Clients Description And Functioning Social Work Essay

knobs interpretation And Functioning Social Work EssayThe leaf node is a sixteen-year- of age(predicate) Afri bunghole Ameri end female who is with nestling(predicate) with her minute child. The lymph node attends junior in high spirits aim. The knob lives with her bugger off, season unkn stimulate, who is unemployed.B. SettingPeak View behavioural wellness is located in Colorado Springs, Colorado. Peak View behavioural wellness is a psychiatric hospital dedicated to providing quality c ar to semipublicise growth and structure for lymph glands and families (Peak View Behavioral Health, 2012). Peak View Behavioral Health treats adults ages eighteen and older and, in January 2013, go out begin to work children ages four to seventeen. The hospitals services include acute psychiatric c ar, partial hospitalization, intensive push withpatient services, substance jest at, twenty-four hour assessment and Electroconvulsive Therapy.C. Reason for ReferralThe knob was refe rred to each(prenominal) star schoolhouse ane, an alternative school, by her prior public school forefront. The thickening is pregnant with her second child and has been suspended from the public school. teenaged pregnancy, intended or non, can pass on oppose consequences. Common consequences of callow pregnancy include dropping out of high school, living in pauperisation, relying on public welf ar, and experiencing higher directs of psychological distress, as compared to their same age peers (Stoiber, 2005). The consequences of the knobs pregnancies are pondered by her situation. She has been referred to an alternative school and downs psychological stress which impacts her relationships. The principal was sure of the nodes stolon pregnancy, although no previous preventatives were causeed. The principal suspects the client is having bar in her home life, although she depart non disclose to the principal how she became pregnant twice. leaf node is not happ y to the highest degree the suspension from public school. leaf node does not understand why she is being suspended because she feels as though she has not d cardinal anything wrong. Although she is up heap about the suspension from her public school, she does front interested in the referral to the alternative school as demonstrate by her includeing the referral and attending Each One Teach One. One of the highlighted strengths in the lives of African Americans is their strong educational or achievement orientation (Boyd-Franklin, 2006). Although the client is experiencing a cast out loving and economic environment, she appears to be motivated to stop herself. The clients commence does not stomach the referral for client to attend the alternative school. The clients return encourages the client not to attend school and get on the Welfare.D. leaf nodes translation and Functioning lymph gland is of average height and pregnant. Client attends school intumesce groomed, e. g, hair brushed, teeth brushed, showered, and wears clothes that are clean and well-fitted. Although the client is pregnant, she is adapted to walk to school and walk up and d sustain the stairs to her flat tire without difficulty. Client took necessary testing precautions to be tested for Human Immunodeficiency computer virus (HIV) after learnedness her flummox passed away from Acquired Immunodeficiency Syndrome (AIDS). Consequently, client tested positivist(p) for Human Immunodeficiency Virus (HIV).Client does not speak grammatically correct English as bear witness by client stating sentences such as I is learning, I does my work, and what this one is? Although client reports she sits in the back of the classroom, does not open a book and does not participate, clients math teacher reports client does well in math. Client has difficulty culture. The clients fret reports client as stupid and not ever amounting to anything. Client identifies one of her strengths as cooking. Client reports auditory and visual hallucinations in the form of vampires telling her you are one of us. Client fantasizes about being white, living rich and famous, and being save from her current situation.E. Physical and Economic EnvironmentThe clients ride is unemployed and receives welfare of an unknown monthly amount. Clients receive has custody of clients madjutantn child in order to receive aide on that child. Client attended public school until suspended and will be attending Each One Teach One. In the evenings, client cooks and cleans for the household. Client describes her begets day as a beached whale lying on the couch. Client states her m early(a) eats, postdate T.V., eats, watch T.V.The client and mother live in a two bedchamber flatbed, rent unknown, in Harlem. Client describes the neighborhood as the ghetto and consumed with crack heads. The clients apartment showing is sprayed with graffiti. Americans visualize the ghetto as where the black people live re channeliseing a poor, susceptible to crime, drug-infected and violent part of the city (Anderson, 2012). The client defines her neighborhood as the ghetto collect to drug activity and crime.F. flowing Social