Page 1 of 23
336 Sample of Final Paper Assignment # 5 Assessment and Intervention
Running Head: ASSESSMENT AND INTERVENTION PLAN
Assessment and Intervention Plan: Dianne’s Story
XXXNYZZOKKCXXXZZ
Theory and Practice of Generalist Social Work 1
47-336-01
Dr. Wilfred Gallant
University of Windsor
December 17, 2007
Introduction
It seems as though, like day evolves into night, people change and evolve as well. Dianne and I have been working together throughout the course of three sessions. We have built a strong helping relationship and it seems as though Dianne has placed trust in our bond. During our previous sessions, Dianne has disclosed thatshe is 33 years old and was previously a social work student before she had to pause her schooling. She is a single parent, however her child is in care due her crack cocaine relapse. Dianne suffers from cervical cancer and has also been diagnosed with Bipolar and Multiple Personality syndrome. She explained that she experienced personalities that exhibited anger, addiction, depression and a combination of all three of these. Dianne is also homeless with no source of income. Dianne has also explained that she is originally from Ottawa, where she used to reside with her parents, but has come to Windsor to seek out treatment for her substance abuse problem. At this point in our relationship, Dianne and I will be working towards assessing her current situation, creating a contract, as well as intervention and treatment plans. This will further be analyzed throughout this paper.
Assessment
The assessment phase of the generalist social work interview allows the social worker to aid the client through empowerment, making rational judgments, as well as decision making (Timberlake, et. al., 2008). The assessment phase thus, allows the social worker and client to create a strength-base problem-solving action plan through the analysis of the data collected (Timberlake, et. al., 2008). Both the client and the social worker work “…towards identifying client system strengths, capabilities, and environmental resources…” (Timberlake, et al., 2008, p. 243). I reviewed the issues of concern that were disclosed in prior sessions in order to confirm that these issues still need to be addressed and if there are any new issues that have come up between sessions. Dianne has explained that her main issues of concern are her addiction to crack cocaine, her lack of income and shelter, her son being in her parents care instead of hers, her mental health conditions and her cervical cancer.
Problem Prioritization
In order for a social worker and their client system to be able to implement the contract planning, intervention and treatment plan phases they must properly prioritize the problems and needs first (Timberlake, et al., 2008). This will allow the social worker and the client system to determine which need or problem should be addressed earliest. Often times, client systems have more then one problem or need pending (Timberlake, et al., 2008).
The social worker will attain the best results if they are able to re-assess the problems-person-environment that was discussed in previous sessions. Keeping these key factors in mind, the social worker must also be conscious of his or her relationship with the client (Timberlake, et al., 2008). In order to keep the trusting relationship strong throughout their time together, it is important that the social worker and the client system be able to improve the problem or satisfy the needs as soon as possible (Timberlake, et al., 2008).
In order to properly assess which problem or need should be addressed first the social worker and the client system can use the Problem Prioritization Scale (Timberlake, et al., 2008). This scale allows the social worker and the client system the ability to measure a problem’s potential for change by using a point system (Timberlake, et al., 2008).
Dianne’s prioritization scale can be reviewed in Appendix A. According to the scale, Dianne’s problem with crack cocaine use has the highest potential for change. This problem scored 27/30 in regards to potential for change.This score was due to the fact that Dianne was capable to stay clean for five years until her recent relapse. She is highly motivated to change because she wants her son back and she has many great treatment centers in this area that are available to her.Dianne also insisted, during this interview, that she feels that this is the problem she would like to address first. The scale, thus, corroborates with Dianne’s feelings.
Assessment Statement
Each problem that is identified by the social worker and the client must have an assessment statement. In other words, each problem or need should have a comprehensible statement of the nature of the issue of concern (Timberlake, et. al., 2008). Dianne’s crack cocaine addiction will be the focus of this assessment statement. The social worker and the client should come to a clear understanding of how the problem interlocks with the client’s needs. When Dianne and I explored this question we came to the understanding, with the data collected from prior sessions, that Dianne’s crack cocaine use has caused her biological, psychological, social, cultural and spiritual distress. According to Dr. Gallant, a professor at the University of Windsor, one must take a holistic approach to the assessment. Therefore it is crucial to consider all five of these components (personal communication, December 4, 2007).
Another question that needs to be explored is if the issue of concern is the only problem or are there other connecting problems as well (Timberlake, et. al., 2008). In regards to Dianne’s crack cocaine addiction, there are many other issues associated with it. Dianne has bipolar and has a personality disorder. With that said, Dianne has trouble regulating her moods and emotions, yet with the added mood changes that come from crack cocaine use (Laugeault, personal communication, November 20, 2007), her moods seem to change more severely. Dianne dropping out of university and being homeless is also associated with her drug use. Also, her son is out of her care due to the addiction.
