Biopsychosocial assessment of child neglect in Marvin's case

¶ … multiple factors present influencing the client in the situation described, including social, environmental and psychosocial factors. The client Marvin is currently suffering from emotional, physical and educational neglect largely resulting from environmental factors but also social circumstances. Environmental factors contributing to his case include lack of proper housing and possible nourishment, a family history of substance abuse and poor living conditions. Both child and parent in this case lack adequate social support networks to work through their problems and deal with the stressors associated with their lifestyle.

The most pressing issue influencing the client's case in this case is environment. Child abuse is more frequently the result of environmental factors that include family, relatives and poverty as well as multiple social factors that predisposition a family to disadvantage (Gitterson, 2001). Marvin is a product or consequence of uncontrollable aspects of his environment. So to is his mother who has suffered for years in an environment that has led to increasing addictions and problems.

Child abuse comes in many forms including emotional abuse or educational neglect in addition to physical or sexual abuse. Emotional abuses include chronic verbal assault or "scapegoating of a child by an adult" (Gitterson, 368). Physical abuse is present in this case where the parent is failing to provide the child's basic needs and thus increasing the child's susceptibility to outside injury or harm. Child neglect of a physical nature more often than not involves lack of adequate supervision, as is the case in this situation (Gitterson, 268).. As a result children can fail to thrive particularly in an environment where adequate shelter, food or clothing aren't available. Chronic truancy often results from educational neglect. Alcohol and substance abuse in the home leads to emotional neglect (Jones, 1990)

In this case the abuse can be attributed to an ecological approach (Smith & Carlson, 1997), which suggests that child abuse involves societal, parental, and child factors that eventually lead to neglect. It includes abuse through social constructs or conditions and stressors as well as environmental ones. As a strength however the clients involved seem to share love for one another and dedication to one another to resolve the issues at hand. The mother figure in this case wants to do what is right for her child, which will positively affect the outcome more likely than not in the future for this case.

Much of the client's parental influence is probably largely a result of verbal and emotional abuse the client's mother suffered. The case study suggests a history of depression in the family, which may contribute biological factors to the client's case. History of addiction is also likely in the family given the clients mothers reported addiction to cocaine. Also influencing Marvin is his mother's single parent status. Fortunately the client's mother loves her child much but lacks the parenting skills necessary to provide a loving and supportive environment. Homelessness and substance abuse are contributing to the problem.

Section 2 -- Treatment Planning and Contracting

There are multiple issues to address in this particular case including possible genetic linkages to alcoholism, depression and anxiety (Smith & Carlson, 1997; Gitterman, 2001). Conditions like this often include genetic and neurochemical predispositions that may influence a patients treatment outcomes (Gitterman, 2001). Studies suggest that despite genetic predispositions however the chances of family members of succumbing to a condition rest more on the environment, which may include family and relatives behaviors, attitudes and the resources available to those individuals (Gitterman, 2001). Supportive environments are often vital to the success of someone overcoming poverty, homelessness and substance abuse (Getterman, 2001). Many victims in these environments become "socialized to a lifetime of crime and victimization" (Gitterman, 4).

Social workers however can help these clients overcome their challenges by engaging in responsive interventions like helping children of alcoholic or depressed parents learn techniques for disengaging themselves from their environment and developing psychological or emotional distance from the hassles and conflicts evident in their daily life (Germain & Gitterman, 1996; Gitterman, 2001). This process is often referred to as adaptive distancing and encourages children to sustain external connections while learning to disengage themselves from the problems at hand.

In this case the client and I have made efforts toward aw working agreement including (1) helping Ms. Rizzo realize that she must strengthen her parenting skills to provide Marvin the care he needs. This will be accomplished in part through weekly therapist sessions, (2) having Ms. Rizzo participate in Marvin's treatment and (3) having Ms. Rizzo play a more active role in Marvin's school progress. In addition we have outlined a number of steps that must be taken to help Ms. Rizzo overcome the underlying problems affecting her relationships including her substance abuse problems. So far this has been the biggest challenge. The client is showing an active interest in communicating with Marvin and taking part in his school progress. The client is also working to budget her money for food and utilities and prioritize expenses. Ms. Rizzo is attending counseling for substance abuse but this will be a long and likely difficult road for the client who has abused for many years. Cognitive behavior therapy might help Ms. Rizzo uncover the self-defeating patterns that are leading her to abuse in the first place. The earlier she recognizes the patterns the better likely she is to change them.

