Micro & Macro Intervention on Susan

Intervention based on Narrative Model & Strengths Perspective

Client Assessment

Resources

Client Assessment

Narrative Therapy (Morgan, 2000) &

Strength Perspective (Roff, 2004; Guo & Tsui, 2010)!

• For vulnerable population like the homeless, start from their strength! (Possibilities!)
• CT complete surveys online to earn some income/CT has completed a couple job training - Resourcefulness!
• When talking about her job and housing, CT shows great resiliency and positivism.
• CTs are the Experts!

Micro & Macro Intervention

• Micro: CM work with CT 1-1
• Macro: CM work with staff from YWCA/MHMR/SA/Parenting Center/Library, etc.

Strengths

• Positivism
• Resiliency
• Resourcefulness

Limitations

• Denial of MH Problems
• Victimization
• Blaming Problems on Others

Goals/Service Plan

Client Description

• African American Female
• 55 years old
• Single
• Unsheltered and Chronically Homeless
• Family: None

Presenting Problem

• Homeless (Chronic!)
• Unemployed (Since 2007)
• Knee Problems
• Mental Illness
• Conflict Theory (Eshleman, 1981; "Conflict," n.d.)

Intervention - Change

Who is Affected by the Problem?

• Community Resources in Fort Worth (Library, Shelters, Church Services)
• Homeless service workers
• Other homeless individuals
• People who are trying to help her
• Systems Theory (Friedman & Allen, 2010)

CM and CT came up with goals/Service Plans together:

1. Continue treatment with JPS

2. Updates on SSI/SSDI

3. Job Training Courses

4. Counseling

5. Empowering Families Workshop

5. Housing (Ongoing) - Shelters/Transitional housing, etc.

What needs to be changed?

• Acknowledge MH problems
• Getting housing/transitional housing
• Getting employed
• Continuing treatment

What is likely to change?

• Without acknowledging her own MH problems, it will be difficult for CT to change other aspects of her life

Goal Planning & Intervention

Mental Health Problem

• Appearance/Behavior: okay.. BUT!
• Paranoia/Anxiety caused by chronic homelessness; In Denial of MH
• Accuses a lot of homeless shelter employees of paying others to rape/beat her and other homeless women;
• Blames problems on others; Distrustful.
• Verbally abuses other people when become outraged
• Burned bridges with various homeless resources in Tarrant County

CT's Motivation, Capacity, and Ability to Change

Tasks, Activities, and Skills

• CT is motivated to get a job/housing.
• CT has the capacity to get employed and receive other services.
• However, CT does not acknowledge that she has any MH problem. Therefore, change is difficult.
• CT's MH problems cause other things to happen. (e.g. getting banned)
• Conflict Theory: conflict is natural and inevitable in all human interaction
• Person-In-Environment: the reciprocal relationships and other influences btw an individual and the physical/social environment.

• Applied for YWCA Emergency program
• Asked CT to received counseling once
• Asked CT to attend "Empowering Families" workshop
• Asked CT to get assessed by MHMR
• Advocated for client when working with other agencies
• Motivational Interviewing with CT
• Narrative Approach

Evaluation

Cultural Aspects

• Cultural aspects: African American, homeless culture. These were implied and respected.

Street Outreach Services (S.O.S.) Program

References

• Eshleman, J. R. (1981). The family: An introduction (3rd ed.). Boston, MA: Allyn and Bacon, Inc.
• Friedman, B. D., & Allen, N. K. (2010). Systems theory. In J .R. Brandell (Eds.), Theory & practice in clinical social work (pp. 3-20). Thousand Oaks, CA: Sage.
• Morgan, A. (2000). What is narrative therapy? Retrieved from http://www.theinstituteofnarrativetherapy.com/What%20is%20narrative%20therapy.pdf
• Guo, W, & Tsui, M. (2010). From resilience to resistance: A reconstruction of the strengths perspective in social work practice. International Social Work, 53(2), 233-245. doi: 10.1177/0020872809355391
• Roff, S. (2004). Nongovernmental organizations: The strengths perspective at work. International Social Work, 47(2), 202-212. doi: 10.1177/0020872804041414

• Goals were not achieved: CT did not follow through with plans made (No counseling/empowering families/MHMR assessment)
• YWCA decided CT was not a good fit.
• Barriers: CT's MH problems.
• Current status: termination & referral process. CM told CT about MHMR PATH Outreach team. (PATH is same as SOS but they also do MH screening/assessment)

• CCFW: Over 40 programs
• S.O.S.: help the unsheltered homeless people in Tarrant County through
• Outreach
• Material Assistance,
• Case Management,
• Advocacy
• Referrals

CASE REVIEW

Catholic Charities Fort Worth (CCFW)

249 W. Thornhill Dr.

Fort Worth, TX 76 115

817-534-0814

• An unsheltered homeless female client (chronically homeless)
• Looking for housing/employment
• However, she shows mental health problems that she does not acknowledge
• Her MH problems and other factors are major barriers from reaching self-sufficiency

• Learned: Change comes from the CT. MH problem could be the most urgent problem.

Micro Intervention

on Susan