Social Work and Crisis Theory - Essay Example

Social Work – Case Example Life consists of a run of lessons as well as challenges that allow individuals to move towards growth and development. In a way, such lessons and challenges give substance to one’s existence and help mold them to the persons that they are. A person’s own behavior and personality owes a great deal to his responses and manner of coping towards the various hurdles that he meets in life. According to Crisis Theory, crises are normally existent in our lives. During a crisis, a threatening event disrupts the balance or equilibrium in an individual. Coping mechanisms are necessary to overcome such disruption and restore balance. Crises are basically an opportunity for growth when resolved properly as persons in crisis are more open to adapting new problem solving skills. However, when coping mechanisms do not work and crisis is left unresolved, that is when problems arise. Moreover, unresolved crisis will further make the person more likely to be unable to resolve future issues (Crisis Intervention 2006). In this paper, we will tackle on the case of the fifteen-year-old Con who ran away from home and now seeks guidance and counseling. As a social worker in charge of Con’s case, it is best to fully understand his situation and do proper assessment before a suitable intervention can be formulated. Relating the concept on crisis, we will assume that Con is a teenager undergoing crisis. The issues that revolve around him constitute the array of circumstances that bring about his crisis. Con is classified as an adolescent as he is fifteen years of age. As an adolescent, Con faces a series of challenges which may have brought about the predicament he now faces. In Con’s case, his act of running away from home may be a manifestation of the rebellion that is likely of children his age that may be the result of the changes he is undergoing at present (Adolescent Psychology). Moreover, the distant relationship he feels towards his parents along with his closeness to his peers can be the result of his struggle to establish his own identity and his quest for independence. Being in the stage of puberty, Con is placed under a lot of pressure and the increasing anxiety that he experiences in response to all the pressures can trigger a maturational crisis. Hence, the crisis he faces causes him to feel elevated levels of anxiety that might have been the cause for his behavioral manifestations. In order to help Con, interventions must then be focused on correcting the maladaptive behaviors he manifests so that he can function effectively in the society where he exists. To do this, we will borrow concepts from Crisis intervention as well as Cognitive Behavioral Therapy. Here is an outline of the plan of care for the management of the said case. Step 1: Directly establish a constructive relationship with Con During this step, it is important to remember to put emphasis on sincerity, respect, and sensitivity to the feelings and the circumstances that Con is experiencing. Patients in crisis can be critical and may take a hint on insincere moves. At this phase, rapport should be built. The crisis worker must be able to gain the child’s trust to allow for openness of communication between Con and the social worker. Here are some ways of establishing rapport with the patient: Do active listening. The social worker should listen for the hidden message behind the patient’s words and making sure that you have gotten it correctly. It may mean that you take a long period of time to listen and allow the patient to express and open himself to you. Recognize nonverbal cues that may construe a significant meaning (Crisis Intervention 2006). Maintain eye contact. This will allow the patient to feel that you are interested in what he is saying and can encourage him to share. Instill hope. This is one very important thing to establish in this phase. Let Con know that things can be better for him. Rapport can be better established by giving respect and awarding consistent and unconditional positive regard for Con. Make him feel that something useful was gained through your encounter and that there is promise that his situation can improve (Mulhauser n.d.). Step 2: Assessment: Draw out and encourage the expression of painful feelings and emotions and discuss the precipitating event In order to correct the behavior, thought distortions should first be modified as there is a huge link between thoughts and feelings and the behavioral manifestations of an individual. Identify the thoughts and feelings that may have been the root of the distress that the patient is undergoing (Sussman 2006). Examine feelings of frustration, anger, hopelessness, and other negative thoughts that might be badgering the patient. Conduct an analysis on the patient’s current level of functioning. Assess how the patient functions at home, in school, with his peers, and relate it with the emotions that he might be feeling. In this case, Con ran away from home. He has not attended school since then. He sleeps at his friend’s place or elsewhere. Attempt to uncover the feelings and emotions that are behind the occurrence of these events. Focus on the series of happenings that have lead to the current situation and identify the thoughts and feelings that caused it (Crisis Intervention 2006). The following questions can be used to guide the conversation. 1. What is your reason for running away from home? Or what happened at home that caused you to run away? 2. How is your relationship with your family members? Your friends? 3. How are you at school? 4. How did you manage to survive after running away? 5. How do you feel towards the people around you? In his phase, a nonjudgmental atmosphere is needed to foster cooperation and participation of the patient. Step 3: Explore the existing strengths as well as the needs of the patient Being a fifteen-year-old boy, Con has necessities which have been cut off when he ran away from home. It is important to identify these needs so that they can be addressed promptly. For instance, Con currently has no money and no accommodation. Moreover, his education is being compromised, as well. Identifying available resources that can provide support for the patient is vital as well. Ask the patient to identify them so that you may know the people he considers for support. These can be his peers, or others. Step 4: Set the goals with the patient Once the crisis worker has identified the patient’s strengths, weaknesses, and resources, he or she will utilize these bits of information to determine the goals of the interaction. In this step, the formulation of goals is done by both the worker and the patient (Richards 2010). This means that active participation by the patient is required. Treating the patients as partners rather than just mere objects of care will increase the likelihood of successful implementation