In this case the client has been offered confidentiality however there are limitations to that confidentiality. For one the DSS has to check in periodically and report on Marvin's progress to ensure that the situation is improving and that Marvin is not continually neglected. There are certain situations where maltreatment or failure to comply with the guidelines of treatment must be reported for the health and well being of the child.

I have learned that complex relationships often exist in situations where children are abused. Children are not always abused due to lack of empathy, compassion or love on the part of their caregiver. Rather in this case Ms. Rizzo demonstrates very earnest feelings for her son, and the two share a warm relationship. The abuse Marvin has experienced is more the result of environmental factors, which can hopefully be changed and adapted in the future.

Section 4 -- Worker self-analysis

According to Ivey & Pederson (1993) biases often pose barriers to communication between individuals. Thus it is important as a care worker that I minimize the biases that exist between me and the client so my efforts are best directed at helping the client. Most people are trapped by their own biases only when they are not aware of them. It is important going into a situation that a counselor or social worker overcome any preconceived notions or biases they have regarding a particular situation to best facilitate communication between client and counselor.

The client and I in this case shared few similarities. Thus it was important going into this meeting that I dispel any preconceived notions I might have regarding the clients status which might affect my empathy. For example, typically I might assume that a child abuse case involves a child that is clearly not loved by the parents. This is clearly not the case here however as the mother has expressed good concern over the welfare of her child, she simply lacks the skills and abilities to care for her child correctly for the time being.

Anxiety can severely limit the healing process. It is important that a social worker be free from anxiety so they may engage in active listening during assessment and help encourage the client to succeed despite the obstacles they may face. Anxiety however is also a natural byproduct of life. For a social worker to overcome anxiety I feel it is important that they first become aware of what obstacles they face or factors that make them feel anxious, then acknowledge them to help overcome them. It is important that the social worker also separate themselves and their personal experiences from the client experiences, so they are better able to explore content and feelings when or if the client touches on painful subjects for the social worker. The social worker must focus and remember that the client's agenda is separate from his or her own .

Again I feel the best way to prepare for this setting is to be aware of my own personal biases experiences, thoughts and perceptions about the clients case prior to working with the client. It is critical that I separate my feelings from those of the client, and also work through any issues I have with a particular subject so I don't bring those issues into the client social worker relationship. It is also important during the interview process that my full attention is given the clients and not my own personal feelings, anxiety or painful perceptions of the case at hand.

The client has a right do demand objectivity from me. Every situation is unique and different; no two cases are the same. This idea alone can help a social worker prepare for interaction with a client by helping the social worker understand that regardless of any similarities between a client case and their own history, the two are separate and unique. A formal case review prior to meeting with the subjects can help a social worker recognize any personal biases, feelings or emotions they may have related to a case.

It is then the job of the social worker to separate his or her personal feelings and experiences from those of the client. The social worker also has an obligation to become aware of and remove any tension or anxiety that might exist regarding a particular case prior to interacting with clients. If this is not possible then it is probably best that the client take on another case.

References:

Ivey, A. & Pederson, P.B. (1993). Culture-centered counseling and interviewing skills: A

practical guide. Westport: Praeger.

Gelles, R.J. & Lancaster, J.B. (1987). Child abuse and neglect: Biosocial dimensions.

New York: Aldine De Gruyter.

Germain, C.B. And A. Gitterman. 1996. The Life Model of social work practice:

Advances in knowledge and practice. New York: Columbia University Press.

Gitterman, A. (2001). Handbook of social work practice with vulnerable and resilient populations. New York: Columbia University Press.

Jones, L. 1990. "Unemployment and Child Abuse." Families in society: The Journal of Contemporary Human Services 71(10): 579 -- 88.

Smith, C. And B. Carlson. 1997. "Stress, Coping, and Resilience in Children and Youth."

Social Service Review 71(2): 231 -- 56.