Review the below case study and then answer the following
Treatment Planning Exercise for detailed located in the Getting Started Section of the course.
Using the case of the Smith family complete the following assignment. You can either use Jessica, her mother Mrs. Smith, or the family as a whole:
1. Identify the presenting the presenting issue.
2. Using the EBP process, identify a searchable question for her issue; ONE client factor that should be considered when planning for treatment; identify one clinician factor that is important to note.
3. Create ONE treatment goal;two objectives for that goal; 3 strategies/tasks to achieve that goal and meet those objectives. The goal, objectives, and tasks should all be written in SMART format.
4. Identify ONE evaluation strategy that would be appropriate to evaluate the progress of your work. Provide a rationale for why this approach might be effective.
The Case of the Smith Family
You are social worker for Families First, a private non-profit organization that provides families in a rural county in West Virginia with comprehensive social services including parenting classes, psycho-education and activity-based groups, babysitter training, day-care provider training, employment counseling, legal services, child visitation mediation services, and referrals to other social service agencies in your county that can provide food, clothing, housing, and medical care. Recently, the organization was featured in the local newspaper because it obtained a federal grant to train women in non-traditional jobs such as welding and carpentry.
You are a case manager at the agency under the supervision of a licensed clinical social worker. Your role includes service coordination and supportive services. Service coordination includes community outreach work, where you link the family not only to your own agency services but refer to other community agencies and informal resources to meet the unique needs of each family you service. Supportive services consists of providing emotional support, providing information, assessments, supportive therapies, resolving conflicts, and advocating on behalf of the family to assure they receive the services to which they are entitled.
You collect the following information from the client during the intake interview with Ms. Smith, Mr. Jones, and Jessica. Jessica sat in the waiting room for part of the visit, but she came in at the end of the session to share her perspective.
Identifying Information
Susan Smith is a thirty-one year old Caucasian woman who is the mother of a thirteen-year old girl, Jessica.Mrs. Smith has no other children. Ms. Smith reports she was married to Jessica’s biological father shortly before graduating from high school, but the couple is now divorced. Ms. Smith reports she is not currently married but is in a “stable relationship” with the Caucasian man, John Jones, who accompanied her to this interview. Ms. Smith and Mr. Jones who is 40-years old report that they consider themselves a family since Mr. Jones has been in the household for more than two years, and they are jointly raising Jessica.
Reason for Referral
Ms. Smith reports the reason for seeking the services of Families First is that she is concerned about the well-being of her family. Some of the specific concerns she identifies are visitation problems with her ex-husband; Jessica’s grades; Jessica being bullied at school; and Jessica recently running away from home on two occasions after physical fights with her step-father when he saw her low report card grades.
Ms. Smith disclosed that she has a friend who made use of the services of the agency in the past when she was “in trouble.” When questioned about the reference to trouble, Ms. Smith began to cry. She reported she had received a call from the local Department of Human Services and had been asked to meet with a social worker. She alleges that she is “clueless” about why she is being asked to meet a social worker, but her biggest fear is that her daughter, Jessica, may be removed from her custody because of the recent runaways.
Ms. Smith also reported that she also has a meeting scheduled next week with the school social worker because her daughter is having attendance, academic, and behavioral difficulties in school. Ms. Smith reports that when she asked Jessica why the school social worker would want to see her, Jessica said that she just wants everybody to leave her alone.
Although Mr. Jones was present for the intake interview, he made no comments during this portion of the interview.
Sources of Information
This information was compiled by the MSW intake officer for Families First from a sixty minute face-to-face interview with Ms. Smith, Mr. Jones, and (for part of the interview) Jessicathat took place on September 15, 2015 at 2 PM.
Developmental History
Ms. Smith reported her developmental history as unremarkable. She began walking at around 9 months of age, talking in full sentences when she was about three, learned to read and write at five or six, and was very athletic as a young girl and young woman. She reported that although she was just eighteen when she had Jessica, her first child, the pregnancy and delivery were normal and without complications. She reported she had six weeks of maternity leave after her child was born and then went immediately back to her job as a cashier/store manager at a local convenience store.
Ms. Smith reported that Jessica was a full-term baby who weighed 8 pounds 8 ounces at birth and was 21 inches long. She said Jessica was an easy baby who did a lot of smiling and gurgling. Jessica slept through the night almost immediately except when she was sick with a cold or stomach ache. Ms. Smith reported Jessica started walking around 11 months of age and talked in full sentences when she was about two and a half because “my in-laws thought she was the cutest thing, talked to her all day long, showed her off to everybody and spoiled her rotten.” Ms. Smith reported there were no developmental issues when Jessica was a toddler or a pre-school child.
