Integrative Case Study Write a case study based on an actual case from your advanced/second year (i.e., 2nd year (24 hour) gerontology field practicum. Please take all precautions to disguise the client system including using initials and changing any case details that could make the client identifiable by others. In addition, obtain consent from the client and approval from your field instructor to use him/her/them for the embedded assessment/portfolio. The case study must reflect your ability to apply learning from all major content areas in the MSW curriculum including Human Behavior and the Social Environment, Social Welfare Policy, Practice, and Research. You are required to organize the case study using the subheadings below in the order listed. Include the bulleted information under each section below in a written narrative (i.e., essay in paragraph format). Use American Psychological Association (APA) current edition format, including references when citing theorists and other sources. Overview of the Case Describe the client system, including the composition (., the client may be an individual, group, community, or organization). Give a succinct but comprehensive statement of the client system(s) presenting problem. This statement should be enough to establish a thorough understanding of the significant factors that are impacting the identified client (., the client may be an individual, group, community, or organization). Application of Social Welfare Policy to the Case: Competency 5- Behavior 1 Identify and critically analyze social policy at local, state and federal levels and the effect on the aging experience. Competency 5- Behavior 2 Analyze and advocate at a macro level for policies that enhance the aging experience and advance the well-being of older adults Delineate a (Macro) Policy that could (has) or currently transforms the client/ organizational system (1 paragraph) What is the policy to be analyzed? What is the nature of the problem targeted by the policy? How is the problem defined? Origin of the problem, challenge, or opportunity and for whom is it a problem? Historical Analysis (2 paragraphs) What policies and programs were developed in the past to deal with the problem? How did these policies specifically impact African American (Individuals, Families, Communities, or Organizations) Problem, Challenge, or Opportunity and Solutions Identify the client/ organizational problem, challenge or opportunity What people, or groups of people, initiated and/or promoted the policy (ideologies)? What people, or groups of people, opposed the policy (ideologies)? Describe key elements of proposed change (theoretical/model basis of the proposed change based on literature review) Policy/Program Evaluation (2 paragraphs) Competency 9 – Behavior 1 Use appropriate methods for evaluation of outcomes with older adults. Competency 9- Behavior 2 Apply evaluation findings to improve practice effectiveness at the micro, mezzo and macro levels with older adults. Solution, Vision for Change & Implementation Strategy Description of plan for enhancing driving forces Description of plan for influencing and containing resistant forces Description of plan for Incorporating of benefits and losses to target group/others in strategy Description of plan for engaging allies in strategy Description of plan for engaging or minimizing adversaries in strategy Description of plan for utilizing sponsor and agent (or others) in strategy Evaluation Plan Outcome objectives have specific timeline, target population, realistic products/results are measurable, statements are clear and concise Plan for continuous assessment of change Theoretical Framework and Context for Analyzing Client System’s Situation Competency 6- Behavior 1: Apply concepts of aging and biological, psychological and social aging theories to engage older adults. Competency 6- Behavior 2 Utilize empathy and other cultural and population specific interviewing skills to engage and support identification of the strengths and challenges of older adults. Theoretical Framework for Understanding the Case Identify and discuss a theory of aging that can be integrated and applied to effectively assess the client’s/consumer’s situation and presenting problem (. Role theory, Life Course Perspective, Continuity theory, etc.) and discuss the practical application to this case. Students should ensure that the application of the identified theory(ies) demonstrate their ability to integrate the frameworks AND a thorough application (individual, family, communities, organizations) within the case. Impact of the Urban Environment on the Case Competency 11- Behavior 1 Apply knowledge of the dynamics and complexities, strengths and challenges of urban communities as the foundation for urban social work research and practice with African American older adults living in the urban communities. Competency 11 – Behavior 2 Apply culturally appropriate approaches to practice with African American older adults living in the urban communities. Discuss how the dynamics of the urban environment impact the client system, including cultural, social justice and economic factors affecting the presenting problem of the client system (., racial/cultural, sexual orientation, physical or mental disability, gender, class, etc.). Ethical Considerations for the Case Competency 1 Behavior 1 Identify ethical dilemmas in practice with older adults and make ethical decisions by applying the NASW Code of Ethics, NABSW Code of Ethics, relevant