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Generalist Practice Assignment IV

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Generalist Practice Assignment IV

Problem Identification/Engagement

Alcohol and drug abuse have become an increasingly challenging issue that has continued to ravage the world population. With the current statistics, efforts being implemented have continued to fail in the various ways where the ongoing trends continue to challenge most of the strategies used with more psychological methods. To effectively capture the current situation’s degree, drug abuse is characterized as one of the leading death cause factors, with at least 90 deaths per day only in the US (Galanter et al., 2015). Consequently, the amount of expenditure relating to drug abuse has also increased, resulting in loss of productivity in healthcare centers and over ‘stretched’ hospital resources.

With the above information in mind, this paper will highlight the environmental impact on the development of substance abuse regarding the efficacy of interventions put in place to manage drug abuse in the community in discussion. The main systems that will be focused upon include family, friends, and community. The majority of psychological scholars have highlighted these groups as one of the most intense social networks that largely influence both the development and prevention of drug abuse. The family in discussion will be called “the Jake Family,” which is not the real name for privacy protection. However, the paper will analyze most of the cultural and social dynamics surrounding this family to effectively examine the influence of this abuse in one way or another.

Case Analysis

Cynthia, not her real name, is a 23-year-old female presented two months ago by a probation officer for detoxification and rehabilitation of alcohol and opioid abuse. According to the file presented to Santa Maria, Cynthia is described as a heavy user of whatever drug she was into or decided to use. In her recollection of the past two weeks, before she was admitted to the Center, Cynthia reported having at least used two 48-ounces cans of beer, 15 bags of heroin, and approximately 1500 dollars’ worth of cocaine. As mentioned, Cynthia’s case is one of the many that Santa Maria has witnessed in the Jake Family. On the brighter side, similar trends have been noted either as triggers and probable effective interventions in most cases.

Through the review of the past patients from Jake’s family, one thing that stands out is that all of them started experiencing a problem of drug abuse during the adolescent stage. This issue has been observed in situations where all three family members were reported to experience personality change. In most cases, their behavior suddenly turned more aggressive, nervous, jittery, and with occasional disciplinary problems both at school and home. However, personality change and some of the symptoms seem to differ from one person to another, i.e., putting in mind that they did not use similar drugs. By noting that the Jake family is a bit “well-off”, all the patients have admitted to having been surrounded with alcohol and ease access to other drugs.

Data Collection

Santa Maria uses several approaches in collecting data from patients, i.e., regarding the setup needed for each patient recovery plan. In this paper, there are three methods used in the collection of data. They include Clinical Interviews, Observation, and First Extraction of data.

· A clinical interview is one of the most effective methods applicable in investigating such issues where a researcher can speak with the patient on a one-on-one basis. This approach is significantly essential due to its ability to untangle the individual’s problem, emotions, background, and the general social context, which in this paper largely revolves around the family relationship (Cohen et al., 2017). For these reasons, Cynthia was heavily engaged in a face-to-face discussion of herself and her family background. Through this method, the patient’s perception of the treatment is easily recognized and some of the elements that motivated her to embrace treatment.

· The observation method is used to obtain data from clients by assessing the reaction to their respective environments. For example, like in the case of Cynthia, whose admission was not voluntary, the observation method in data collection is significantly critical in understanding the patient’s perception and treatment progress. This approach was made successful with the help of nurses during this assessment and those who had a good history with our particular client. This method’s use is also very important in identifying social dimensions and family background factors that contribute to this study.

· The review of the patient’s history, i.e., including her past relatives, was significantly essential for this study. To attain this information, the extraction of data, of course with the patients’ consent, was retrieved from an electronic patient management program (Cohen et al., 2017). This method contributed to the ability to understand Jack’s family’s ‘conjoint’ personality in regards to their response to the recovery program. Through the data extracted, Cynthia’s addiction was made more vivid since the other two family members’ review outlined some of the common issues that needed to be reviewed during her treatment.