Ms. Smith reported some of her relatives nicknamed Jessica “Beebee” for “Biracial Baby” and Ms.Smith did not like that. When questioned about the nickname, Ms. Smith reported her ex-husband is an African-American man named LamarGriffith. Ms. Smith reports that her parents were not supportive of her relationship with Mr. Griffith, and they refused to attend their wedding. Ms. Smith reports there is no history of inter-racial marriage in either the maternal or paternal families, and it is rare in their part of rural West Virginia.
Ms. Smith reported that when Jessica was in the second grade, she was having trouble “coloring in the lines,” and the school sent her for an assessment. The findings indicated that Jessica’s fine motor skills were very slightly delayed, but the school told Ms. Smith not to worry about it. Since that incident, there have been no other developmental assessments. Ms. Smith reports that her daughter has been followed since birth by Newbury & Smith, Pediatricians, 110 South Main Street, (301-467-9391).
Mr. Jones reported that although he can’t remember much of his developmental history he has been told repeatedly by his family he “came out of the womb running his mouth and raring to go.” Mr. Jones reported that he was big for his age so when he was sixteen he got a full-time job. He said he always intended to go back to school but never made it. Mr. Jones reports that his current job is as a foreman on a construction site in downtown Baltimore, which is a two-hour commute each way from their home.
School History
Ms. Smith reports she did well in school, although she dropped out in the eleventh grade to marry Lamar Griffith because she was expecting Jessica. She reported she always made the honor roll and hoped her daughter would follow that tradition. She reported she has been thinking lately that she might want to go back to school to learn something that “will make me more money than cashiering.”
Mr. Jones reported he dropped out of school in the 10th grade.
Jessica is in the ninth grade at High Ridge MiddleSchool. Ms. Smith reports there were no problems with Jessica and her academic work during kindergarten, elementary, and the first two years of middle school.Until the last year and a half, Ms. Smith reports that Jessica was a solid student, receiving mainly Bs, but occasional As. Now, however, she is receiving mainly Ds with some Cs and some Fs. Ms. Smith says she is worried that Jessica may not pass this year and make it to 10th grade. Jessica reports that she is not concerned about her grades, and she is frustrated with her parents, mainly herstep-father, for trying to intervene and punish her as a consequence for her poor grades. Jessica says that she isn’t capable of doing any better because she just isn’t smart, especially when it comes to math.
Jessica reports that she has a few friends, all of whom are in the “funky” crowd. When asked what that means, she says they are like her in that they are “weird,” “alternative,” and “don’t give a s*^~ about what others think of them.” She states the “popular girls are all scared of me because they think I am going to hit on them or something” as an explanation as to why she does not have many friends. Jessica spends most of her time outside of school with her friends or playing video games alone at home. She states that there is “nothing to do” in her town and that she doesn’t “fit in.”
Family History, Cultural Background, Current Issues
Ms. Smith and Mr. Jones report they met at the convenience store where Ms. Smith works about three years ago. After six months of seeing each other on a regular basis, they started dating. They made the decision to live together six months after that. They currently live in a townhouse in a low-income development near the outskirts of the small town. Mr. Jones reports his income in the high $50,000 rage and Ms. Smith reports an income of the low $20,000 range. Both of the adults own cars and are discussing what will happen when Jessica is old enough to drive. Ms. Smith reports that one of the things she doesn’t like about her job is that she gets laid off when the business is not doing well. She reported the lay-offs occur during the winter months because the store services sportsmen who purchase bait and camping supplies. Winter is approaching, which makes her feel “stressed out.”
Ms. Smith reports her adult personal relationship history has been “rocky.” She reports that she does not always “pick good ones.” She has stated that a couple of her partners had been violent towards her and that Jessica witnessed some of it. Ms. Smith reports Jessica has been very angry with her for not making the choices she feels would be best for the two of them. Jessica nodded agreement.
