many dimensions practice theory models human behavior change process interventions H u m a n i t i e s

many dimensions practice theory models human behavior change process interventions H u m a n i t i e s

Clinical Assessment and Intervention Assignment

Assessment: Conducting a biopsychosocial assessment in integrated health

Peter is a 47-year-old Latino male who is married and currently living with his wife (age 45) and 2 children (Samuel, age 12, and Anne, age 14). He has been a computer engineer at a large company for 15 years and is a respected colleague at the company. Recently, he has suffered from frequent stomach and headaches that have finally led him to visit his doctor. He also shared that he has not been sleeping well for the past three months. Peter has a conflictual relationship with his wife, and they argue over parenting issues and priorities with their two teenage children. Peter has a history of intergenerational trauma (physical abuse at the hands of his father) and mental health issues. Recently, Peter’s mother, who is 75 years old, was diagnosed with liver cancer. He has a fairly close relationship with his mother who lives two hours away from him. Peter does not have an active social life, and he spends most of his time either at work or with his family.

In planning to conduct a bio-psycho-sociocultural assessment with Peter, please discuss the following:

1) What components should be included in the assessment?

2) What questions would you ask to assess these different components?

3) Who you would include in the assessment process and for what purposes?

4) Based on the assessment, how would you and Peter define his problem in a solvable manner?

Intervention: Creating a plan based on your assessment

Based on your assessment, please formulate an intervention plan. Include the following in your intervention plan:

1) How would you assist Peter in developing helpful and attainable goals?

2) Who would you include in the treatment process and for what purposes?

3) Clearly and thoroughly describe the proposed intervention procedures. This description should be an actual treatment plan, such as one you would place in the patient’s medical record or treatment file. You can base your intervention plan on any of the following as appropriate:

•Models of integrated health

  • Appropriate evidence-supported treatments
  • Assumptions and research about risk and resilience factors that affect human development and behavior
  • Theories about how people change their thoughts, feelings, and behaviors in different situations
  • Skills
  • Techniques
  • Strategies
  • Used in the practitioner-client interactions

•Person-Centered Care (see Stanhope and Straussner, Chapter 10)

•Trauma-informed Care

•Motivational Interviewing

Please draw from the readings, assessment instruments, and models of integrated care discussed in this course.

Please be sure that this assignment is written as a paper (not a list) and that you fully answer the questions. Subheadings and bullets are appropriate.

The paper should be 8-10pages (double-spaced,12-point Times New Roman font), include a cover page (not included in the page count) and have APA style 7thedition formatting.

Please refer to course Text as reference:

  • Stanhope and Straussner (2018) Social Work and integrated health care: From policy to practice and back.
  • Curtis and Christian (2012) Integrated care: Applying theory to practice.
  • No need for additional references.

Additional information to clarify the above assignment.

1)Context for the case of Peter: If you are currently in an integrated care setting for your internship or job, please imagine Peter in that setting and that your role is to be his social worker in that setting. You will have to explain your setting a little bit in the paper so that I understand how that is influencing your assessment and treatment plan. If you are currently NOT in an integrated care setting, imagine him at his primary care doctor’s office and that you are the social worker in that setting.

2)Format for the assignment: All questions should be answered in APA essay format. In addition, you must ALSO include what the actual treatment plan would look like in his chart. This can be done with headings and bullet points. The essay portion should give me a good understanding of why your treatment plan looks the way it does.

3) Biopsychosocial cultural questions- In this portion you are walking me through your PLANNING process for conducting a biopsychosocial cultural assessment with Peter in an Integrated Care setting. The Power Point for Session 3 as well as the readings for session 3 provide you with models of integrated care. Make sure you are referencing which model you will be using with Peter and how that influences what questions you’re asking him. If you feel you need extra information to decide on a direction you can add to his case example in your paper e.g.-I will assess Peter for substance use by asking x questions. In my scenario Peter answers that he is struggling with substance use. His frequency of use is x times a week and has x consequences.

4) Treatment planning questions- In essay format explain which model you will be using for treatment planning and how that influences your approach, how you conceptualize the problem and the interventions. Remember to ground yourself in the integrated care setting as well. This will influence who you include in the treatment plan (family members, medical team members, care coordinators, specialists) etc.

5) The Treatment Plan- Ensure your actual treatment plan that would go in the client’s chart includes the following:

  • The mental health issue you will be addressing (There is no right or wrong here as long as you give me rationale in your assessment. You don’t have to give me a DSM-5 diagnosis, you can give me the category. Here are some examples: Trauma, Depression, Anxiety, Substance Use etc.).
  • The problem/s you will be tackling. For each problem you need the following:
    • At least one long term goal
    • Each goal broken down into measurable steps (SMART)
    • A timeline for treatment progress
    • Interventions for each goal with frequency (e.g.-1x a week individual therapy 45 minutes for 8 weeks, bi-weekly family sessions with x family members, 1x a month care coordination, Psychiatric evaluation, 1x a month psychiatric medication management, social work coordination with PCP bi-weekly etc.). You choose the type of intervention and frequency; these are just some examples, but you don’t have to limit yourself to those options.

Integrated Healthcare Models and Frameworks

The Medical Model

  • The provider engages in a scientific process that draws on observations and procedures to determine the cause of illness and design a treatment
    • Self-report of symptoms plus tests and procedures
    • The goal is objectivity
    • Client often excluded from decision making

Prevention and Wellness Model

  • In 2010 Patient Protection and Affordable Care Act (ACA) created new emphasis on prevention and wellness
  • Community Approach
  • Attention placed on
    • social determinants of health
    • Boosting community resiliency
    • health status and risks of population are monitored

The Recovery Model

  • Connects the other health care models
  • Similar to CCM, focuses on self-management of long-term health disorders, but strives to instill hope
  • Shifted definition of recovery to the “development of new meaning and purposes in one’s life as one grows beyond the catastrophic effects of mental illness”
  • Recovery NOT one-step task, it is a journey with many dimensions

Practice Theory Models

Human Behavior

Change Process

Interventions

The Stress Vulnerability Model

Amount of vulnerability differs from person to person

For some conditions, related to factors like early exposure to viral infection in utero

  • Reduce person’s biological vulnerability and stress
  • Factors include medication, coping skills, communication, and problem-solving skills and structure
  • Impacts vulnerability by either triggering the onset of the disorder or worsening the course
  • Stress can include life events, relationships, etc.
  • Combinations of stress and vulnerabilities may lead to different types of a disorder
  • Individuals and families can build protective factors to minimize or manage stress

May help reduce severity of symptoms and impact the illness course positively

The Transtheoretical Model:Stages of Change

  • Six Stages of Change:
    • Precontemplation
    • Contemplation
    • Preparation
    • Action
    • Maintenance
    • Termination