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Psychosocial Case

"The Road to Adoption":

The Case of Lilly.

TOPIC

INTRO

Client Identifying Information

*Disclaimer All Identifying information in this presentation is fabricated for confidentiality purposes*

Lilly Frazier

13 Years Old

African American Female

Not Married

Resides in Hampton, Virginia with foster Mother D.

Client is under: Hampton Department Social Services Foster Care and Adoption Unit

(Emergency Removal Order)

Problem Statement

Presenting Problem:

Lilly was placed into Foster Care after great aunt caused physical harm.

- Great Aunt does not want Lilly back in the home and is not willing to work with CPS with conducting home visit, not willing to learn other forms of discipline

- Relative Information Form was completed, relatives have not contacted the department back or been consistent

Stressors: Non Productive Behavior Problems:

Physical Abuse Defiance, Lying, Sexual Acts, School Issues

Abandonment

Referral Source:

CPS was contacted by Lilly's teacher,

-Visible Indications of physical abuse (facial bruises and bleeding)

Precipitating Event:

Lilly defiance and getting into trouble at school

Relevant

History

RELEVANT HISTORY RELATED TO THE CLIENT

Lilly was victim of physical abuse by mother

(1) Founded Level II Newport News Social Services . . . case was transferred to Ongoing Services . . . Mother declined services

(2) Founded Level II victim of physical harm

Great Aunt agreed to take custody

Lilly stated that she feels angry towards her family because no one wants her and there was no structure .

Lilly has admitted to partaking in substance misuse because of the environment that she was in.

Lilly has been struggling focusing in school.

Emotional Status

Emotional Status

Lilly's psychological status was assessed there was no indication of sexual trauma, severe mental issues, developmental delay suicide, or lethality, the client is currently on no medications besides vitamins.

Due to client's history of physical harm, and current family issues, PTSD and Depression and Anxiety are possibilities.

Oriented To: Client is fully aware of time, objected, other people, places, and persons, she is very aware of her situation and the details it involves

Clothing: Neat/Clean, Situation Appropriate

Grooming: Well-groomed

Mood: Normal

Affect: Appropriate

Eye Contact: Avoided (Embarrassed)

Motor Activity: Unremarkable

Posture: Normal

Attention: Unremarkable

Emotional Status

Concentration: Normal

Judgment/Insight: Appropriate

Memory: Normal

Speech: Normal

Thought Content: Mood/Situation Appropriate

Thought Processes: Circumstantial

Hallucinations: None

Estimate of intelligence: Average

Social Functioning: Impulsive

Client

Strengths/ Limitations

Client Strengths/ Limitations

Education

Occupation

Financial Situation

None

7th Grade Virtual Learning

Dependent on Foster Mother, Does recive $10 week allowance

Disability

Developmental Issues

Diversity or Oppression

None

No diversity within the foster home , minimal diversity in the community.

No identified oppression.

Skills&Training

Tech Savy

No Certification

Client Strengths

Resilient

Confident

Proud

Creative

Assertive

Brave

Optimistic

Strong

FAMILY

SUPPORT

Family/Social Support Network

Family Constellation

Significant Others

Client did not state that she has a significant other but does have sexual relations

Family is not making an effort to attend visitation regularly to see the client.

Mother and Father was contacted with no response.

Community Organizations

Religious & other affiliations

Due to COVID-19 client is involved in minimal community organizations.

Aware of Christianity, does not attend church but believes in God.

GENO GRAM

ECOMAP

Clinical Assessment

Clinical Assessment/Summary

Professional Conclusions:

- Due to the negative energy flow and non compliance from the client's mother an other family members, the client is at rick of depression, anxiety, and PTSD.

- Due to Lilly being a victim of physical abuse on three documented occasions, she is vulnerable to other forms of abuse.

What does this client need?

-Trauma counseling with Center for Child and Family Services

- A tutor to hold her accountable to completing school work

- A mentor

-Opportunities to be involved in the community

What is the client seeking?

-Permanency (Desires to stay in the foster home)

-Stability

-Love

Explanation of observations

Clinical Assessment/Summary

What meaning does the client ascribe to the problem?

