Assignment

Discussion : Policy Analysis and Application

According to the NASW Code of Ethics section 6.04 (NASW, 2008), social workers are ethically bound to work for policies that support the healthy development of individuals, guarantee equal access to services, and promote social and economic justice.

For this Discussion, review this week's resources, including Working with Survivors of Sexual Abuse and Trauma: The Case of Rita. Consider what change you might make to the policies that affect the client in your case. Finally, think about how you might evaluate the success of the policy changes.

• Post an explanation of one change you might make to the policies that affect the client in the case. Be sure to reference the case you selected in your post.

• Finally, explain how you might evaluate the success of the policy changes.

Support your post with specific references to the resources. Be sure to provide full APA citations for your references.

References:

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore: MD: Laureate International Universities Publishing. [Vital Source e-reader].

"Working With Survivors of Sexual Abuse and Trauma: The Case of Rita" (pp. 81-83)

Rome, S., Harris, S., & Hoechstetter, S. (2010). Social work and civic engagement: The political participation of professional social workers. Journal of Sociology & Social Welfare, 37(3), 107-129.

Working With Survivors of Sexual Abuse and Trauma: The Case of Rita

Rita is a 22-year-old, heterosexual, Latina female working in the hospitality industry at a resort. She is the youngest of five children and lives at home with her parents. Rita has dated in the past but never developed a serious relationship. She is close to her immediate and extended family as well as to her female friends in the Latino community. Although her parents and three of her siblings were born in the Dominican Republic, Rita was born in the United States.

A year ago, Rita was sexually assaulted by an acquaintance of a male coworker. Rita and a female coworker met Juan and Bob after work at a local bar for a light meal and a few drinks. Because Rita had to get up early to work her shift the next day, Bob offered to drive her home. Instead of taking Rita directly home, however, he drove to a desolate spot nearby and assaulted her. Afterward, Bob threatened to harm her family if she did not remain silent and proceeded to drive her home. Although Rita did not tell her family what happened, she did call our agency hotline the next day to discuss her options. Because Rita's assault occurred within the 5-day window for forensic evidence collection of this kind, Rita consented to activation of the county's sexual assault response team (SART). Although she agreed to have an advocate and the sexual assault nurse examiner (SANE) meet her at the hospital, Rita tearfully stated that she did not want to file a police report at that time because she did not want to upset her family. The nurse examiner interviewed Rita, collected evidence, recorded any injuries, administered antibiotics for possible sexually transmitted infections, and gave Rita emergency contraception in case of pregnancy. The advocate stayed with Rita during the procedure, supporting her and validating her experience, and gave her a referral for individual crisis counseling at our agency.

My treatment goals for Rita included alleviation of rape trauma syndrome symptoms that included shame and self-blame, validation of self-worth and empowerment, and processing how it would feel to disclose to others when the time felt right. In addition, Rita would receive important information regarding state policy and procedure for victims of sexual assault that would assist her in deciding when and how to report the crime if she chose to do so.

My treatment involved crisis intervention and stabilization along with emotional support and validation surrounding her experience. Managing her trauma and acute stress symptoms were key to her recovery. Those symptoms included guilt, shame, emotional shock, powerlessness, anxiety, fear, anger, and doubting her judgment. We processed Rita's emotional dysregulation and sense of outrage over what happened. Over the weeks that followed, we also explored Rita's relationship to her immediate and extended family and how they had high expectations for her and her future. Rita's shame over the assault prevented her from telling her family for fear they would also be shamed and judge her for accepting a ride from someone she did not know well. We discussed the policy for reporting a sexual assault to the police in our state and how Rita only had a 90-day window to report the crime after her forensic evidence was obtained. After 90 days, the forensic kit would be destroyed.

The problem with the current 90-day hold policy in our state for victims like Rita is that a person in crisis experiences strong and conflicting emotions and is faced with an acute sense of disequilibrium and disorientation. This, in turn, affects her or his ability to retain information and make decisions. The person, therefore, has barely enough time to make sense of what happened to her or him, let alone decide what to do about it. The 90-day hold policy may not afford a traumatized victim of sexual assault enough time to make a decision to report to law enforcement.

I utilized a strengths-based model in my treatment with Rita to help her address the decision to report the crime. A strengths-based framework is client-led with a focus on future outcomes and strengths that the client brings to a problem or crisis. It is an effective helping strategy that builds on a person's resiliency and ego strength. An integrative strengths-based intervention can contribute to the development of a positive outcome for clients in crisis.

I counseled Rita for 6 months. After 5 months, Rita felt strong enough to disclose to her family and file a report with the police. However, because the 90-day window had closed by the time she was stabilized and emotionally ready to file, her forensic evidence was unavailable.

Discussion : The Social Work Advocate in Politics

Social workers often have commitments to specific policies, laws, or funding of programs that are vital to the population they serve or an issue that they strongly support. Such commitments often lead social workers to become involved in political issues and the campaigns of specific candidates. Being a social worker, such campaign experiences, the outcomes of your efforts, and how effective you felt you were may affect your view of the political process and the likelihood of becoming involved in similar campaigns in the future.