Assessment

The main problem investigated in this study involves understanding the general composition of family structuring in relation to the development of substance abuse. Additionally, the research has been largely focused on the analysis of the efficiency of some of the most commonly used programs. Through the growing trend in drug rehabilitation, these initiatives’ focus has continued to shift, with more scholars identifying psychological treatment as more efficient in most situations. This issue has been described as one of the core reasons most patients end up relapsing soon after they get out of the recovery center. However, it is essential to note that this reasoning does not disqualify any other treatment program’s efficiency.

With the above information in mind, this study will try to identify the extent of family impact in triggering and enabling substance abuse and the means of improving treatment programs. The long-term goal will focus on analyzing the efficiency of the proposed initiatives in solving family and environmental dynamics. This plan requires a minimum of two years to be fully implemented and reviewed. The short-term goals will incorporate the evaluation of program efficiency and the available resources needed to fully implement this objective, i.e., caregivers’ capacity to efficiently offer psychological attention to patients even after they are discharged. To see through this part of the study will require at least three to six months of proper plan implementation and re-evaluation.

Intervention

Self-Directed Behavior and Self-Management Programs

The rehabilitation process is a significant personal initiative that requires the client to participate in the treatment plan. Thus, it is crucial for clients to fully own the treatment plan since there will be no significant change without this action. The main approach of this method direct interpretation of the situation by a psychologist to the client to understand how to deal with their problems independently. For example, the counselor should begin by explaining to clients about their conditions and the results of some of their choices, noting that their life is at their hands (Werb, et al., 2016). Like in Cynthia’s case, her willingness to each program was largely correlated with how much she participated or understood these initiatives’ purpose.

This method has been identified to be significantly effective in promoting an individualized treatment that barriers family constraints, which is a major issue in this case study. Overall, this approach’s main focus is to help the client make effective and sound decisions that will promote positive behavior change. The five basic steps required to fully implement this program include; identification of goals that will result in positive behavior change, identifying the course of action needed to reach this goal, self-evaluation, actual implementation plan, and revising some of the needed changes to align with the program (Werb, et al., 2016).

Psychotherapy Method

Over the years, the psychotherapy approach has become an essential tool in rehabilitation centers. Recent studies continue to support counseling as one of the most critical features in enhancing rehabilitation initiatives where psychologists have a responsibility of evaluating clients’ problems, helping them to set positive goals, encouraging, and preserving positive changes they have undergone throughout the recovery process (Myrick & Del Vecchio, 2016). However, the need to use this method as one of my main initiatives is because of its ability to understand a broader image relating to each particular case. For instance, through this approach, the counselor can understand some of the family factors that tend to promote substance abuse in the Jake family continuously.

The individualized treatment approach depends on psychotherapy, where the most common method is behavioral therapy. This method becomes even more interesting when the patient’s recovery process requires the counselor to identify some of the client’s external factors. Therefore, the psychotherapy approach use dismisses applying the generalized treatment for patients using the same type of drugs since individuals respond differently to various treatment programs (Myrick & Del Vecchio, 2016). Individualized treatment also makes patients feel more comfortable and well understood during treatments. One of the main outcomes that can be obtained from individualized counseling is that it is considered very effective in assisting clients in developing short-term behaviors that allow them to make rational decisions, develop coping strategies, abstain from drug use, and maintain this progress.

As stated earlier, the use of psychotherapy is significantly important when assessing broader dynamics, wherein this case group counseling is critically vital in understanding the client’s social context. For example, the use of this approach will incorporate the previous addicts from Cynthia’s family. Through this focus, we will identify some relatable triggers for substance within the family background. The need to emphasize this approach is due to the fact that although Santa Maria Center conducts group therapies, it has a very limited scope of conducting family intervention sessions. In essence, despite how effective self-directed programs and individual treatment turnout, counseling should be extended to the client’s friends and family members. This process allows the patient to know the crowd that he or she is supposed to be surrounded with even after being discharged.