- Lilly is optimistic that a family member will contact the department but she does desire to stay with her Foster Mother

- The client is aware that she has an issue with running off, lying, stealing, and is participating in sexual acts, does not seem to have a 'true' desire to fix the problems.

DSM-5

- High risk for Depressive Disorder, Anxiety, and PTSD

Explanation of Evidence

Intervention

Intervention

What practice skills did I use?

-Empathy

-Active Listening

-Cultural Competence

-Patience

-Critical Thinking

-Boundary Setting

-Information Gathering

What treatment model should be used?

-Cognitive Behavioral Therapy

-Narrative Therapy

What theories did I integrate?

-Systems Theory

-Rational Choice Theory

-Empowerment Theory

Explanation of evidence based support

Toxic Stress

Leila Morsy and Richard Rothstein

“Stress” is a commonplace term for hormonal changes that occur in response to frightening or threatening events or conditions. When severe, these changes are termed “toxic” stress and can impede children’s behavior, cognitive capacity, and emotional and physical health.

Social class and childhood stress. Beginning in infancy, lower social class children are more likely to have strong, frequent, or prolonged exposure to major traumatic events, the frightening or threatening conditions that induce a stress response.

Income and childhood stress. The lowest-income children are more likely to be exposed to frightening or threatening experiences than other children.

Race and childhood stress. Black children are more likely than white children to be exposed to frightening or threatening experiences.

Childhood stress and depressed outcomes. Independent of other characteristics, children exposed to more frightening and threatening events are more likely to suffer from academic problems, behavioral problems, and health problems.

Policy Recommendations

  • Providing Support for Parents before issue occurs
  • Train school staff to support children
  • Address racially disparate policies and practices in schools.
  • Engage health care professionals in screening and treatment.

Plan

Plan

Main Resources

Trauma Counseling

Together Lives Change Program (TLC)

-Mentoring

-Family Healing & Reunification Services

-Day Treatment

-Independent Living Coach Trainings

The UP Center

Outpatient Therapist

Gaps In Resources

Many resources are catered to individuals with psychological

issues and are on medication

Plan

Agency Mission Statement

Our mission is to create a collaborative system of services and funding that is child-centered, family-focused, community-based and cost-effective when addressing the strengths and needs of troubled and at-risk youths and their families in the commonwealth.

The department works to ensure that all Hampton families are able to become healthy and self-sufficient.

Goals include:

Empowering families and children to escape the long-term effects of poverty

Protecting abused or neglected children and adults

Supporting families for healthy development

Social Justice Issue: Intentionality

No Social Policy Issues

Congruence Level

High. HDSS is committed to permanency and strengthening the family. HDSS is aware of possible social justice and policy issues and combats them.

Self-Evaluation

Self-Evaluation

Value Challenge:

-Being non-biased

-Open mindedness

Ethical Dilemma

-Other Social Workers in the office conversations about the case

-The client asking for my phone number

Managing conflict

-Unsuccessfully being able to get in touch with Lilly's family members

-Lilly's defiant behavior

Application of the NASW Code of Ethics

Dignity and Worth of a Person

This client needs to feel worth!

Processional Growth

-Solidified the population I desire to work with

-Note taking skills on home visit

-Actual client interaction

References

C. (n.d.). National Association of Social Workers (NASW). Retrieved November 8, 2020, from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

Poulin, J., Matis, S., & Witt, H. (2019). The Social Work Field Placement: A competency-based

approach. New York, New York: Springer Publishing Company, LLC.

doi:10.1891/9780826175533

Reference

Human Services (Social Services). (n.d.). Retrieved November 8, 2020, from https://hampton.gov/269/Human-Services

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.

Morsy, L., & Rothstein, R. (2019, May 1). Toxic stress and children's outcomes: African American children growing up poor are at greater risk of disrupted physiological functioning and depressed academic achievement. Retrieved November 8, 2020, from https://www.epi.org/publication/toxic-stress-and-childrens-outcomes-african-american-children-growing-up-poor-are-at-greater-risk-of-disrupted-physiological-functioning-and-depressed-academic-achievement/

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