Social Work Biopsychosocial Assessment Term Paper
Excerpt from Term Paper :
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 3 -- Understanding of Social Work Skills
I used a variety of techniques during the assessment including attending, which is often considered one of the most important or basic skills for counselors or social workers (Ivey, 1993). Attending is nothing more than paying close attention to what the client is saying during a session, and requires that the interviewer not only demonstrate interest but also understand patterns of communication within the interview (Ivey, 1993). In addition I worked closely to interpret verbal and nonverbal cues the clients give off during discussion sessions that may be helpful in gaining insight into their emotions and feelings. Good attending skills during the assessment phase of the client interview help the client share and talk more (Ivey & Pederson, 1993). They also send the message that you are open and interested in communication. In addition I worked to establish a comfortable relationship, encourage natural gestures and took interest when the subjects were uncomfortable at times during the interview or when special emphasis was put on some topics more so than others.
I also use paraphrasing during the interview, which allowed me to provide feedback on what the clients are saying, or to put their message in context so the clients understand that I understood the essence of what they were trying to communicate during our session (Ivey & Pederson, 1993). Paraphrasing and summarizing are both techniques that can help build understanding particularly in new client relationships. Summarizing is best reserved for the end of an interview when the interviewer can sum up the information the client has provided in a few small phrases (Ivey & Pederson, 1993).
Many interventions were effective in helping the current clients overcome their trials and tribulations including cognitive behavioral therapy and comprehensive assessment. Community-based support is also indicated in this case. The current mode of thinking with respect to child abuse and neglect cases suggest that techniques involving parent child interaction are best suited to identifying patterns of parental responsiveness and interaction (Gitterson, 2001). In this case I identified abuse family interaction patterns, which involve interfering behavior for the child, and less parental responsiveness to child needs (Gitterson, 2001).
A cognitive behavioral approach is also indicated, (Gelles & Lancaster, 1987). This type of approach concerns itself with enabling people to identify patterns or ways of thinking, believing and talking that lead them to detrimental outcomes. By becoming aware of self-defeating patterns clients can often overcome them and go on to lead a productive and more self-sufficient life free from the addictions and problems that bombarded them prior to treatment.
During the session I found myself torn between compassion and the desire to help Ms. Rizzo and anger that she would have to suffer in this situation to begin with.…
Sources Used in Documents:
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.
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