Total33identifying Informationappendix C Final Examination C ✓ Solved
Client: Sylvie (Caucasian American) Age 30: Gender: Female Employment: Unemployed Education: Junior College Associates Degree Marital Status: Separated from spouse-Kevin Children: Casey Age 15 (Pete {African American} is dad) John Age 10 (Pete is dad) Sid Age 5 (Teddy {African}is dad) Agency Type: Outpatient Counseling Services Presenting Problem: Sylvie reported that she was experiencing symptoms of depression (ongoing for about a year), including some suicidal ideation (ongoing for about a week). Other depressive symptoms included feelings of sadness, helplessness, and guilt; crying spells, fatigue; loss of interest in daily activities; sleep problems (insomnia); and appetite problems and weight loss (dropped from a size 8 to a size 4 since November). Sylvie reported that she had no current suicidal thought or intent.
Background Information: Sylvie stated that she had been separated from her husband, Kevin, since November. She said he is a “good man” but she “wants out” of the two year marriage. Last week she quit her job, due to her stress level, and since then has been unemployed. She is living in an apartment with her 15 year old daughter; her husband stated that he will pay this month’s rent only.
Sylvie has not seen her two sons for the past several weeks at the insistence of her ex-husbands. She tearfully stated that “without my children I’m nothing—I don’t want to live.” Sylvie reported that she is facing embezzlement charges from a former employer. This situation began in July, and trial is pending in May. Sylvie denied that she embezzled any money from her employer. She quotes her lawyer as saying, “we have a good case.” Sylvie related that her main social support these days is from her 15 year old daughter, Casey, and her friend, Jeremy. Sylvie stated that “Casey loves me and stands by me and is upset and crying now too.” Jeremy is a “good friend,” “we’ve recently gotten closer although we’ve been friends for a while.” Sylvie additionally related that about one year ago she found a lump in her breast. Diagnostic tests were inconclusive about whether it was benign or malignant and this situation is being followed by her physicians. One month after finding the lump in her breast, Sylvie was diagnosed with and had surgery for an ectopic pregnancy. Additionally, last month Sylvie was diagnosed with an ovarian cyst.
Sylvie stated that this is the first time she has sought mental health services. She denied problems with alcohol or drug use or abuse. HISTORY: Childhood. Sylvie reported that she grew up in an alcoholic home. Her father drank daily and Sylvie related observing regular verbal fights between her parents. She denied physical abuse during childhood but identifies verbal abuse. Her parents are divorced, and her father continues to drink. Her mother remarried 5 years ago. When she was approximately 12, Sylvie was raped by an uncle. Several years ago this uncle returned to town and moved in with her grandmother. Sylvie related fearing for her own and her daughter’s safety. She does not visit her grandmother’s home anymore.
Marriage and Children. Sylvie became pregnant with Casey at age 17; she was not married and lived with her parents. Three years later (when she was 20) she married, Pete, Casey’s father. John was born several years later. She divorced Pete before John was born when she found Pete “in bed with another woman.” At age 22, she married Teddy. They remained married for approximately 6-7 years. Their son, Sid, was born when she was 24. She stated that Teddy was verbally and physically abusive to Casey and John. She also stated that Teddy verbally and physically abused her. Sylvie stated that she divorced Teddy because of his treatment of her two oldest children. After the divorce, she and Teddy shared custody of Sid, who lives with Teddy.
Employment and Education. Sylvie graduated from high school and junior college. She has worked a variety of jobs, including housekeeping, retail sales, office work, and secretarial work. Her longest job was a 5 year stint as a legal secretary. She has lived and worked in various towns in the south.
Legal Problems. Sylvie described a “problem of writing bad checks.” She related that she was arrested several times for this activity, which was an ongoing problem for a number of years. She stated that she dealt with this problem by not having a checking account “for years”, until this past year. Sylvie reported that she did not embezzle any money and that the charges were linked to her male employer’s wife’s jealousy of her. She denied any romantic or sexual relationship with her employer. Trial is set for May.