When asked about her relationship with her ex-husband and how visitation is handled, Ms. Smith became tearful again and said,“I just want him out of my life!” Ms. Smith reported that she and her ex-husband separated when Jessica was less than 9-months old. She then took Jessica to live in another town and refused to allow the child’s father to see them. Ms. Smith reported she moved around to different friends and family members, never telling her ex-husband where they were. Months would go by without any contact with them. This pattern went on for three years until finally the ex-husband obtained an attorney who filed papers for him to have regular visitation. Since that time, Jessica’s father has been an active figure in her life, but there continues to be problems related to visitation as well as Jessica’s relationship with her father and step-mother.
Ms. Smith reports she has a “good enough” relationship with her own mother who frequently watched Jessica when she was a baby while she went to work. She reported there is some friction because her mother does not approve of her lifestyle, living with a man to whom she is not married.
Mr. Jones reported that he had been married when he was 20-years old. He left his wife and a young son after four years. “But I support that child,” he stated. He reports he sends a monthly check to the Child Support Enforcement Division of Baltimore City. He reports he has no contact with his wife. Mr. Jones reported that he has very little contact with his family of origin who all live in Texas because he no longer follow the strict fundamentalist religious practices in which he had grown up.
Ms. Smith reported she is a little concerned about her daughter’s sexuality although she accepts her daughter for who she is. She reports her daughter identifies as a gay woman although Ms. Smith believes her daughter has not had any physical/sexual relationship with any individual. For the first time in the interview, Mr. Jones made a comment unprompted. He reported that he believes that this is a phase that teenagers go through and that Jessica is too young to make that kind of decision for herself. Jessica refused to answer any direct questions by the social worker about her sexual orientation.
Jessica appears to be experiencing significant stressors outside of the family setting. The majority of her difficulties occur at school, where she is earning failing grades and beginning to get into fights. She states that she is a victim in these fights, as the other kids taunt her because she has come out as gay. In response to what she describes as harassing behaviors, she described name calling, pushing and shoving in the hallways, and notes left in her locker. As a result, Jessica’s way of coping with the bullying has been to be provocative in school. For example, she wears very large t-shirts with insulting phrases on them and reports instances where she gave someone “the finger” because another student looked at her “funny.” She also has changed her appearance significantly, through various hair colors and haircuts that do not conform to the mainstream style of the middle school, which is located in a fairly small, rural, and conservative town. There are reports now from the school counselor that the fights are increasing, and while the school counselor states that Jessica does experience some harassment, the school’s viewpoint is that that Jessica also instigates a significant percentage of the fights. Jessica is also skipping some classes, either at the start or at the end of the day and has been caught forging her mother’s signature on at least one note where she was trying to excuse an absence. The school administrators are now tracking these absences, and over the last six months, they have increased significantly and the school administrators are becoming very concerned about her truancy.
Ms. Smith and Mr. Jones report they regularly attend a small Baptist church near their home, Zion Baptist Church, 115 West Main Street, (301-777-8906). They reported they were attracted to the congregation because “everybody was just so friendly and loving.” Ms. Smith reports that although she was raised without a religious tradition, her relationship with Mr. Jones led her to embrace the church and the church experience. She reported that she is a member of the Nurses Guild, a small group of women who assist members of the congregation during the weekly Sunday services. Mr. Jones reports he is taking classes to be appointed a deacon. Jessica reports that she does not attend the church, although she knows her parents want her to attend.
When asked about a vision for the family future, Ms. Smith reported she would like for everyone to get along and have a nice, normal happy family with Jessica and John. Mr. Jones reported he wants the same thing. When asked her vision for the Smith/Jones family, Jessica was silent.
Assessment of Current Functioning
This is a blended family in the very early stages of formation with the complications of parenting an adolescent bi-racial female who is having problems in school, identifies as a sexual minority, and may or may not be the focus of a Department of Human Services concern.
Summary, Conclusions
Susan Smith, the mother of 13-year old Jessica Smith, and John Jones presented to this agency in search of services that will improve the well-being of this blended family. In addition to resolving the challenges of becoming a blended family and stepparent-child conflicts, Ms. Smith and Mr. Jones face the challenge of creating a two-parentvisitation agreement with Jessica’s father while raising an adolescent with significant challenges of her own including but not limited to problems in school, racial minority status, sexual minority status, and anger towards her mother who exposes her to interpersonal violence. Additionally, Ms. Smith’s employment history places the family financial situation at risk if Mr. Jones were to leave the unit. This was the first in a series of interviews to be conducted to determine which services might be appropriate for this family. After supervision with the Unit Manager who requested additional information, the family was called to arrange a second interview.