For this Discussion, reflect on your experiences if you have ever participated in a political campaign. What was the outcome of your participation? If you have not participated in a campaign, choose a campaign topic you support or oppose and consider the ways you might like to participate in that campaign. Likewise, think about your experiences if you have ever lobbied on a topic. If you have not, choose a topic for which you might like to lobby in favor or against. Finally, consider how you think social workers might have a powerful and positive effect as elected officials.

• Post an explanation of the role of lobbying and campaigning in social work practice.

• Then, explain how you think social workers might have a powerful and positive effect as elected officials.

• Finally, explain of the impact, if any, the experiences and opinions of your colleagues have had on your own experiences and opinions.

Support your post with specific references to the resources. Be sure to provide full APA citations for your references.

References

Rome, S., Harris, S., & Hoechstetter, S. (2010). Social work and civic engagement: The political participation of professional social workers. Journal of Sociology & Social Welfare, 37(3), 107-129.

Popple, P. R., & Leighninger, L. (2015). The policy-based profession: An introduction to social welfare policy analysis for social workers. (6th ed.). Upper Saddle River, NJ: Pearson Education

DISCUSSION : Systems Perspective and Social Change

Zastrow and Kirst-Ashman (2016) stated, "Clients are affected by and in constant dynamic interactions with other systems, including families, groups, organizations, and communities" (p. 35-36). As a social worker, when you address the needs of an individual client, you also take into account the systems with which the client interacts. Obtaining information about these systems helps you better assess your client's situation. These systems may provide support to the client, or they may contribute to the client's presenting problem.

For this Discussion, review "Working With People With Disabilities: The Case of Lester."Consider the systems with which Lester Johnson, the client, interacts. Think about ways you might apply a systems perspective to his case. Also, consider the significance of the systems perspective for social work in general.

• Post a Discussion in which you explain how multiple systems interact to impact individuals.

• Explain how you, as a social worker, might apply a systems perspective to your work with Lester Johnson.

• Finally, explain how you might apply a systems perspective to social work practice.

Be sure to support your posts with specific references to the resources. If you are using additional articles, be sure to provide full APA-formatted citations for your references.

References

Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA: Cengage Learning.

Working With Clients With Disabilities: The Case of Lester

Lester is a 59-year-old, African American widower with two adult children. He lives in a medium-sized Midwestern city. Four months ago, he was a driver in a multiple vehicle crash while visiting his daughter in another city and was injured in the accident, although he was not at fault. Prior to the accident he was an electrician and lived on his own in a single-family home. He was an active member in his church and a worship leader. He has a supportive brother and sister-in-law who also live nearby. Both of his children have left the family home, and his son is married and lives in a nearby large metropolitan area.

When he was admitted to the hospital, Lester's CT showed some intracerebral hemorrhaging, and the follow-up scans showed a decrease in bleeding but some midline shift. He seemed to have only limited cognition of his hospitalization. When his children came to visit, he smiled and verbalized in short words but could not communicate in sentences; he winced and moaned to indicate when he was in pain. He had problems with balance and could not stand independently nor walk without assistance. Past medical history includes type 2 diabetes; elevated blood pressure; a long history of smoking, with some emphysema; and a 30-day in-house treatment for binge alcoholism 6 years ago following his wife's long illness with breast cancer and her subsequent death.

One month ago he was discharged from the hospital to a rehabilitation facility, and at his last medical review it was estimated he will need an additional 2 months' minimum treatment and follow-up therapies in the facility.

As the social worker at the rehab center, I conducted a psychosocial assessment after his admission to rehabilitation.

At the time of the assessment, Lester was impulsive and was screened for self-harm, which was deemed low risk. He did not have insight into the extent of his injury or changes resulting from the accident but was frustrated and cried when he could not manipulate his hands. Lester's children jointly hold power of attorney (POA), but had not expressed any interest to date in his status or care. His brother is his shared decision making (SDM) proxy, but his sister-in-law seemed to be the most actively involved in planning for his follow-up care. His son and daughter called but had not visited, but his sister-in-law had visited him almost daily; praying with him at the bedside; and managing his household financials, mail, and house security during this period. His brother kept asking when Lester would be back to "normal" and able to manage on his own and was eager to take him out of the rehabilitation center.

Lester seemed depressed, showed some flat affect, did not exhibit competency or show interest in decision making, and needed ongoing help from his POA and SDM. His medical prognosis for full recovery remains limited, with his Glasgow Coma Scale at less than 9, which means his injury is categorized as catastrophic.

Lester currently has limited mobility and is continent, but he is not yet able to self-feed and cannot self-care for cleanliness; he currently needs assistance washing, shaving, cleaning his teeth, and dressing. He continues with daily occupational therapy (OT) and physical therapy (PT) sessions.

He will also need legal assistance to apply for his professional association pension and benefits and possible long-term disability. He will also need help identifying services for OT and PT after discharge.

He will need assistance from family members as the determination is made whether he can return to his residence with support or seek housing in a long-term care facility. He will need long-term community care on discharge to help with basic chores of dressing and feeding and self-care if he is not in a residential care setting.

A family conference is indicated to review Lester's current status and short-term goals and to make plans for discharge.