Initial Goals for Therapy. Sylvie related that her goals in seeking help were to (1) H O M E W O R K ?’s Use the Description Assessment & Contract (DAC) assessment outline to generate an assessment of Sylvie. Note: Use Figure 9-5, page 243 as your guideline Complete an eco-map depicting Sylvie’s current situation. (5 points) Complete a genogram depicting Sylvie’s familial history. (5 points) Identify and discuss the information that you would need to complete a multi-dimensional assessment of Sylvie. What information is missing from the case description? (10 points) Note: Use pages 242 thru 248 as the primary basis for your responses Briefly discuss what you see as the client’s 3 most pressing problems. Provide justification for the 3 problems you selected. Identify which of the identified problem(s) you would address first & provide justification for your answer. (20 points) Based on your preliminary assessment (Questions 1-3) and problem typology (Question 5), select 2 problems and construct a task-centered intervention plan for Sylvie using the 5 column format (Problems; Goals & Objectives; Client’s Tasks, Worker’s Roles & Tasks). Be as detailed as possible. (15 points) Note: See page 325. Based on your task-centered intervention plan, complete a contract for your work with Sylvie using the Sample Form for Client-Social Worker Contract distributed in class. (5 points) NOTE: Follow the guidelines on pages 359 and 360 to develop your contract Discuss how you would monitor client progress toward realizing the objectives and overall goals. How will you determine the effectiveness of your intervention with Sylvie? (5 points) NOTE: To be discussed in class on 11/16/20 – See Chapter 12, beginning on page 342 How would you assess Sylvie’s readiness for termination? (5 points)
Paper For Above Instructions
Sylvie's case presents significant challenges that encompass multiple dimensions of her life, necessitating a structural and efficient approach to assessment and intervention. This paper will address the identified components of the assignment, employing a detailed scale of analysis to clarify Sylvie's current situation and shape the therapeutic plan that aligns with her needs.
Assessment of Sylvie
Utilizing the Description Assessment & Contract (DAC) assessment outline, I shall provide an overview of Sylvie's myriad challenges and establish a base for our intervention strategy.
Eco-map and Genogram Completion
The eco-map will illustrate Sylvie's immediate environment, showing her limited support system primarily centered around her daughter Casey and friend Jeremy. The challenges posed by her legal issues and lack of stable employment must be clearly depicted within this external environment.
A genogram will further clarify familial connections, including her relationships with her children's fathers, highlighting historical patterns of abuse and separation. These visual tools will enhance understanding of the family dynamics at play and inform the therapeutic direction.
Multi-dimensional Assessment Information
To achieve a thorough multi-dimensional assessment, essential information includes Sylvie's medical history beyond current conditions, deeper insights into her psychological state, any previous therapeutic interventions, and a detailed account of her financial circumstances. Critical details missing from the initial case description include Sylvie’s coping mechanisms and social communication patterns, which are vital for complete understanding.
Pressing Problems Identified
Analyzing Sylvie’s situation, three pressing problems emerge:
- Depression and Suicidal Ideation: Sylvie exhibits severe depressive symptoms which threaten her stability and well-being.
- Legal Troubles: The pending embezzlement charges are exacerbating her stress and social isolation.
- Social Isolation and Loss of Parental Role: The lack of contact with her son significantly contributes to her feelings of worthlessness.
The most pressing issue to address first is Sylvie's depression and suicidal ideation. Immediate risks to her well-being necessitate urgent intervention. Once stabilized, we can tackle the legal and social issues in succession.
Task-Centered Intervention Plan
Based on the identified problems (depression and legal issues), the intervention plan will be structured as follows:
| Problems | Goals & Objectives | Client’s Tasks | Worker’s Roles & Tasks |
|---|---|---|---|
| Depression and Suicidal Ideation | Reduce depressive symptoms to stabilize mood by 50% within three months. | Attend therapy sessions weekly; complete mood tracking exercises. | Provide therapeutic interventions; monitor mood and safety closely. |
| Legal Troubles | Prepare for upcoming trial by gathering evidence and affirming innocence. | Document all events related to the embezzlement charges; attend legal consultations. | Facilitate connections with legal resources; provide emotional support. |
Contract Development
Following the structure outlined in class, the contract with Sylvie will emphasize mutual commitments, maintaining her engagement in the therapeutic process, and outlining expected outcomes and timelines. This contract shall serve as a guiding document shaping expectations and responsibilities.
Monitoring Client Progress
Monitoring Sylvie's progress will involve periodic assessments to evaluate symptom reduction and overall goal achievement. I will employ feedback tools to affirm her perspective on improvements and adapt intervention methods accordingly. Evaluations at regular intervals of two weeks will allow timely adjustments to her treatment plan.
Readiness for Termination
Sylvie's readiness for termination of therapy will be gauged through specific indicators—including her stability in mood, diminished suicidal ideation, and reintegration into daily activities. Plans for a gradual exit strategy over several sessions will ensure that she feels secure and supported throughout the process.
Conclusion
In summary, Sylvie’s case contains several interwoven layers requiring careful assessment, targeted intervention, and clear monitoring pathways. By focusing initially on her depression and subsequent legal issues, we can navigate her towards recovery and improved well-being.
References
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- National Alliance on Mental Illness. (NAMI) (2022). Mental Health Conditions: Depression.
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