Reference no: EM133263722
By looking at the Cognitive behavioural therapy CBT in social work and multidimensional assessment interview techniques for this case study. What ideas work around acceptance therapy with this approach
As Georgina sips her first cup of chai for the day, sitting on her shady veranda admiring her verdant garden, she thinks about her partner, Chris. Chris died almost two years ago. They'd moved to Smalltown (population about 9,000) from the city when they were in their 30s. Georgina's family hadn't supported the relationship between her and Chris and had cut off all contact once they'd moved out of the city. Chris was all the 'family' Georgina felt she had. She and Chris worked so hard to build their mud brick house, plant their orchard and develop their vegetable patch. They'd both enjoyed scouring local tips, demolition sites, second-hand shops and recycling yards to source building materials. Chris had taken up lead lighting, so most of the windows in the house are original designs, crafted by Chris. Their hard work over the years meant that they had been largely self-sufficient for much of their fresh food. What they couldn't grow they'd usually try to barter from other eco-friendly producers in the area. The garden is a lot of work for Georgina now she's alone, but some of her friends and neighbours help out from time to time, in exchange for fruit, vegetables and eggs.
Georgina still earns a steady income from the art and craft gallery she established and continues to run in the main street of Smalltown. She runs the gallery as a cooperative and this collective approach to the business helps to support a range of local artists. She sells most of her own handmade silver jewellery, paintings and sculptures through the gallery, but also has a growing online business. She's also part of the newly formed local branch of 'Seniors Creating Change' and is about to start a clip for YouTube.
This particular morning, Georgina is recovering from her 74th birthday party; it wasn't a huge party in terms of the number of guests, but the 35 or so people who did attend were quite exuberant and really wanted to celebrate Georgina's life. She's been scrolling through photos on her phone, taken the night before, and these photos make her smile. There'd been many speeches about her artistic endeavours, her community work and her dedication to the local pioneer women's museum. Georgina and Chris had been instrumental in establishing and then maintaining the museum; they'd used their links with women's groups in the city to gather artefacts and stories of women's lives.
Georgina really misses Chris; she visits the cemetery most weekends to ensure there are always flowers from the garden on the grave. The local council does a good job maintaining the cemetery grounds; it's a peaceful place with picturesque views of the surrounding hills and valleys.
As Georgina finishes her cup of tea, she decides she'd better feed the chickens, as they're used to being fed much earlier in the morning. As she fills the chickens' feeding tray with vegetable scraps left over from the party, some of the new chickens she recently received escape the enclosure. Georgina's old dog Blanche is usually uninterested in the chickens, but the fuss the escapees are creating has attracted her attention and she starts to chase them around the backyard. Georgina is worried that Blanche might harm the chickens. She yells at Blanche to stop, but the dog is very excited by the commotion, ignores Georgina and continues to run after the chickens. Georgina runs after Blanche, knowing that if she can reach her, she will soon settle her down and get the chickens back to their yard. As Georgina pursues the dog, she slips over, hitting her head.
Georgina is awakened by Blanche licking her face and nudging her. She isn't sure how long she's been on the ground, but her head and neck really hurt. After taking a few more moments to regain her senses, she tries to get up - it's not going to do her any good to be out in the hot sun for very much longer. As she tries to move her arms to support herself, she feels a stabbing pain in her right wrist and fears it is broken. She manages to manoeuvre onto her side but, as she rolls over, she experiences a sharp pain in her hip as well.
She calls out for help a few times, in the hope that someone might hear, but she knows her neighbours' houses are a little too far away to hear her yelling. She'd always enjoyed living on the big house block, but in this moment she's not so sure.
After quite some time, Georgina uses her 'good' arm to drag herself back to the veranda. Fortunately her mobile phone is within reach and she calls her close friend, Sam, to come and help. Sam arrives about 10 minutes later and is shocked by how much pain Georgina is in. Same also notices a swelling and a nasty bruise emerging on Georgina's forehead and calls the ambulance. Georgina is taken to Smalltown Multipurpose Health Centre. She's very worried: does she have some broken bones? Does she have osteoporosis just like her mother did? What is she's out of action for a long time - who will look after Blanche and the garden? The gallery? Who'll upload the YouTube clip?
Once she arrives at the health facility and her injuries assessed, she's asked in a loud voice, 'Do you still live at home dear? Can we give your husband a call to let him know what's happened?'
Due to her injuries, Georgina is told she'll need to spend quite a long time in hospital before she can be assessed by the discharge planner. If she recovers well enough, she might need some home nursing and support for a while. Georgina is worried she might not be able to manage at home - there are quite a few stairs inside the house and she does have a large garden to care for. She couldn't bear to live anywhere else but at the place she and Chris built for themselves. Since Chris's death, the home is the only physical reminder of Chris - every time the sun shines through the leadlight, she feels Chris's presence. She worries about being forced into a nursing home - she's not ready for that yet! She gets a bit upset from time to time, but doesn't want to 'burden' her friends or the nursing staff with her concerns.
The nursing staff and ward attendants are usually very attentive and Georgina has a steady stream of visitors throughout her hospital stay. She worries a lot about Blanche and hopes the neighbours keep a good eye on the old dog while Georgina is not there. She's love to see Blanche - it would be a real tonic.
After finding Georgina sobbing quietly to herself one day, one of the nurses asks Georgina is she'd like to speak with a social worker in more depth about her situation. The nurse finds it frustrating that there's never enough time to sit with people and to comfort them, as there are always so many other people to care for on the ward. Georgina isn't keen to 'see a counsellor' at first, but eventually agrees that it can't do any real harm. She finds the social worker easy to talk to and she's able to discuss her current circumstances and plans to return home, along with how's she's dealt with Chris's death.