (see pgs. 214- 219 Cummins, Sevel & Pedrick,2012). 5
Contracting
Based on the problem identified proceed to discuss the steps you would take in the development of a service contract. Describes in detail the principles used in informing the contracting process as well as short and long term achievable goals with proposed activities; clearly identifies the process in choosing the intervention technique(s) to be used; describes the time frames and the summative evaluation process (how will we evaluate progress as we continue to move forward on the plan) see pgs. 225-232 (Cummins, Sevel & Pedrick, 2012) 5
Treatment/Intervention Choose a treatment/intervention technique you believe will effectively address the assessed problem. Has shown from the literature that this treatment intervention has been contextually appropriate and effective for this problem by citing no less than 5 different references from books and/or scholarly journals with publication dates no earlier than 1995.
Demonstrates critical thinking in the process of selecting and applying the treatment modality. 15
(Scholarly Presentation) Summary
References Not less than 15 and not more than 20 double spaced pages (inc. references); uses APA style precisely in the body of thepaper as well as citations; correct grammar, spelling and sentence structure; easily readable with concise and logical orderingof ideas: provides an introduction for the reader that effectively describes the intent of the paper; provides a summary that is reflective of conclusions obtained about the effectiveness of the intervention chosen and implications for future research directed at resolving the identifiedproblem. 5
