RESPONSE 1

Respond to two colleagues who presented a different strength and/or solution in analyzing one of the levels of practice.

Colleague 1: Kevin

Micro-Level practice focuses on personal interaction with the client on an individual level or with a couple or family. The intervention of micro social work effects change on an individual basis and involves working closely with clients to support them through their challenges while maintaining the client’s self-determination (NASW, 2017).

Mezzo-Level intervention entails bringing people together who are not as intimate as a couple or group of family members but might mutually build and benefit from this social or resource network (Holosko, Dulmus & Sowers, 2012). It might directly change the system that is affecting a client, such as a classroom or neighborhood group. Mezzo work may include group therapy counseling, self-help groups or neighborhood community associations (NASW, 2017).

Macro-Level practice focuses on systemic issues. It might include creating and maintaining a network of service providers in order to establish a continuum of care. Macro-level intervention can intersect with the political realm by creating and lobbying for policy changes. The planning, implementation, and maintenance of social programs are also processes which macro-scale approach is applicable. Coordinating multiple services and policy work offers an opportunity to address several overlapping social problems (NASW, 2017).

Explain how you would assess Paula Cortez’s situation applying the micro-level of social work practice and specifically identify two strengths and/or solutions in this level

The student understands the essential concepts of Paula’s self-determination. Nevertheless, a micro-level approach could assist her through counseling, empathy, active listening, goal setting and building rapport with her to produce a healthy therapeutic relationship (Arendt, 2017). The directive for recognizing and focusing on Paula’s strengths is crucial to the committed client empowerment and fulfillment. Paula’s resilience was drawn from her cultural background that played a part in her independence especially from mainstream medicine. Also, Paula’s strengths were exhibited in her uniqueness in teaching herself how to paint with her non-dominant hand and her ability to gather professionals together to work with her (Cowger, 1994).

Describe how you would assess Paula Cortez’s situation applying the mezzo-level of social work practice and specifically identify two strengths and/or solutions in this level

The student would be non-judgmental and resourceful and use the mezzo-level approach when it comes to connecting Paula with the right referrals to assist her with preparation for the pregnancy (Plummer, Makris & Brocksen, 2014).The psychiatrist also was a supportive example of a mezzo interaction regarding Paula’s well-being during her pregnancy and worked with the social worker in making the hard decision of having Paula involuntarily admitted into the hospital (Plummer et al., 2014). Clearly, Paula’s resilience proceeds her, and it created a sense of purpose; a new beginning from what was a troublesome past filled with disappointment, emotional and physical abuse (Plummer et al., 2014).

Describe how you would assess Paula Cortez’s situation applying the macro-level of social work practice and specifically identify two strengths and/or solutions in this level

The student also recognizes that macro-level social work is essential in helping Paula to identify her personal needs. With advocating, the social worker can propose interventions and implement strategies through local government assistance, provided reasonable healthcare assistance, food and protected shelter that would aid Paula’s complex needs (Plummer et al., 2014).

Describe what the value of applying strength-based solutions is.

Applying strengths-based approaches will be helpful in successfully shifting the balance of care and developing services that are focused on prevention and independence. For example, Paula’s newborn child created that sense of purpose. Paula became independent and began to acquire social services on her own (Plummer et al., 2014). Paula maintained her autonomy which was of value to her.

References:

Arendt, V. (2017). Changing Areas of Practice: The Transferability of Social Work Skills. New Social Worker, 24(2), 10-25.

Cowger, C. (1994). Assessing client strengths: clinical assessment for client empowerment. Social Work, 39(3), 262-268.

Holosko, J., M., Dulmus, N., C., Sowers, M., K. (2012). Social Work Practice with Individuals and Families: Evidence-Informed Assessments and Interventions, 1st Edition. [Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781118419359/

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014a). Sessions: case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

The National Association of Social Workers. (2017). Code of ethics. Retrieved from https://www.uaf.edu/socwork/student-information/checklist/(D)-NASW-Code-of-Ethics.pdf

Colleague 2: Lorraine

Your description of how micro-, mezzo-, or macro-levels of practice aid social workers in assessing families. Assess Paula Cortez’s situation using all three of these levels of practice, and identify two strengths and/or solutions in each of these levels.Assessing families is an important part of what we will do as social workers. 