Functioning1. Family Situation. The client and mother live in apartment together. The clients mother has custody of the clients first born child and claims that child for welfare purposes, although the child actually lives with clients grandmother. The clients get under ones skin previously lived in the home with client and mother prior to touching out. Clients relationship with her mother is volatile. The clients mother reported she should accommodate aborted her. Client cooks for her mother, cleans the home, and runs errands for her mother when needed. Client fantasizes of missing to be on the cover of a cartridge or in a music video.Client has current and early(prenominal) history of intimate and physical squall. Client was raped by her father. The clients first child, and the second child she is pregnant with, are products of rape by the clients father. The clients mother is aware of the rape of the client by her father only if blames the client for taking my man. The clients mother as well blames the client for clients father moving out of the house. The clients mother to a fault admitted to knowledgeablely ab using client, stating who was going to please me. Client has also experienced physical abuse at the hands of her mother. The clients mother has slapped her and propel a frying pan towards her head. The clients mother is communicatoryly abusive commerce client names such as bitch, whore, good for nothing and stupid.2. Current Sexual/ randy Relationship. Client reports never having a boyfriend however wishes she had a light skin boyfriend with nice hair.3. Occupational/ domesticate Situation. Client has been suspended from public school and referred to Each One Teach One, an alternative school, collect to her second pregnancy. Client enjoys math and does well in math, as reported by her math teacher. Client has difficulty reading and tested at a second grade reading level. Client has difficulty with her peers as evidenced by clients physical onset towards peers, i.e., slapping, punching, and curse at her peers. Client has obedient relationships towards teachers and principal as evidenced by following directions without defiance.4. Other Social Relationships and Social Roles and Satisfaction. Client reports never having a boyfriend and does not have any friends. Client takes pride in being a mother but is not able to be a mother to her first child due to her own mother not allowing her child to live in their home because of the childs explainmental disability. Client has persuadeed wanting to get her child back. Client does not before long attend a church but fantasizes of participating in the church choir. For generations, African Americans have apply spirituality and religion as a crucial instrum ent for survival (Boyd-Franklin, 2006). One role of the African American church is to act as a refuge, as a bema in an a lot times unfriendly world (Boyd-Franklin, 2010). Although client does not currently attend church, in her fantasies, she finds the church as a prophylactic place from her negative and hostile environment.5. Medical/ mental. Client is pregnant with her second child. Clients first pregnancy resulted in a female with schoolingal disabilities. At time of clients referral to Each One Teach One, client had not but seen a doctor for her second pregnancy. Client found out from her mother her father passed away from AIDS and client tested positive for HIV. Clients mother refuses to be tested for HIV because she believes she has not contracted the disease because she and clients father did not shackle in anal sex.6. Legal Issues. Client does not have any legal issues at this time.G. Personal and Family History germane(predicate) to current focusClient was born in Nov ember 1971 in Harlem. get down reported client would sleep in the bed with her and the clients father. Client was feeding bottle fed as a baby, as clients father would drink the converge milk from clients mothers breast. The clients mother reported client was three years old at the time of her first cozy abuse by her father. Client has experienced sexual abuse by her father and mother, and physical and literal abuse from her mother. Individuals who are of lower economic status are more(prenominal) apparent to experience psychic injurytic events, and African Americans are more apt(predicate) to be of lower socioeconomic status (Gapen et al., 2011). Clients mother reports there is no alcohol or substance use in the home.II. AssessmentPsychological FunctioningThe clients intellectual functioning is at a moderate level as evidenced by grammatically incorrect language and a second grade reading level. In edges of the clients psychological functioning, her self-importancetism functions are moderately compromised. The egos ability to unify and combine mental transites is called ego functions (Berzoff, Flanagan, Hertz, 2011). Reality testing is the egos ability to recognize and agree with physical and friendly honesty. The most important aspect of this function is the ability to tell the remnant between inner reality and external reality (Berzoff, Flanagan, Hertz, 2011). The clients function of reality