Evaluation

Two methods have been used in this study to assess and measure the effectiveness of the interventions mentioned above. They include Mental State Examination and Subject Rating of Symptoms. The Mental State Examination method is used to identify the treatment plan’s progress where the counselor can observe both the verbal and non-verbal response indicators. For instance, after a few weeks of the treatment plan, Cynthia was more attentive when her confidence seemed to improve with time. The measure of success can be seen from the comparison of first meeting sessions where she was observed to be less reluctant in speaking out her mind and always seemed to be in a bad mood.

The Subject Rating of Symptoms method is used to assess the progress of treatment initiatives through the review of the client’s problem perception. These ratings are designed in a manner that the counselor can identify either positive progress or the severity of each patient. For example, the normal scale ranges from 0 to 10, where a patient at 0 has almost no problem while any patient from 8 to 10 is in a severe state (Cohen et al., 2017). Some of the questions can comprise emotional conditions to any other thought relating to the recovery process. On the same note, Drug Abuse Screening Test (DAST) is a formal assessment that can also be used to measure both the recovery progress and severity of the patient’s condition. In this case, the test was conducted during the Clinical Interview, where Cynthia answered 15 to 20 questions. This process was carried out in a very open manner where she seemed to be motivated to participate.

Raw ScoreRangeSeverity
1713 and belowNeutral Situation with manageable problems

One of the main problems that Santa Maria has not effectively supported is Aftercare programs. As stated earlier, most clients who have relapsed reported that this action was directly contributed due to the lack of aftercare initiatives. Apart from mandatory drug tests and psychological therapies like in Cynthia, Santa Maria should establish a safe and structured aftercare program that will provide the required environment for a sober lifestyle. This action can also be backed up by implementing the Matrix Model, which promotes self-help by offering education on some of the main programs applied in the rehabilitation center (Myrick & Del Vecchio, 2016). Through this approach, the Center can understand some of the underlying issues that contribute to the development of substance abuse and occasional relapses.

Termination

The main approach that I would start to use in the termination process will involve “follow up” that will help me assess the client’s progress after she has been discharged. Therefore, this termination can also be described as natural termination where the decision is based upon the evidence that the client is ready to go back to the outside world (Zastrow, 2016). However, in the event where the client may feel not ready to move out of the recovery program, they have the right to continue staying. The last things that I can use in the termination process include the “referral” initiative, which is supposed to direct the client to more support groups in which she can feel secure and relate to the environment.

Social Work Values

Apart from only acting from a professional standpoint, Counselors have a lot of responsibilities towards clients and society. From the start, Counselors must be empathetic individuals who can relate with their clients to the point of building a passionate relationship with one another. Also, counselors have a role in providing a safe environment in which patients can feel comfortable and free to talk about their addiction struggles. This action should also be extended to the patient’s family members and friends to avoid any possible relapse. However, one of the main ethical issues that have been identified in this study includes the “Right to Patient Privacy, Stereotyping, and Clinical Negligence.” These issues can be easily resolved through continuous staff education and training (Zastrow, 2016).

Identification with Profession

Generally, with increasing rehabilitation treatment trends, the psychological approach seems to be continuously embraced, where studies continue to show efficient recovery statistics. The majority of the people who have undergone this process have reported that it was more effective in how they could relate and handle various situations that could have led to relapse. This prospect has also revealed that psychosocial context is one of the leading factors that continuously provoke substance abuse, mainly in family and community systems. Therefore, I largely foresee an increase in psychotic programs, which will enhance the recovery programs, reducing the rates of relapses.

References

Cohen, L., Manion, L., & Morrison, K. (2017). Research methods in education. Routledge.

Galanter, M., Kleber, H. D., & Brady, K. T. (Eds.). (2015). The American Psychiatric Publishing textbook of substance abuse treatment. American Psychiatric Pub.

Myrick, K., & Del Vecchio, P. (2016). Peer support services in the behavioral healthcare workforce: State of the field. Psychiatric rehabilitation journal39(3), 197.