Understanding the family unit and how the intricate  parts of this unit interact and affect one another is essential.  On the Micro level it is important to understand each individual unit and the family’s dynamic.  This understanding of the family helps social workers identify how the  influences exist within the overall unit.  On a Mezzo level it is important to understand the families interaction as a group and the groups interaction with the community in which it lives and works.  The families access to resources and whether these resources are being utilized or not.  On a Macro level we examine how this family fits into the social environment on a larger scale and how social policies impact the family as a whole.  According to Holosko, Dulmus & Sowers (2013),  “The key challenge here is to recognize how the common themes of making available material and social resources and achieving health and well-being for all family members are constructed within the global economy and have different meanings across different contexts” (p.244).As I review Paula Cortez’s situation from a Micro level I can see several areas of strength.  However, the strengths I identify here have to do with Paul’s level of resiliency.  Paula has faced several life altering medical conditions, one being her HIV positive status.  Paula has been diagnosed as bipolar, yet has been able to remain out of the hospital of over 5 years.  On a  Mezzo level Paula has been admitted to a skilled nursing facility due to paralysis on her right side, yet has been able to progress within that facility and regain some mobility within her right arm and the ability to walk again.  Paula became pregnant and despite her overwhelming medical condition she has been able to request and receive 24/7 in home services for her child.  On a Macro level Paula is identified as low income.  Although Paula is part of a larger issue regarding poverty and the imbalance of societal wealth,  she is doing her best to utilize public assistance to help her in providing a stable environment for her self and her child.  Paula is utilizing many social resources to assist her with her childcare as well as her health issues (Plummer, Makris & Brocksen, 2013).

Describe the value in strength-based solutions.

I am a overwhelming fan of strength based solutions.  Strength based solutions provide he client with a strong focus on their abilities and on what can be done as opposed to what can’t.  There are key themes social workers should incorporate when assessing families.  According to Holosko, Dulmus & Sowers (2013), “A commitment to the belief that families bring strengths and resources to the helping relationship, and these can be harnessed in finding solutions. This means that the assessment can provide opportunities for exploring both problems and resources within the family” (p.247).  It is important for clients to focus on the genuine possibilities and work towards realistic, measurable and obtainable goals.  When clients are operating from a strengths perspective, they can begin to envision their goals as actual possibilities.  Operating from a strength perspective does not discount the serious nature of the families issues at hand, it incorporates the understanding of the risk involved with the family’s situation while incorporating a strength based approach to it.  According to  Holosko, Dulmus & Sowers (2013), “An understanding that a focus on strengths does not diminish the importance of identifying risk and safety issues and finding ways to protect clients from harm and causing harm” (p.247).

Holosko, M. J., Dulmus, C. N., & Sowers, K. M. (2013). Social work practice with individuals and families: Evidence-informed assessments and interventions. Hoboken, NJ: John Wiley & Sons, Inc. Chapter 9, “Assessment of Families” (pp. 237–264)

Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories. Baltimore, MD: Laureate International Universities Publishing. “The Cortez Family” (pp. 23–25)

RESPONSE 2

Respond to two colleagues whose assessments of family cohesion differ from yours. Resolve the differences or explain how each viewpoint is valid.

Colleague 1: Farren

The Circumplex Model of Marital and Family Systems is a tool that is used when working with families. The models address three dimensions which are cohesion, flexibility, and communication (Olson, 2000). The model is designed for treatment planning and clinical assessments and focuses on treating marital and family system and focuses on togetherness (Olson, 2000). The goal of this model is to promote flexibility and provide balance amongst the members and create ways to effectively communicate.

The Cortez family would benefit from the Circumplex Model as they appear to lack togetherness and everyone appears to be doing their own separate things. The family would benefit from cohesion as it balances togetherness as the family appears to be very distant from one another (Plummer, Makris, & Brocksen, 2013). Balanced families have better communication skills than unbalanced families (Olson,2000). The Circumplex model would also assess the family’s flexibility as it would assess how the family reacts to change. In the Cortez family, Paula is pregnant and has numerous health issues, and the father had remarried and Miguel was in school and had a job. The family system appears chaotic and the family is distant and has their own lives, however, Miguel did step in and provide some support but it was limited (Plummer, Makris, & Brocksen, 2013). Communication reinforces the previous 2 dimensions (Olson, 2000). In the Cortez family, it does not appear that there is effective communication going on however, Paula and Miguel appear to communicate more together then they do with David.