testing is compromised at times, as evidenced by auditory and visual hallucinations and retreats to her fantasy world. The clients ego function of compriseling impulses is also compromised, as evidenced by aggressiveness towards peers.The egos attempt to maintain an accurate level of positive self-worth in the face of stressful or aggravating circumstances is self-esteem regulation (Berzoff, Flanagan, Herzt, 2011). The clients self-esteem could be defined as low due to physical, sexual, and verbal abuse. The clients low self-esteem can be seen throu gh her fantasies of wanting to be someone else, e.g White, famous. Defense mechanisms guard the self from danger, actual or perceived (Berzoff, Flanagan, Hertz, 2011). In terms of defense mechanisms, the clients defense mechanisms could be classified advertisement as immature. The clients immature defense of dissociation, where a painful memory is innocent from the feeling, is evidenced by the clients fantasies of herself leading a different life (Berzoff, Flanagan, Hertz, 2011).B. Emotional FunctioningBetween nine and twelve months of age children begin to develop Internal on the job(p) Models to characterize emotions and expectations resulting from interactions and communication between infant and health professional (Riggs, 2010). Consistent with the notion horny abuse negatively impacts Internal Working Models and the ability to regulate affect, research suggests delirious abuse places children at adventure for poor self- impression and disorders of emotional regulation and impulse control (Riggs, 2010). In regards to the clients emotional functioning, her limited range of emotional expression and poor impulse control are demonstrated by her use of aggression and anger towards peers. The clients negative coping responses can be seen through her fantasies, as she cannot verbally express how she is feeling.According to shackle theory, unsteady fond regard styles are apply because they are adaptive in relation to the behavioral responses of their attachment figure (Riggs, 2010). One guinea pig of unsteady attachment pattern is disorganised attachment. Disorganized attachment can be connected to child abuse, lack of resolution to trauma or loss by parent, and maternal frightening behavior and psychiatry (Riggs, 2010). The clients attachment pattern can be classified as disorganized due to her experience of sexual abuse, by her mother and father, and physical abuse, by her mother. The clients disorganized attachment can also be attributed to he r mothers lack of support in regards to her sexual abuse by her father, i.e., blaming the client for the abuse. Evidence of clients unassured attachment in early childhood can also be seen, currently, through clients dismissiveness, i.e., that she takes care of her mother despite the abuse, low self-concept (Berzoff, Flanagan, Hertz, 2011).C. Social/Behavioral FunctioningAttachment insecurity, due to emotionally abusive parenting, adds to poor social functioning. In early attachment relationships, children begin to develop the skills needed to build future social relationships, such as self-awareness, empathy, negotiation, and booking resolution. The security of attachment influences many areas of interpersonal relationships, including effectiveness in peer pigeonholings, reciprocity in relationships, empathy, problem solving, conflict resolution, and establishing close and intimate relationships with peers (Riggs, 2010). The clients social isolation, as evidenced by her lack of peer gathering, demonstrates the clients insecure attachment with caregivers. The clients lack of apprehension in peers and adults is displayed through clients aggressive behaviors.D. Environmental Issues and Constraints Affecting the SituationThe client lives in a neighborhood in which she would consider the ghetto. Client lives with her mother, although the relationship is unstable. Children with a very insecure attachment to their mothers are more potential than other children to live in high-risk families and environments (Kwako, Knoll, Putnam, Trickett, 2010). The client has experienced sexual, physical, and verbal abuse from her caregivers. African American families experience higher rates of poverty than families of other races. Living in poverty step-ups the risk of exposure to trauma and trauma is found more often in African American populations (Graves, Kaslow, Frabutt, 2010). The clients turbulent home environment, unsafe neighborhood, and lack of social supports and resources exacerbates clients mistrust in others, social isolation, and negative self-concept.E. Motivation and Commitment to ServicesThe clients mother does not support client attending school and would kind of client take welfare services. Despite the clients mothers lack of support, the client is motivated to attend school to continue her education and be a positive mother for her children.F. Workers collar of Clients Presenting Situation/ProblemThe client is a sixteen year old, black teenage mother of two. The client has experienced severe childhood sexual trauma by her mother and father. The clients two pregnancies are results of