Werb, D., Kamarulzaman, A., Meacham, M. C., Rafful, C., Fischer, B., Strathdee, S. A., & Wood, E. (2016). The effectiveness of compulsory drug treatment: a systematic review. International Journal of Drug Policy28, 1-9.

Zastrow, C. (2016). Empowerment Series: Introduction to Social Work and Social Welfare: Empowering People. Nelson Education.

Engagement

During the engagement stage, the social worker should focus on building trust and rapport with the client, so that mutually agreed upon goals can be determined. In engagement, the social worker is actively involved with the client, listening to her/his perspectives on problems, reasons for seeking treatment, and desired outcomes of therapy.

Assessment

During the assessment stage, the focus shifts to information gathering. In assessment, social workers should collect key data about the client through interviews and other assessment techniques and instruments and collateral contacts. This information will assist both the client and the social worker in defining problems and possible solutions. During assessment, social workers must remember to operate from a strengths-based perspective, with careful attention to seeking information about client’s skills, capacities, resources, and other strengths.

Planning

The planning stage is focused on goal development, based on a mutual understanding of the client’s problems, lifestyle, and environment. During this stage, the social worker and client work together to develop an action-plan that is suited to the client’s unique circumstances. This action-plan should include specific objectives and tasks that work toward accomplishing the stated goals, with a clear timeline for action, and expectations of who will do what.( Formalize a Contract)

Intervention

Intervention is the stage when the client and social worker mobilize resources to implement the action-plan, both complying with their agreed-upon expectations. During this stage, the social worker should monitor client progress, and the client should bring to the social worker’s attention any challenges, obstacles, or threats to carrying out the action-plan. Plans and timelines can be adjusted as needed to ensure that the intervention is working for the client.

Evaluation

During the evaluation stage, the social worker and the client focus on goal attainment, continuing to monitor progress to determine when goals are met, and/or whether new goals should be set. Clients can be directly involved in the evaluation stage through self-monitoring, allowing them to track and reflect upon their own progress. The social worker, at this stage, critically evaluates how an intervention is working based on client progress. If goals are not being met, it may be necessary to return to the assessment stage to better define the problem.

Termination

The ultimate goal of any therapeutic intervention is that a time will come when the client is able to maintain progress on their own. Termination is thus the last stage of the generalist practice model. During this stage, the client reflects on her/his accomplishments, and client and social worker work together to identify resources and supports in place to help the client should

problems re-emerge.

Follow-Up Re-Examine client situation (acquiring information about a client after termination.

***Following these 7 stages of the generalist practice model assists social workers in effectively intervening with clients to resolve problems and improve well-being, while keeping the client involved in the entire problem-solving process. It is important to remember that there is no set length of time for any stage, and in some cases, social workers and clients will need to return to a previous stage, depending on client progress. The client should be at the center of any problem-solving process, and the generalist practice model offers a useful to guide to supporting clients on their path to self-determination and biopsychosocial health.

ASSIGNMENT VI: CASE PRESENTATION

(PRESENTATION FORMAT)

INSTRUCTIONS: The presentation will require you to demonstrate your knowledge of generalist social work practice. The presentation should be based on the Generalist Practice paper. You will be required to illustrate the steps of the problem solving process beginning with engagement and problem assessment through Termination. This is an extensive process requiring the utilization of your knowledge in the following areas: Engagement, Assessment, Planning, Intervention, Evaluation, and Termination. The following areas must be addressed in this assignment. !!!! Please do not give information which would allow others to identify persons in this situation.

A. Engagement

1. Problems

2. Feelings

3. Goals

B. Data Collection

1. Data collected

2. Need identification

3. Problem formulation

C. Assessment

1. Goal identification (long and short term)

2. Type of contract- collateral contract

3. Target systems

4. Client conference

D. Intervention

1. Intervention strategies

2. Type and use of resources (formal and informal)

3. Social Work functions

E. Evaluation

1. Methods of evaluating case

2. Extent of goal attainment

3. Documentation requirements

F. Termination

1. Type of termination

2. Dealing with termination

3. Transfer

4. Follow-up

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