The social worker and the client must also ask who are the people involved that may be imposing the problem onto the client (Timberlake, et. al., 2008). With the aid of the data collection phase from a prior session, Dianne and I were able to determine that crack users are influencing Dianne to use. It is also important to find out why the client finds themselves to be in the problem situation presently. In regards to Dianne, she explained that she started using again because her partner was using as well. Since Dianne was sober for five years prior to her recent relapse, it is clear that she has attempted to make positive changes. She has had success with riding herself from her crack addiction but she relapsed due to environmental factors. This has influenced her score in regards to the problem prioritization scale.
A social worker and the client needs to determine the major cause for all of the problems and needs in the client’s life (Timberlake, et. al., 2008). Since we have gathered information in regards to all of the implications of Dianne’s problems in prior sessions, it is clear that her crack cocaine use has caused the majority of the sub-problems she is facing. Therefore, the assessment statement is as follows, Dianne’s major problem that needs to have a contract, intervention and treatment plan is her crack cocaine addiction. Once her crack cocaine addiction is in control, her other sub-problems should naturally improve, yet may need further assistance. It is important for the social worker to understand the potential of the client’s ability to change (Timberlake, et. al., 2008). Therefore, the change potential for Dianne, in regards to her problem of crack cocaine addiction, is assessed as very high because she has a history of success and is highly motivated (refer to Appendix A) (Timberlake, et. al., 2008).
Ecological-Systems Perspective
In order to assess the client system in a holistic manner, one must take on an ecological-systems perspective (Gallant, personal communication, December 4, 2007). This perspective allows the social worker and the client to assess the issue at a micro, mezzo and macro level in order to have a complete understanding. Social workers and client systems must understand that all three of these levels interact and interlock with one another, which means that one issue can very well affect a client system on all three of these levels at any given time (Timberlake, et al., 2008). One must examine the biological, psychological, social, cultural as well as spiritual components of the client system in order to understand how the issue of concern may or may not affect the client at a micro, mezzo and macro level.
Biological assessment.
Dianne’s crack cocaine use has highly affected her physical health. During this meeting Dianne explained that she has many physical ailments due to her crack use. She expressed that she has sores on her skin because she was picking at it thinking that she had insects crawling under her skin. This type of self abuse and paranoia is common among crack users (Laugeault, personal communication, November 20, 2007). Dianne has also explained that her teeth are falling out, rotting and hurt a great deal. This type of tooth decay is also common among crack users (Laugeault, personal communication, November 20 2007). She also disclosed during this session that she has many blisters on her lips from smoking crack cocaine and is also experienced trouble breathing. For instance, crack cocaine can cause “… a wide variety of pulmonary complications including interstitial pneumonitis, fibrosis, pulmonary hypertension, alveolar hemorrhage, asthma exacerbation, barotrauma, thermal airway injury, hilar lymphadenopathies, and bullous emphysema” (Restrepo,Carrillo, Martínez, Ojeda, RiveraHatta, 2007).
Psychological assessment.
During this session together, I asked Dianne is her crack cocaine addiction had any effects on her mental health. Dianne explained that when she is coming down from a high she experiences a large deal of depression.Wingood andDiClemente (1998) explainthat often times when women use crack cocaine they experience feelings of depression. She also explained that she experiences paranoia when she is coming down from the highs. Dianne revealed that she experiences a great deal of stress when she is going through withdrawals because she wants to get high but is trying to fight the urge to use.Weiss, Ciccocioppo,Parsons, Katner, Liu, Zorrilla,Valdez, Ben-Shahar, Angelletti and Richter (2001) explain that during withdrawals, crack users experience a dangerous amount of stress.
Social assessment.
Dianne has regrettably disclosed that her social life has diminished quite a bit due to her addiction. She explained that she has lost important and strong friendships and relationships with family members because they do not accept her substance abuse problem. Further, due to her addiction she lost custody of her son. With that said, she fears that her relationship with her son has been destroyed and she hopes to be able to regain his trust and care for him again. Dianne also explained in this session that she has made many negative relationships because of her addiction to crack cocaine. She explained that she is doing her best to stay away from the other drug users that peer pressure her but it is a difficult task when she needs to fulfill her need of crack.
Cultural assessment.