sexual abuse from the clients father. The client lacks emotional support from her mother and is often ridiculed by her mother in terms of her appearance, intellectual functioning and overall being. Emotional abuse in the attachment relationship significantly increases the likelihood of ontogeny insecure attachment, which is proven to be linked to low empathy and reciprocity, hostility or aggression and impulsivity, exploitation or ridicule by peers, social withdrawal or exclusion from convention activities, and general patterns of un- associateness and isolation (Riggs, 2010).The client lacks any type of social support from peers and, often times, interactions with peers result in aggressive confrontation. Clients distrust in peers and adults is evidenced by lack of nurturing relationships. Up to this point, client has not accessed friendship resources. Previous experience with racism frequently prevents African Americans from accessing supporter and/or services from organizations which historically have safeguarded Caucasians (Graves, Kaslow, Frabutt, 2010). Clients mother is distrusting of participation institutions which whitethorn lead to clients inability to access support.According to attachment theory, a child forms representational models, i.e., internal working models, of attachment figures, of the self, and of self-in-relation to others based on their relationship with primary caregivers. When a childs caregiver responds in a sensitive, loving, and consistent manner, a working model of other as loving, reliable, and supportive is internalized. On the other hand, experiencing emotional abuse and drop down may instill damaging beliefs about the self, e.g., I am stupid, I am not decent of attention, which may result in maladaptive models of self, other, and self in-relation to others. Instead of developing a working model of the self as worthy of love and attention, negative models of the self as worthless, incompetent, or powerless may result (Wright, Crawford, Castillo, 2009). referable to the clients mothers unstable and inconsistent caregiving patterns, client has developed a low concept of self, as evidenced by the clients feelings of unworthiness to have or accept any type of relationships.Although the client has experienced severe childhood trauma, insecure attachments with ca regivers, and family and community instability, the client appears to be moderately resilient. Resilience refers to patterns of positive variant during or following major adversity or risk (Lopez Snyder, 2011). go about with two pregnancies, unsupportive and abusive caregivers, and lack of social support, the client continues to be motivated to pursue her education, regain custody of her first child, and become a caring and loving mother to her children.III. Evidenced Based Practice searchThis former began the search using the Google Scholar search engine with the term psychodynamic sermon for female African American adolescents of sexual abuse. This search reelected articles related to interpositions for substance abuse. The same search term was used again but the term intervention was ex commuted for the term treatment. This search yielded articles on cognitive behavioral interventions. This writer because moved to using the search engine PsyhInfo. Terms including psychod ynamic treatment, psychodynamic intervention, African American, adolescent and sexual abuse were again interchanged to aide in the search. This compose then added the term sexual abuse subsister to the search. This search began to yield interventions related to psychodynamic interventions. This author began finding articles related to psychodynamic assemblys as a psychodynamic intervention.Continuing to use the PsychInfo search engine, this author then used search terms psychodynamic conventions, adolescents, sexual abuse survivor and African American. This author was able to yield articles related to psychodynamic sorts. This author then moved to using the University of Southern California Library to continue the search. This author again used the terms psychodynamic groups, adolescents, sexual abuse survivor and African American to yield further articles in regards to psychodynamic groups. This author was able to accumulate six articles in regards to psychodynamic group inter vention. Overall, this author found it extremely difficult to find, in the literature, psychodynamic interventions specialised to African American adolescents who have experienced sexual abuse.IV. Intervention formulateIn the first years of childhood, the family is responsible for the care and development of the child. In healthy families, children learn they can depend of their environment to provide emotional security and physical safety. Children then gain behaviors which allow them to treasure their own emotional and physical health free from parents or caregivers. Poor health also can develop early in life. Children who live in families with characteristics such as family conflict, i.e., frequent episodes of anger or aggression, and lack of nurturing, i.e., relationships which are cold, unsupportive, and neglectful, can have negative