Reference no: EM133192337

Assignment: Social Work

Read the case study.

Joe is a 43 year old Caucasian male who was referred to the VA clinic for case management services. He was referred for support services from his general physician. Joe feels hesitant about obtaining VA services, but cannot articulate why he feels that way. He has avoided the VA since his discharge.

Joe served in the Iraq war as a paramedic for two years until he was discharged due to a back injury that occurred when he was lifting someone after a car bomb was detonated. Since his discharge in 2009, Joe has been doing some side work in painting and gardening. He had to retire from his work as a paramedic due to his inability to lift over 20 pounds due to his injury. This has left him feeling extremely depressed. Joe wanted to retire from the armed forces and continue his work.

Joe lives alone. He became engaged right before he left to Iraq, but broke off his relationship in 2009 due to his feeling inadequate and unable to properly support a family. Since that time, he has dated occasionally, but purposefully sabotages his relationships when they become too serious. The report from his general physician indicates a history of erectile dysfunction and a refusal to be treated for his symptoms. His physician also has concerns about anxiety and depression. He has two dogs that he enjoys spending time with and socializes once or twice a month "at the bar." Joe's form of socialization usually revolves around heavy drinking at some local bars with his "friends from the bar". He reports binge drinking 2x a month, but does not self - report that he has substance abuse issues. Joe says that he prefers to socialize with people he does not know very well because he is not successful in maintaining relationships since he returned from Iraq. He has disconnected from his friends from his hometown and high school. He reports that he also drinks occasionally in the evenings when his pain medication is not working for his back. He is currently prescribed Vicodin for pain, but Joe reports that he does not want to become a "pill head" so he rarely takes them. He reports that he does not want to socialize with other Veteran's because it makes him think about how he did not finish his "dream job."

Joe was raised in Lancaster, Ohio. Both parents are still alive and he has a younger sister (age 30). His sister has a five year old son who Joe enjoys spending time with on holidays and occasional weekends. She lives about three hours away, therefore they do not see each other often, but he describes the relationship as positive. He reports that his sister completely cut off her relationship from their father because she feels he has been verbally abusive her whole life and does not want her son around him. Joe describes his father as a "functional alcoholic." Joe reports that his father always worked full time, but would get intoxicated every evening after work. Joe attributes his sister's opinion about his father as "my Dad just went off at the mouth when he was drunk, but he is a good man." Although his father is retired, he still drinks daily. His mother has no history of substance use, but was hospitalized three times during Joe's adolescence due to "depression." Joe also states that he thinks he drinks a lot less than his father. Joe denies suicidal ideation of depression and says his family pretty much "deals with stuff and don't whine about things." He reports that he feels like he is just "existing" over the last decade, but would not harm himself because he could not hurt his family.

Joe describes himself as "a middle age man who feels old." He tells you that he thinks the prime of his life was stolen out from under him and he really does not fit in that well in society. He also describes a feeling of disappointment that he was unable to carry out his time serving in the military. His father served in Vietnam and his grandfather served in Korea. He feels he has "broken the family tradition."

Joe's strengths include a sense of humor, his loyalty to his family, a strong artistic ability in painting, a strong work ethic (continuing to do some construction work even while in physical pain), an ability to relate well to animals and a love for nature and gardening.

Task

I. If you were to meet Joe for the first time, describe two behaviors you could exhibit during the engagement phase and explain WHY you chose those behaviors (be specific).

II. In regard to assessment, state at least 3 questions you could explore further in regard to a bio-psycho-social assessment. Meaning, what else do you need to learn about him to formulate an effective treatment plan?

III. How would you prioritize his top three problems-explain your rationale and write them in order.

IV. With the information you already know, if you had to write two goals and two objectives for each goal, what would they be? (Please remember to keep the objectives measureable).

V. In regard to the NASW Code of Ethics, state at least two ethical principles you could apply to this client. Describe why you chose each.

VI. Give an example of how you could use the following with the client: clarification, reflection of feelings and reflecting meaning. Be sure to give an example of each skill and label the one you are discussing.

VII. Do you have a duty to warn or protect regarding this client with the information given? Explain your answer.

VIII. What are two questions you could ask this client pertaining to the concept of spirituality?

IX. Would you have a countertransference reaction with this client? Explain why or why not.

X. If you had to a single system design research project with this client, give an example of an AB design you could do in regard to reducing his depression.