Assessing these dimensions can assist the social worker in treatment planning as it can help the social worker create goals by assessing the gaps in the family dynamics. In the Cortez case communication amongst the family members appears to be very limited. Also, the family lacks cohesion. The Circumplex Model would have identified these issues and create goals that will alleviate some of the family’s issues if they are able to successfully achieve their goals as the model is designed for clinical assessment and treatment planning (Olson, 2000).

Reference

Olson, D. H. (2000). Circumplex Model of Marital and Family Systems. Journal of Family Therapy, 22(2), 144–167.  Note: You will access this article from the Walden Library databases.

Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories. Baltimore, MD: Laureate International Universities Publishing. “The Cortez Family” (pp. 23–25)

Colleague 2: Amanda

 The circumplex model of families and relationships are built on three different dimensions. These dimensions include cohesion, flexibility, and communication (Olson, 2000). Each of these dimensions are broken down to show us how a family functions. Cohesion is described as the amount of time the family spends together as a whole. There are four types of cohesions that could be possible within a family unit, disengaged, separated, connected, and enmeshed (Olson, 2000). Disengaged is the lowest form of togetherness while enmeshed is overly together. Flexibility is like cohesion, but this shows amount of change in its leadership, role relationships, and relationship rules (Olson, 2000). The levels of flexibility include rigid, which is the lowest, structured, flexible, and chaotic, which is the highest level (Olson, 2000). If there is no conformity or leadership within a family unit, there will indeed be chaos. Communication is different and has many different aspects to it. This is when the family unit can communicate with regards to their listening skills, speaking skills, self-disclosure, clarity, continuity tracking, respect, and regard (Olson, 2000). The circumplex model serves as a framework to assess family systems, because each dimension helps you to identify to what degree the family is suffering.

           The Cortez family case is slightly complicated. This family unit includes Paula (mother), Miguel (son), and David (father). This family no longer live together as a family due to Paula’s illnesses, however they are still close to one another (Plummer, Makris, & Brocksen, 2013). In the first dimension of the circumplex cohesion, Paula’s family tends to be disengaged. I say disengaged, because David and Miguel are doing their own thing with limited attachment or commitment to Paula (Olson, 2000). The second dimension is flexibility. Paula’s relationship with her son Miguel is chaotic. I chose chaotic because there is no leadership between them, nor is there proper decision making. Paula is constantly going off her medications making her impulsive (Plummer, Makris, & Brocksen, 2000). The last dimension is communication. Paula has poor communication within her family unit. She doesn’t ask for help when needed, and she rarely speaks with Miguel or David unless she must.

           Assessing these dimensions helps the social worker in treatment planning, because to set goals and help family units, we must know how the family is functioning daily. This can also help with the breakdown of what maybe causing some family problems. Treatment plans are vital to clients who are struggling to keep their family together such as a separation or divorce. Its helpful to the social worker to set goals, and if these goals are followed than there is a chance the family unit can change, if the goals are not followed than the chance of a change is slim.

References:

Olson, D. H. (2000). Circumplex Model of Marital and Family Systems. Journal of Family Therapy, 22(2), 144–167.

Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories. Baltimore, MD: Laureate International Universities Publishing.

 

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Assignment: Child Abuse and Neglect

Physical, emotional, and sexual abuse can have a devastating impact on a child and his or her family members. Social workers need to understand how to recognize and respond to cases of abuse expertly and efficiently. With an empathetic and helpful social worker, victims/survivors of abuse can take their first step onto the long road toward healing. For this Assignment, read the case study Working With Survivors of Sexual Abuse and Trauma: The Case of Brandon and then consider what you would do if you were a social worker and had to report a parent of suspected child abuse.

1. ·      Submit a 2-page paper in which you review the approach taken by the social worker in Brandon’s case.
2. ·      Identify how the social worker might have used the ecological model to understand Brandon’s situation based on a person-in-environment perspective.
3.  ·      Explain the use of the ecological model in this case on micro, mezzo, and macro levels.
4.     Describe strengths the social worker may have missed in assessing Brandon and his mother.
5.  ·  Review the challenges that the social worker identifies and explain the impact the abuse could have had on Brandon had his strengths not been identified and addressed. Please use the Learning Resources to support your answer.