consequences on mental and physical health (Repetti, Taylor, Seeman, 2002). Unfortunately, due to clients exposure to an abusive and un-nurtur ing environment, she has developed poor mental health, as seen by her moderate level of defense mechanisms, poor self-concept and lack of support. ascribable to the clients insecure attachment with caregivers, which has led to lack of support and untrusting genius to others, the intervention employed will be psychodynamic group psychotherapeutics. Because of clients young age, client will be more suitable for time limited psychodynamic group psychotherapeutics, which occurs between twelve and thirty sessions (Wise, 2009). The format used for psychodynamic group psychotherapy is verbal. The alkali of the group should be to feel and talk, rather than act. Because it is a psychodynamic therapy, the healer should wait for the group interactions to occur freely and then comment when let (Wise, 2009). During the process of psychodynamic group psychotherapy, the therapist will attempt not to set agendas but follow the suggestions of the group. The belief is the group process will la st lead to the most emotionally charged subjects if allowed to proceed without interruption. The therapist in the psychodynamic group psychotherapy session will attend to the group and mortal members based on how the session begins (Rutan, 1992).The implementation of the psychodynamic group psychotherapy intervention is community based, therefore the client will need to access community organizations to utilize the treatment intervention. As previously promissory noted, the client has not accessed community resources thus far. Another hurdle the client will have to submerge in order to maximize optimum results from the psychodynamic group psychotherapy intervention is a proper match to therapist leading the group and participation. Because client is untrusting of other others it may be difficult to engage client in group psychotherapy process. A therapist who creates an environment of acceptance, judgement and trust, and provides empathy and responsiveness will have a better cha nce of care and engaging challenging members (Gans Counselman, 2010).The conclusion of psychodynamic group psychotherapy is to make aware parts of the unconscious which result in negative distortions in present day perceptions (Rutan, 1992). Furthermore, goals of treatment are to assist in overcoming resistance to experiencing, expressing and arrest emotion. The psychodynamic group psychotherapy model allows for resolving the tension between forbiddance of emotions and explosiveness. The group format also allows for members to work together to manage and bind feelings (Wise, 2009). This aspect of psychodynamic group psychotherapy will be near to client, as she has difficulty expressing her emotions, as evidenced by aggression towards peers. Although the client will gain emotional regulation skills through the psychodynamic group psychotherapy intervention, this will not be her main treatment goal.Psychodynamic group psychotherapy is also another way for individuals to interac t within a system of relationships. This is beneficial due to most presenting problems having a relational context. Allowing individuals to interact and then reflect gives the individual the opportunity to use the group as a place to observe and change patterns (Wise, 2009). The client has expressed a desire to have safe, nurturing and loving relationships with others, but due to low self-concept does not feel worthy of such relationships. The clients goal for psychodynamic group psychotherapy will be to increase number of quality relationships from zero to at least two by the conclusion of the group sessions. The clients relationships will be measured by her own self-report, as well as therapist observations of her interactions and relationships with fellow members of the group and development of social skills.The catalyst for change in psychodynamic group psychotherapy includes change by imitation, i.e, learning by observing others, identification, i.e., unconsciously taking on tr aits or characteristics of others, and internalization. The therapeutic process develops using confrontation, explanation, interpretation and working through (Wise, 2009). Additionally, other therapeutic aspects which are addressed include support, self-revelation, learning, and self-understanding, with interpersonal learning as the utmost important (Wise, 2009). Because the client has developed negative internal working models, due to insecure attachment with caregivers, i.e. mother and father, the interactions with others in the group setting may begin to assist client in developing higher self-concept and more nurturing relationships.V. Discussion, Analysis and Rationale for Interventions ChosenPsychodynamic group psychotherapy was chosen as the intervention for the client due to her experience of sexual abuse by caregivers. Time limited, as well as on-going psychodynamic group psychotherapy has been effective in treating women with a history of sexual abuse, due to the opportun ity for the individual to reduce the feelings of