Social Work Clinical Practice Sociology

SOCIOLOGY

Sociology: Social Work Clinical Practice

Part 1

Answer to Prompt 1

Since the client is a young adult aging out of foster care, he is unaware of how they would respond to him when they would get to know he belongs to a foster home. Also, he is worried about employment opportunities in the outer world since he has learned that there are not many bright chances for young adults like him in the practical world. His negative feelings about the outside world and worries about his employment are the problems that he faces currently.

The client’s problem could potentially guide my intervention since changing attitudes towards the outside world and eliminating employment worry would be a short-term therapy. The client’s problem would be determined by formulating goals and setting the timeline, which is already detected in this case. The cataloging of tasks and planning them in order reflects the client’s actual problem identification for an accurately targeted CBT intervention.

Social workers or clinicians need to be familiar with CBT since they must ascertain the client’s risky thoughts or mannerisms that would lead the clinician to conceive a preventive program without delay. CBT is a treatment that is developed with the choice and willingness of the client so that a decrease in his high-risk or urgent attitudes should be concentrated on immediately. To prevent future or long-term psychological problems, clinicians should be familiar with CBT interventions for eradicating hazardous problems. Social work encapsulates empowerment desperately needed for those who might need CBT treatment. The clients might not seek help on their own, and to detect their correct problems, there should be someone qualified to make the clients independent and free of their issues. The theoretical knowledge that the social workers should possess regarding CBT would be translated into practical implications for supporting their clients to achieve the targeted change. The abstract theories and concepts that social workers should discern must be used to alleviate personal or social distress for creating an amplified betterment for the society since a client’s friends and family members would also be satisfied when the client is properly treated with CBT, which is only possible through clinicians’ familiarization and conceptualization of CBT.

Answer to Prompt 2

The client discussed above is suitable for CBT intervention like cognitive restructuring since he seems to be overgeneralizing the outer world’s perceptions towards him. He needs to learn not every person experiences the same situation each time. He might be placing far too much importance on minute details that direct him to stress himself excessively. He needs to discern that negative thoughts about the outer world and his self-perceived fears of facing the world should be changed, for which CBT intervention is required.

The client is a good candidate for CBT as he needs to be exposed to the outside world for the first time after coming out of the foster home. He needs to face his fears of not getting a satisfactory job, possibly being a foster child. Exposure therapy would be helpful CBT intervention for this young adult as he should confront his fears. The counselor would slowly expose him to similar fears before coping with them. The client should be able to digest things slowly, one step at a time, with small increments in CBT intervention so that strengthening of his coping abilities could be certified. He needs to understand that failure would be inevitable initially, and he also might not be able to get a fine job on his first try. However, it should not de-motivate him, and he should not continue to overgeneralize negative thoughts. This is the situation that asks for CBT intervention for the said client.

Part 2

Answer to Prompt 1

Structuring and education complement each other since cognitive-behavioral therapy (CBT) helps enlist the tasks included in the therapy that define the direction of therapy. The sessions are designed upon the planning dimensions of the CBT since the main goal is to generate hope within the clients. When learning skills are promoted among the clients, it is expected that CBT would work better with the facilitation of the change in behavioral and psychological problems.

Also, education, or more specifically psycho-education, goes hand in hand with structuring in CBT since the schooling of the core concepts of the therapy forms the grounds for the actual effectiveness of the therapy. It should be considered embedded with the structuring concept because the recurring educational methods such as taking notes in the notebooks are part of the structuring concept.

The main components of CBT for which psycho-education should be routinely provided are the nature of automatic thoughts, cognitive distortions like jumping to conclusions, overgeneralizing, filtering, etc. The lesson that should get across is that thoughts could be easily changed with the mind’s willpower since they are not facts that should be believed sternly. Like the other five senses, they are a sensor of their feelings. Seeking help or advice should not be avoided as destructive thoughts should be treated as soon as possible before making a person a failure via stress-inducing behaviors.

Answer to Prompt 2

Learning something new would be a type of technique in psycho-education under CBT for the above-identified psychological disruptions like automatic thoughts and cognitive distortions. Making inaccurate interpretations is the primary reason for disturbing thoughts that need to be changed via psycho-education. The patient needs to be taught that the meaning of a situation should not be attached to certain situations and prevented from remembering unwanted or unpleasant memories that make them frightened. He would need to be tutored that previous experiences might not always end up the same way and that decided interpretations should not always be attached to similar situations.

Moreover, some worksheets for psycho-education in CBT would be beneficial for changing the existing mind frames and learning something new. One of the worksheets is ‘unhelpful thinking styles,’ specifically useful for changing overgeneralization. For instance, if the patient cannot do a task right and thinks that he is not capable of doing things correctly, the worksheet could be the best CBT technique for educating him that certain thinking styles are experienced by everyone at least once in their lives.

Another useful psycho-education tool would be the informative flyer or handout on safety-seeking behaviors. The patient should know if he is exhibiting certain behaviors, what those behaviors mean, whether those behaviors ask for safety and protection that might come from his encounter with a catastrophe. The types of safety behaviors are avoidance, escape, and subtle avoidance.

