The client is depressed
Each student will conduct and write a bio-psycho-social-spiritual assessment on a “client” you meet during our in-class Interviewing Skills Practice (ISP) assignment. Adapt your interview to your particular client, taking into consideration any practice issues for minority or oppressed clients, the agency setting, and the presenting issues.
This paper should be written in narrative form and should include, at a minimum, the following information in headings:
1. Client Identifying Information: Date of interview(s), age, gender, ethnicity, religion, marital status, and referral source, etc. Caution: Remember confidentiality: Do not use the client’s / peer’s real name and disguise any other identifying information. Also remember to write this as a legal document, meaning that it should be objective and neutral and not contain information about others unless it is stated in terms like “client reports…”.
2. Source of Data: Identify all sources of client information. (e.g., the individual client, family members, data from charts, schools or other agencies).
3. Descriiption and development of the presenting issue(s): Include the reason for social work involvement at this time. What was the precipitating event that brought the client to seek help at this time? Describe in depth the current client situation. (Remember the 5P’s of assessment: presenting problem, predisposing factors, precipitating factors, perpetuating factors, protective factors).
4. Client History:
a. Include chronological developmental history including all major events from prenatal to present.
b. Family History: Include chronological history of family and relevant extended family, and brief descriiptive information about family members. Include a genogram if relevant.
c. Medical and psychiatric history
d. Marital or relationship history
e. Developmental functioning
f. Education/Employment
g. Religion
h. Financial History
i. Alcohol and/or drug history including any history of treatment or recovery
j. Legal history, e.g., arrests, mandates, outcomes
k. Military History, including combat or trauma exposure
l. History of violence including physical and sexual abuse
m. Home and neighborhood environment
n. Recreation and social functioning
o. Relevant contextual and community factors
p. Other relevant information
5. Draw and complete an eco-map. If possible complete the eco-map with the client and describe the process. What did you and your client learn from completing this? ANALYZE and INTERPRET what is present / missing from the client’s social network; what difference does having this information mean to you in your assessment?
6. Assessment: This will be your analysis of the client on four levels: individual, interpersonal relations, the family unit, and the family’s interchange with its social network and other environmental (macro-level) or ecological factors. Here you will also include at least 1 page discussing how this person’s situation (at each of the four levels) is impacted by the systems s/he is a part of and his/her relationships with those systems. Use systems theory and terminology where appropriate. What is your formulation / analysis of what is occurring for the client / client system based on your social work knowledge? Use your critical thinking and social work knowledge to ground this professional opinion. For example, in what stage of the life span is your client and why does this matter? In what stage of the family life cycle is the client system and why does that matter? How does your client think / feel / behave? How motivated is the client? What environmental factors like ethnicity, culture, poverty, access, laws, and policies, etc. impact your client’s ability to act?
7. Strengths: What are the client’s strengths? Think of how the client has coped to date with the issue(s). What are their social, intellectual, physical, emotional, and environmental resources?
8. Problem List: Develop a problem list from your interactions with your client that prioritizes the most important aspects of work.
9. Identify your client’s goals. Be sure they are in keeping with your scope of practice and agency mandate (keep in mind the SMART goal framework).
10. For each goal, list specific objectives / steps that will help the client achieve the goal. Include outcome criteria for assessing each goal and completion dates, if appropriate.
11. Intervention Strategy: In this course, students consider the multiple dimensions of intervention, (e.g., individual, family, group); and what intervention is most appropriate given their skill level at this point in their professional development (e.g., case management, task centered social work, CBT, SFT, MI, crisis intervention). How do you plan to intervene with this client? Remember to make a logical link between the client’s presenting issue, the client’s goal(s), and your chosen intervention. Provide a rationale for your choice of intervention. Cite three peer-reviewed research-based sources that support your intervention strategy (e.g., Conduct a library literature search to determine for example, “Is MI effective practice for substance use disorder?”; “Is there evidence that group work grounded in CBT is best for socializing teens?”)
12. Obstacles to client success: What potential setbacks might the client encounter? Identify how you will help your client plan to address them.
13. Recognizing that we grow in our assessment competence with supervision, self-awareness, and practice, engage in a self-assessment of your work in this assignment. In this self-assessment please address the following:
a. What skills did you use in conducting and writing this psychosocial assessment? Identify as many specific skills as possible, using social work language from the course.
b. What strengths do you think are demonstrated in your work on this psychosocial assessment (e.g., strengths in relation to knowledge, skills and/or values)?
c. What limitations are demonstrated in your work on this psychosocial assessment (this refers to your limitations in terms of knowledge, skills, and/or values…. not limitations of the client)?
d. How might you work to improve in the areas that you identified as limitations (i.e., knowledge, skills, and/or values areas)? How might you use your identified strengths to help you to improve?
