Case Study (2,250 words)
Choose only one case study from the three provided below. As the case manager, this assignment requires you to describe the key factors you would take into account in making a social work assessment and in developing a case management plan with the client. You are asked to draw on a recovery-oriented approach to mental health assessment and case management in social work as outlined in the course text book, Bland, Renouf and Tullgren (2015).
This should include the following:
• a brief explanation of a recovery-oriented approach to assessment and case management in mental health social work;
• the key factors in this case that you would take into account in undertaking a recovery-oriented assessment and case management plan, drawing on the dimensions emphasised in the text book. This will include discussion of existing mental health research literature relevant to the case. For example, in the case of April, you would outline what is known about Indigenous identity and racism, and mental health and sexual abuse. You would identify how this might further enhance understanding of his situation. Please note: you are not being asked to present a case management plan but to speak to the factors you would consider in making a plan;
• the social work theory or theories that would also guide your approach to assessment and case management with this client and why (e.g. strengths approach, empowerment approach, feminist social work approach);
• the ethical and legal implications of the case that would need to be taken into account in assessment and case management;
• further information you might require to enable planning for case management – You may need to use some creativity for the additional information you require.
Chapters 6 & 7 of the course text are a good place to start.
The case study assignment can be presented in the format of a report, and you can use the above dot points as headings. However, you need to draw on the relevant mental health and social work literature for points 2, 3, 4 and 5.
Please note – as a social worker, you are not being asked nor will you be qualified to make a psychiatric diagnosis. You can nevertheless comment on the condition(s) you think are likely based on your systematic assessment of the case and their implications for practice.
Case study 1
April is 21 years of age and recently graduated from university with an undergraduate degree. She is currently working in retail in Adelaide and has plans to return to University to do post-graduate studies. April’s mother is Indigenous and a health professional. Her father is of Anglo-Saxon ancestry and is a tradesman. She also has an older brother. April grew up in the country. She was shy in her childhood, however, she reports that her home life was ‘happy’ most of the time. However, April also says that she was bullied by other pupils about being of mixed race, and always believed that she was ‘unattractive’ and ‘fat’. April was always very close to her family during her primary schooling. She was particularly close to her mother. When at high school, April never invited friends over to her house because she was embarrassed by her mixed racial heritage. Academically, April outshone other students at high school and was elected as a student representative. She said that she remembers this period being the happiest time of her life.
As she started to receive attention from boys, she described feeling extreme anxiety about how to handle their sexual advances. April tells you that one of the first times she went out with a boy, he pressured her into sex. She does not want to talk about this and says, “What happened in the past stays in the past.” During most of high school, April dated Ben. He was her first serious boyfriend. The relationship, as described by April, “Was a loving one and the sex was good.” Ben and April broke up at the end of high school because she was moving to the city for university. When April went to university, she moved to Adelaide and lived in a share house in the inner suburbs. She had a series of relationships and experimented with bisexuality. April has now been dating Josh for nearly six months, but she does not feel very committed to the relationship. Josh usually seems to make an effort towards supporting her, but April said that he often ends up putting her down, particularly about her weight.
April has been a member of a drama group for some time, but more recently she is not enjoying herself. April does not like her job, however, she is not motivated to look for other work. She describes feeling “on the edge” when she is getting ready for work or for her drama group and is starting to use all sorts of excuses to avoid going to either of them. She feels anxious when social functions are sprung on her without notice. April regularly sleeps in until the early afternoon on days she is not working. She has also lost a lot of weight. April’s friends are starting to worry about her and have noticed her weight loss. At first they complimented her on it, but now they tell her it has gone too far. April does not agree. April has recently lost all interest in cleaning her apartment and is paying less attention to her personal appearance. April is now avoiding seeing Josh, her parents and her brother. She has also lost interest in pursuing further education. One of April’s friends have encouraged her to seek support from a social worker – you – at a community health centre.