laws and regulations, and ethical decision-making frameworks to ensure the privacy, autonomy, confidentiality, and self-determination of older adults. Identify ethical principles and identify the standards by number from the NASW Code of Ethics that are relevant to the case. Identify any ethical dilemmas in this case and described the ethical framework utilized along with each step you took to resolve the dilemma. Professional Boundaries Competency 1 Behavior 2: Demonstrate professional demeanor in behavior, appearance, and oral, written, and electronic communication to ethically guide practice and facilitate a positive aging experience. Students will identify and discuss professional boundaries that should be maintained as students progress throughout the case. These should include but not limited to topics such as timeliness, professional appearance, dual relationships, use of personal electronic devices, professional documentation, etc. Diversity Considerations for the Case Competency 4 – Behavior 1: Demonstrate knowledge of culturally competent practice models for working with extended families and organizations serving older adult populations. Competency 2 Behavior 1 Demonstrate advanced understanding of the value of culture on roles, stages, and transitions across the life course and the influence of culture on the aging experience and the values, beliefs and attitudes of older adults Identify and discuss the specific aspects of diversity that impact the social work process with the client system selected for this case. This should include diversity outside of race and could include but not limited to gender, sexual orientation, gender expression, culture, and any other areas of diversity or “otherisms” that have beeen identified. Human Rights and Social Justice Considerations for the Case Competency 3 Behavior 1 Demonstrate advanced knowledge in the social, economic and environmental forms and mechanisms of oppression that impact social justice across the aging experience. Competency 3 Behavior 2 Identify and utilize advocacy practices that advance social, economic and environmental justice for older adults. Identify and discuss the specific human rights or social justice considerations that impact the social work process with the client system and other marginalized groups selected for this case. Students should think broadly on how these issues could or have previously or continue to impact African American individuals, families, groups and organizations. Engagement, Assessment, Intervention, Termination Using evidence based practice specific to your social work area of concentration as your guide, identify a practice framework and explain the processes of engaging, assessing and intervening with the client system identified for this case. Make certain that you address any ethical and/or cultural considerations that might impact service delivery. Organize your response using the outline provided below. Engagement of client. Competency 6- Behavior 1 Apply concepts of aging and biological, psychological and social aging theories to engage older adults. Competency 6- Behavior 2 Utilize empathy and other cultural and population specific interviewing skills to engage and support identification of the strengths and challenges of older adults. Using evidence based practice specific to your concentration and this population, describe the process and specific social work skills and/or techniques that are utilized to engage the client/system. Assessment of client. Competency 7- Behavior 1 Conduct a comprehensive geriatric assessment of bio-psycho-social-spiritual-loss and substance abuse factors that affect the physical and mental well-being of older adults Competency 7- Behavior 2 Utilize research knowledge, therapeutic models, and various diagnostic tools to conduct differential mental health diagnoses to facilitate selection of appropriate strategies for clinical intervention with older adults. Complete a Bio-Psycho-Social-Spiritual Loss Assessment of Client System using the template outlined below. Follow this template exactly: DESCRIPTION OF THE CLIENT SYSTEM: Client/Family Identifying Information Reason(s) for services Household Members (to include relationships with one on another, and their patterns of functioning) Household Living Conditions Financial History (to include all insurance information, excessive debt, etc.) SOCIAL RELATIONSHIPS AND SUPPORTS Family History: In this section, you will present data on family members (be sure to designate the members living in the household). Names, gender, birth dates (or ages), relationships, marriage dates, education, occupations, deaths (causes), chronic conditions (. alcoholism, mental retardation), significant trauma (. fire, rape, incarceration), anything significant to describing individual. Other data that may be significant: adoptions, miscarriages, pregnancies, separations, current locations, etc. Family History: In this section, you will include a family INCLUDE A Genogram of at least 3 generations. Present data on family members (be sure to designate the members living in the household). Names, gender, birth dates (or ages), relationships, marriage dates, education, occupations, deaths (causes), chronic conditions (. alcoholism, intellectual disability), significant trauma (. fire, rape, incarceration), anything significant to describing individuals. Other data that may be significant: adoptions, miscarriages, pregnancies, separations, current locations, losses, over the