Some more useful methods for psycho-education for the abortion of automatic thoughts and cognitive distortion like Socratic questioning, assertiveness skills, improved communication, and problem-solving skills. With Socratic questioning, the counselor would ask about the patient’s thoughts and worries and clarify any issues that he is unaware of. The next step of psycho-education could be problem-solving skills for helping the client in the areas in which his knowledge is wrong or limited. He could be introduced to personal or social problem-solving skills. The discussion for identifying communication gaps and issues should be an ongoing process through psycho-education in CBT to ensure better transferring of knowledge. Finally, assertiveness skills are valuable for having clear and concise communication for meeting the client’s psychological needs. It enhances understanding of the knowledge disseminated by the counselor, facilitating better education for clients in the identified areas above.

Part 3

Introduction

I work for a child welfare agency. The clients I serve are young adults aging out of foster care homes. The services offered to the clients include self-sufficiency in terms of employment and transition to a better and stronger adulthood time. The services also involve finding suitable homes once the young adults are prepared for facing the outer world, finding better educational institutes, financial management, and finding emotional and peer support in the outer world along with continuous psychological counseling that they would be alight when they leave their foster homes.

The client’s description that I serve is from the same target population of the agency I work for. A Black, 18-year-old male is my client for which I have presented a problem scenario in the previous section. He belonged to a multi-racial family in which the parents belonged to one ethnic background, and his other foster siblings were from other cultural backgrounds. He had two White twin sisters and one brother from an Asian background.

My client’s clinical history comprised the death of his parents in a bus accident when they were traveling from another city to the current one. He survived that accident and had to be shifted to a foster home. He had been suffering from post-traumatic stress because of the bus accident and the loss of his parents. It was detected that he might experience behavioral or emotional problems at a very early age and need to have sincere love from someone like his foster parents. Since he belonged to an ethnic minority that had historically been subjected to racial discrimination, extra care had to be taken while assigning him to a foster care family. A multi-racial family was opted the best for him and were contacted immediately.

The reason for seeking treatment is that he is afraid of stepping into the practical world and wants to avoid confrontation with people on his own. Some of his early life symptoms were undergoing post-traumatic stress after losing his parents and entering the foster home. He could not sleep due to continuous stress, became irritated easily, and exhibited troubling behaviors. At the same time, he used to play or draw since he wanted to avoid remembering the triggering event. It is deemed necessary to give him therapeutic intervention through CBT since his tense and upsetting behaviors need to be changed. They might cause trouble in sleep again when he repeatedly thinks of meeting new people and how they would greet him.

As mentioned earlier, his Black culture has been subjected to racial discrimination, which is likely one of his reasons for being afraid of people’s behavior towards him, especially after aging out of the foster home. Trauma-informed care for structuring the client’s thoughts out of negativity and the unexpected events that he might have overgeneralized due to his racial background need to be altered. Cultural competence requires humility for this client as a patient-centered approach needs to be developed via CBT intervention. He should be empowered with more positive thoughts and the conception of trust between the counselor and the client. Also, collaboration and warranting safety for practicing trauma-informed care would help the client’s healing process faster.

The two human behavior and social environment (HBSE) theories that apply effectively to my client are the micro, mezzo, and macro approach and the ecological systems model. The micro, mezzo, and macro approaches work in three layers for understanding. First, the micro-level indicators for affecting the client’s psychological attributes. In the second layer, the mezzo level considers the peer or family networks that form his connection and bring support for him. The third layer is about macro indicators influencing the economic and political regulations, directly impacting his employment opportunities. The ecological systems model suggests that micro, meso, exosystems, macro, and chronosystems with which the client interacts highlight the interconnection with his historical events and future ones. His past experiences landed his presence in the foster home, the care he got from his close relations in the foster home, such as foster parents and siblings, and the interlinking with his cultural background would produce results in the outer world once he ages out of his foster care placement.

Assessment

According to DSM criteria, the client suffers from a social anxiety disorder. The reason that his diagnostic indication refers to DSM 5 criteria for this disorder is that he is fearful of people’s perceptions towards him, he is afraid of how they would judge him once he moves out of the foster home, he feels that it would be scary to be around people as he is fearful of his own cultural identity as well, and his self-consciousness might prohibit him from reaching his full potential when he gets employed.

The assessments that would be used for reaching the diagnosis include diagnostic interviews that are semi-structured clinical interviews, clinical-administered scales such as Liebowitz Social Anxiety Scale (LSAS) and Brief Social Phobia Scale (BSPS), and self-reported scales encompassing mini-spin, social avoidance, and distress scale, and fear questionnaire social phobia subscale, etc. The reason these assessments were selected is that they are considered valuable by the research for checking the social phobias of the client and the specific indicators that trigger his symptoms. If the counselor is an expert himself, he would be able to better analyze the client’s condition deeply with these assessments and his cultural background, sexual orientation factors that activate his anxiety, etc. The frequency of these assessments is believed best before and after the CBT intervention. Once his condition before intervention is marked, any improvement signs could be noticed post-intervention.