Case Study 2
Jennifer is in her late 50s. She was the fifth child in a family of six. Her father was a labourer and her mother was not in the paid work force. She missed a lot of school because her mother was not well – she implies her mother struggled with poor mental health and alludes to domestic violence from her father to her mother. Jennifer was an extremely shy child and rarely had friends to play with. She is not particularly close to her siblings, saying that they see her as ‘weak’ and ‘unstable’ like her mother. Jennifer was often singled out for physical and emotional abuse at the hands of her father, who called her ‘stupid’ and ‘away with the fairies’. She often blamed her mother for not protecting her and for not making the home a happy one.
Jennifer says that because she felt unloved in her family, she married young, yearning for closeness. She wanted to escape her family and fill the void she experienced in her own childhood. She had three children soon after. Jennifer thought that if she had children, that she could make the loving family that she missed out on. Her husband was about 20 years her senior. He had very strong expectations about marriage and gender divisions within the relationship. It was considered natural for Jennifer to tend to household chores, to cook and look after him and to take care of the children. He was the decision-maker and Jennifer had to do as she was told. Although Jennifer was originally looking for love, care and support, her husband was cold, controlling and emotionally abusive. Over time, Jennifer progressively became anxious, distressed and eventually had a nervous breakdown. Her children were still young.
Jennifer often forgot to pick up the older children from school. She started to leave her younger children at home and go wandering during the day. When Jennifer went wandering, she would become disorientated and forget how to get home. One day, the police picked up Jennifer in her disoriented state and took her Glenside. At first, she was detained for three days under the Mental Health Act, which was extended a number of times over a lengthy period. Jennifer was diagnosed with schizophrenia and medicated with anti-psychotic drugs. Eventually, she was released and allowed to return home. However, Jennifer’s husband kicked her out with nowhere to go. This is when Jennifer started living on the streets. As a homeless person, Jennifer was in and out of shelters continuously. But, more often than not, she roughed it out-doors. She had numerous involuntary admissions to Glenside under the Mental Health Act over the next few years and she lost touch with her children. Since marrying and moving away more than ten years ago, Jennifer has not kept in contact with any of her family. She doesn’t even know if her parents are still together, whether any of her siblings have families of their own and where they might be living now.
Jennifer has been referred by a women’s centre to a supported community housing program. The vision is to offer Jennifer a unit of her own and to implement continual supervision and support. You are her social worker.
Case Study 3
Henry is eighteen years old and living with his parents. He has a younger sister, Caitlin, who is sixteen years old. Henry’s father is a tradesman and his mother is a teacher. He was studying an Engineering degree but he has dropped out of his studies. He has been working in a part-time job at the local supermarket until recently. You are a mental health worker and Henry has his first appointment with you at the local community mental health service. He has been referred by his GP. His father also attend the appointment and waits outside in the waiting area while Henry sees you.
Henry tells you that he cannot concentrate and that this is why he has dropped out of his studies. He also came to dread going to uni because he was having panic attacks in lectures and tutorials. Some days, he would have to leave class suddenly, and he felt embarrassed and ashamed about this, fearful that other people might have noticed. Now he feels he cannot go to uni at all. He was still going to work at the supermarket up until a fortnight ago. He has been socialising with some of the other young people who also work there, saying he generally feels more comfortable with them than with the people at university.
When you prompt Henry about his home life, he is reticent to talk about it. He only agrees on the condition that what he says is confidential. Henry says that his parents’ relationship is very conflicted, with lots of fights and verbal abuse. He tries to intervene, but his parents then turn their anger on to him. He says that it is they who wanted him to do engineering, not him. He feels pressured to achieve high marks and earn a high income. He says that his sister seems less pressured by their parents than him, perhaps because she is the younger one. Henry says he wants to get away from home, but the panic attacks terrify him and he does not earn enough money to pay rent or support himself. A couple of weeks ago, Henry had a major panic attack at the supermarket where he works. His supervisor noticed something was wrong and took him aside. He broke down and explained his difficulties. The supervisor rang his parents. Since then, Henry has not been able to return to work and is not seeing his friends from the supermarket either. He feels very frightened and confused about what to do.
The question first appeared on Write My Essay