lifespan etc COMMUNITY SYSTEM: INCLUDE an Ecomap (Depict the connections with various systems currently. Describe relationships between client/family members and the various systems over the. Describe community context and include a description of neighborhood resources. Discuss key community and social relationships over the lifespan crucial to the aging experience (Remember to include a key to explain the type of relationship or connection) ASSETS AND RESOURCES: Information about the client’s informal sources of support. Information about the client’s primary and secondary sources of support. The type (what need does the source meet) and frequency (how often) of support from whom (., friends, extended family members, church, etc) provides support? Assess if the support provided is reliable. SOCIAL HISTORY: PHYSICAL HEALTH (past and present, make certain to include any medication schedules, family history of medical conditions certain to include any medication schedules, family history of medical conditions, ADL, IADL MENTAL HEALTH: This section will include a brief history of family psychiatric problems. Report whether client has a history of psychiatric disorders; admission into mental health clinics(inpatient or outpatient), dates receiving services, outcome of services, medication, treating therapist (past or present); family history or mental disorders. History of homicidal and suicidal ideation. ALCOHOL AND DRUG USE: Summarize if client used any substance in lifetime (. cigarettes, marijuana, cocaine, etc). Periods of sobriety and treatment (when, where and with whom); describe outcome of treatment. SEXUAL HISTORY: Describe sexual activity, sexual orientation, physical, sexual abuse (victim/offender). Explore if relevant to problem situations. It is appropriate to assess if client practices safe sex and receives regular physical check-ups. If client reports being diagnosed with sexual disease, it is appropriate to explore, medication received, primary physician, etc. (andropause/menopause, etc.) EDUCATIONAL: Describe client’s educational background, highest level of degree attained. Difficulties in school (why, where, when); special education needs; suspensions. Include any informal educational skills. If client did not graduate from high school or received a GED, explore what barriers were present. EMPLOYMENT/WORK HISTORY: Summarize client’s type of work; attitudes toward work, reasons for leaving or being fired from previous jobs. Also, include any voluntary work (. community, church, etc.). Make sure to include any military experience and informal employment. RECREATIONAL: Describe their activities or interest they enjoy, such as hobbies, sports, or leisure pursuits, special talents or skills. Are they involved in any church related activities (. bible school, bible camp)? CULTURAL FAMILY NORMS: Describe cultural beliefs; rituals, patterns. Do they have family reunions or times when they come together (outside of marriages and funerals? RELIGIOUS/SPIRITUAL: Describe if client identifies with a particular religion or faith. Describe how client expresses spirituality/religion. Describe client’s current and past religious and/or spiritual practices. Describe if client is associated with a place of worship. Describe if their religion or spirituality is helpful to them. STRENGTHS AND COMPETENCIES: Describe client/family strengths, capacities, abilities, competencies and resources that may help to address and resolve the issues of concerns INTERVENTIONS: Competency 8- Behavior 1 Utilize evidence-based interventions that are appropriately and collaboratively designed to resolve the challenges of older adults and the groups, families and organizations that are part of the aging experience. Competency 8- Behavior 2 Apply concepts of human behavior and the social environment, person-in-environment, and other multidisciplinary theoretical frameworks of aging in interventions with older adults. Describe the evidence-based intervention(s) (utilized to address the older adult’s challenge(s) during the aging experience. Explain the intervention(s) in detail; Discuss implications for practice at each level of social work practice-groups, families, and organizations. Discuss how the intervention(s) might look different at the various levels of social work practice individual, groups, families, and organizations). Include goals and tasks to be completed also where appropriate include who will do what, when and how and how often; consumer and you. Include in-text citations Termination of Intervention with Client System Competency 10 – Behavior 1 Apply knowledge of historical and contemporary contributions of African American scholars, practitioners, change agents, communities and social institutions to the field of aging. Competency 10 – Behavior 2 Utilize African Americans’ contributions to inform culturally appropriate social work research and practice with older adults. Describe the process and plan of a successful termination with the client system based on the evidence based practice model utilized and that is considerate of concerns, challenges, and issues that are part of the aging experience for the consumer you are serving ( . follow-up sessions, losses, and rituals, etc.,) Be specific and make certain that you include feelings and reactions that the client/consumer might experience and explain how you would address the feelings based on the practice model implemented. APPENDIX – References
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