References (use 2 or more)

Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Roose, R., & De Bie, M. (2008). Children’s rights: A challenge for social work. International Social Work, 51(1), 37–46. Retrieved from the Walden Library databases.

Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA:  Cengage Learning.

                  Chapter 4 (pp. 178-253)

Working With Survivors of Sexual Abuse and Trauma: The Case of Brandon

Brandon is a 12-year-old, Caucasian male who currently resides with his mother and her boyfriend. Six years ago, Brandon disclosed that his father had repeatedly sexually abused him between the ages of 4 and 6. Brandon’s mother called law enforcement immediately after the disclosure, and his father has been incarcerated since. Brandon has previously participated in therapy to address challenging behaviors, including physical aggression, difficulty following rules at home and school, and using inappropriate language with sexual overtones toward female peers. Brandon and his mother report that they ceased participating in therapy in the past after there was no change in Brandon’s behavior. Brandon’s teachers have suggested that his behaviors are similar to those of peers with attention deficit hyperactivity disorder, but his mother has declined educational or psychological testing because she does not want her son to be labeled and is unsure if she agrees with the use of psychotropic medication with children.

Brandon began attending trauma-focused treatment after demonstrating an increase in argumentative behavior and minor property destruction at home. His mother reported that the majority of undesired behaviors were initiated during interactions with her boyfriend. Brandon’s use of physical aggression has not increased in school; however, a female peer recently reported him for using sexually explicit language toward her. Brandon admitted to using inappropriate language toward the female peer but appeared to have a limited understanding of what the phrases used meant. Brandon’s mother noted during intake that she is concerned that her son will become a violent sexual offender or a pedophile and noted that his use of sexual language was likely the start of sexual behavior problems.

At the beginning of treatment, Brandon reported that he frequently feared for his physical safety but often could not pinpoint what made him feel unsafe. He had searched the Internet to find registered sexual offenders in his neighborhood, and he had begun sleeping with a loaded BB gun under his pillow in case someone entered the home to assault him again. Brandon had flashbacks when trying to fall asleep and described feeling like he was floating outside of his body when he thought of his abuse. He had seen a television show where victims spoke at the parole hearings of their perpetrators, and he spent many hours thinking about what he would say if he went to his father’s parole hearing in 3 years. Brandon felt like he loved his father very much and that his father was a great father except for when he hurt him. Brandon identified wanting to feel less worried, sleep better, and fight less with his mother as primary treatment goals.

I worked with Brandon in both individual and family sessions to address his symptoms of depression and post-traumatic stress disorder (PTSD). Utilizing the trauma-focused cognitive behavioral therapy approach, early sessions focused on coping skills and emotional regulation. As Brandon became more comfortable with expressing feelings and utilizing coping skills, he began discussing his sexual abuse history and the ongoing effect this experience had on his life. I met with Brandon’s mother for collateral sessions in order to help her identify and process her own feelings about his abuse and to develop skills to support Brandon through his treatment. Brandon’s mother was provided with psychoeducation regarding childhood sexual abuse, and her belief that her son would become a violent sexual offender as a result of his experience was challenged through cognitive behavioral therapy. She agreed to meet the agency psychiatrist, and after the initial consultation she agreed to have Brandon meet with the doctor. After a psychiatric evaluation, Brandon was prescribed a low dose of antidepressant medication.

Brandon completed a trauma narrative that addressed the details of his sexual abuse experience, his disclosure of the abuse, and the trial and subsequent imprisonment of his father. Brandon included a description of his feelings at each point in his narrative, as well as what he learned in treatment about childhood sexual abuse and coping skills to deal with uncomfortable feelings and impulsivity. Brandon shared his trauma narrative with his mother, who provided a safe and supportive space during this experience through the use of skills learned and practiced during collateral parent sessions. Brandon’s symptoms of depression and post-traumatic stress decreased steadily during the course of treatment. After 8 months of sessions and the successful completion of his trauma narrative, the family and I agreed that Brandon was ready to terminate trauma-focused treatment. Brandon continued receiving medication management with a psychiatrist and transitioned into home- and community-based treatment that focused on his ongoing impulsive behaviors.

 

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