Dianne is a Black woman and seems to be well connected with her culture as best as she can at the moment. Dianne explained that she is involved in cultural groups and enjoys spending time with people who share the same beliefs and ideals as she does. According to Lillie-Blanton, Anthony and Schuster (1993), crack cocaine users are not necessarily more often Black. They explain further that crack use is not race specific but more so depends on other environmental factors. With that said, Dianne’s crack use may not be necessarily due to her culture (Lillie-Blanton, et al., 1993). On the other hand, Boyd (1993) explains that female African American crack users are on the rise.
Spiritual assessment.
During this session Dianne explained that she is a Born Again Christian. She enjoys spending time at Church, but has difficulty being in large crowds. Often times she will go alone to collect her thoughts and spiritually reflect. It seems as though Dianne has a positive spiritual relationship with God which can be seen as a strength and an asset that may help with her making positive changes.
Contract Planning
The next step of our meeting was to implement a contract plan (Timberlake, et al., 2008). This contract plan allows the social worker and the client to prioritize tasks and goals that they would like to see be accomplished, as well as a plan that dictates how and when which tasks will be completed (Timberlake, et al., 2008). This type of contract allows the client system to improve on their flexibility, growth, outside resources and will also help minimize environmental barriers that the client may face otherwise (Timberlake, et al., 2008).
It is very important that the client thoroughly understand the contract and what is being asked of him, as well as the social worker (Timberlake, et al., 2008). With that said, it is very important that there is a clear understanding of which problems are going to be incorporated in the contract plan and why. Since Dianne has already explained that she would like her crack cocaine addiction addressed first, and since this is corroborated in the problem prioritization scale, we both have an understanding that we will be tackling this issue first, with the others to follow. Dianne and I conversed about how we may work at accomplishing her goal to become clean, and she expressed that she would need the assistance of a treatment centre. I suggested two different treatment centers to Dianne that are in the area and explained their differences. According to Timberlake, et al. (2008), it is important to give the client system choices and introduce possible environmental resources that may be available to them. Dianne expressed that she was interested in House of Sophrosyne because it is a treatment centre for women only. Dianne explained that, with my encouragement, she is comfortable with calling the treatment centre that same day to set up an appointment to visit the centre and get the process started. I made sure to lend my support to Dianne during this call which allowed her to feel more at ease and empowered. Timberlake, et al. (2008) also explain that encouraging the client system to become an active part of the contract planning process will allow the client to feel empowered and gives them the opportunity to take control over the problem-solving process.I made sure to write the contract plan with Dianne to give her that opportunity. Timberlake, et al.(2008), explain that it may be difficult for some social workers to allow the client to be a part of this process (Timberlake, et al., 2008).This type of client system involvement also impacts the potential for the client to follow through with the tasks outlines in the contract plan (Timberlake, et al., 2008). Due to its importance I made sure to resist the urges to take over and respect Dianne’s ability to be self-determining. With that said the contract will comprise of Dianne contacting and connecting with a treatment centre with my support. Refer to Appendix B to review a detailed contract plan.Dates of the contract plan may be altered due to realistic set backs and challenges the client system may face (Timberlake, et al., 2008). All goals, tasks, responsibilities and dates have been agreed by both Dianne and myself to ensure a collaborative working relationship.
Intervention and Treatment Plan
Intervention and treatment plan strategies are incorporated in the strengths-based problem-solving process of the generalist social work practice at micro, mezzo and macro levels (Timberlake, et al., 2008). Each of these levels of intervention and treatment plans are designed to assist certain issues and concerns, contract plans and goals for different levels of client systems (Timberlake, et al., 2008). Since Dianne is only one individual client system, we will be working with intervention and treatment plans that focus on micro client systems.
The point of micro level interventions with individual client systems is to help empower the client and help facilitate them in their problem-solving process (Timberlake, et al., 2008). This will help the client gain control of themselves and their environment (Timberlake, et al., 2008). Micro level intervention also allows the client system to improve on the barriers and challenges that they have had to face in regards to environmental resources, which will allow them to benefit from them and allow them to reach their goals and aspirations (Timberlake, et al., 2008). Thus, the client will be able to be empowered and be more confident in their abilities to make positive changes in their life, the client system will be able to realistic about societal barriers that they may face, the client system’s knowledge and skills wiill grow and strengthen, they will be able to improve or implement important and positive support systems, and they will also be able to take action and be responsible to make positive changes to their issues of concern (Timberlake, et al., 2008). The components of intervention that apply to Dianne are power-shared relationship, competency based assessment, normalization, collectivity for mutual aid, and knowledge and skills for taking action.