isolation, guilt, and shame. An individual is able to in effect work through feelings when the individual is able to share their experience in a therapeutic environment comprised of compassion and acceptance. The psychodynamic group psychotherapy process provides an individual with the ability to incorporate a new object experience without devaluation or ridicule, while at the same time abandoning previous attachments which were associated with the headmaster event and emotion (Nusbaum, 2000).When an individual is abused, the person tends to identify with the unloving, aggressive, and immoral characteristics of the superego rather than the gentle, loving and protective characteristics. The individual may interpret the caregivers failure to nurture and protect adequately as a sign they are misfortunate and unlovable (Nusbaum, 2010). Evidence of these characteristics can be seen in the clients low self-concept and feelings of unworthi ness to have any type of relationship. Within the psychodynamic group psychotherapy process, the group can demonstrate appropriate levels of protectiveness, love and concern to its members. Negative feelings often experienced by individuals with sexual abuse can often be eased through disclosure of the traumatic experience. The group can then provide corrective superego functions by not allowing its members to blame themselves for the experience, which may have been unavoidable and not their fault (Nusbaum, 2000).Psychodynamic group psychotherapy also deepens the coalescency between group members and facilitates the development of relationships which can be observed and canvas in the context of interpersonal fears and roadblocks. Furthermore, in psychodynamic group psychotherapy individuals can identify interpersonal conflicts and work through primary defense structures which are run by fears of trusting. Additionally, because abuse and neglect tend to occur in dysfunctional famil ies, by successfully working through emotional conflict the psychodynamic group offers the opportunity for interpersonal learning and development of social skills, which are usually not modeled in dysfunctional homes (Nusbaum, 2000).This author is ineffective to implement the psychodynamic group psychotherapy intervention with the client but can visualize how the intervention would unfold with the client. In the first sessions this author would attempt to create a trusting, nurturing and safe environment where client would feel she could engage in the group process and share personal experience. According to psychodynamic theory, constitution is formed developmentally. In this model each stage of development builds on the previous stage and each stage affects the following one. It is important to note in the therapeutic process, defects in earlier developmental stages can be right if that stage can be recalled, relieved and be affectively re-experienced and corrected in the here and now (Rutan, 1992). It will be pivotal for the clients treatment for her to share feelings, emotions and past experiences in order facilitate positive transformation.This author would predict the client would be difficult to engage initially due to her mistrust in others and feelings of unworthiness. After consistent nurturing, accepting, trusting and safe experiences in the psychodynamic group, this author would see the client begin to engage in the group process. Once the client begins to share personal experiences, feelings and emotions this author would utilize a specific intervention, the here and now. The here and now technique would allow this author to use the clients past experience to understand and explain occasions when she unconsciously repeats the past or misperceives the present based on what she has learned in the past (Rutan, 1992). This technique would allow self-learning and self-understanding in regards to how her past abuse and neglect as affected her current relationships.This author expects transference will likely surface in the therapeutic process with the client. Transference can be defined as the misrepresentation of present object relationships on the basis of early object relationships (Rutan, 1992). Transference will be beneficial in the therapeutic process with the client. It will allow for this author to gather selective information and explore the nature of early relationships based on the characteristics the client transfers on to this author (Rutan, 1992).Through the psychodynamic group psychotherapy process the clients main goal will to be to form quality, nurturing and trusting relationships. Relationships are important in forming personality, causing psychopathology, and curing psychiatric symptoms. As individuals develop in the psychodynamic group they are forming important relationships and, while doing so, every part of their character is emerging. Individuals let on their defense mechanisms and transferences while , in turn, receiving feedback from the therapist and other members. There may not be any other therapeutic process where so such(prenominal) data is available to an individual about themselves as in psychodynamic group psychotherapy (Rutan, 1992).