of the plan as well as the likelihood for positive outcomes. As patients feel involved in the process, they will be more likely to cooperate. In setting the goals, be specific and realistic with the client. Ask pointed questions like: How do you like to be different after the therapy? What do you want to happen with your life at the end of the treatment? Assist the client in formulating concrete behavioral goals such as: I would like to get back to school I would like to go back home to my parents I would like to have open communication with my parents These goals that the client determines will be the ones that shall direct every session of the therapy. These goals will then be addressed in the course of the therapy. Step 5: Formulate and implement a suitable plan After determining the goals of the interaction, it is now time to make a blueprint of action in order to attain these goals. During this step, active participation of the patient is encouraged. Focus on what the patient considers as his priorities and begin your plan of action there. Formulate short-term and long-term goals, as well as objectives and action steps in a simple manner (Crisis Intervention 2006). Compile all the gathered data regarding the patient and conceptualize them in cognitive terms. This conceptualization shall be the basis of the intervention you will give the patient (Sussman 2006). In this case, help Con identify the thoughts he had when he acted out the behavior. What was he thinking when he ran away from home? Thoughts may include: “My parents do not love me because the always get angry at me”, “My father does not understand me because he scolds me”, “My mother does not truly care about me because he sides with my father” What was he thinking when he quit school? Thoughts may include: “I’m dumb, what’s the point of going to school” or “School is an opportunity for my parents to find me, I don’t want to go home”, “My life is terrible what’s the point of going to school?” After which, help him understand the link between his thoughts and feelings and the behavior he manifested. Also determine the beliefs that bring about these thoughts. For instance, Con might have felt that he is a nuisance to his family that is why he ran away and does not want to go home. He may also feel that education is not important in his life anymore since and may find no purpose for it. Moreover, he may also have the belief that his peers value him more than his family since they are always on his side. Having these feelings at hand, assist the patient in evaluating them as adaptive or not. Then teach the patient adaptive ways of coping with his difficulties. Help him in changing his perspective on things so that he can feel better about himself and others as well (Mulhauser n.d). This can be done through the following: Slowing down. Teach Con to talk slowly or walk slowly. In this way, negative thoughts can be toned down. Teach him to stop automatic negative thinking which may spur him perform a negative automatic response such as running away from home. Confrontation. Help him confront his fears in gradual and manageable ways instead of running away from it i.e. encourage him express his feelings and thoughts toward his parents, his peers, the people in school. Ask him to record his thoughts for him to look back on and eventually realize the negativity. Exposure. This means exposing the patient to the feared stimulus. For Con, he may be suggested to meet with his parents or to visit he school he used to go to. Activities should then be scheduled for the patient to help become active, behaviorally, in solving his problems (Sussman 2006). Activities can be scheduled per session and can be given as homework for the patient. These activities should then be recorded. In every session, there should be an identified problem to work on. For Con, among the activities that can be given to him are the following: Role playing. Con can be asked to role play a scenario with his parents to see how he will act towards various situations. Through this, Con’s coping mechanisms can be identified and evaluated and eventually be corrected. Art therapy. Ask Con to translate what he feels into drawings and ask him to explain them afterwards. In planning interventions, the needs of Con should also be addressed and be given proper attention. Having known that he has ran away from home and cannot provide for himself, Con’s necessities should also be taken cared of. Assist Con in finding a suitable place to live in must he insist to not go back home. You may contact a relative whom he can live with. Moreover, discuss to him the importance of school and try to negotiate him into going back to school. Discuss with him options that he might want. Step 6: Evaluate the interventions and make some necessary adjustments Of course, after implementation of the plan of action, evaluation is necessary to determine if the interventions that have been formulated have worked for the patient. In doing the evaluation, go back to the goals and objectives that were previously formulated and check if these were met. If not, determine the points where they have failed as well as areas where improvements can be done. Once these areas are identified, adjustments may be needed if interventions were found to be ineffective in helping the patient (Crisis Intervention 2006). Moreover, ask the client for feedback per session. Ask him what he thinks about the previous session and how his progress has been as the sessions progressed. Assess the events that occurred in between sessions and determine how they may have affected the patient’s movement towards his goals (Richards 2010). Step 7: Terminate the relationship and arrange for a follow-up The relationship of the crisis worker and the patient is terminated when the patient restores his pre-crisis level of functioning. Then again, even after the relationship has ended, the worker keeps in touch with the patient and schedules for future meetings and consultations to continue to provide assistance to the patient (Crisis Intervention 2006). From this paper, we have learned about the case of Con’s case. He faces a predicament that requires attention and intervention. In order to assist Con in overcoming his difficulty, concepts were borrowed from the crisis theory and cognitive behavioral therapy. As the crisis that Con was facing brought him to an elevated level of anxiety, his usual coping mechanism did not function. This has caused him to function ineffectively in the society he exists in and has brought about some behavioral problems. Having acknowledged the link between thoughts and behavior, Con’s problems were addressed by way of working to alter his negative thoughts and perspective in order to incur a positive behavioral modification. A thorough evaluation was required in order to determine the pressing issues that Con was facing underneath his behavioral manifestations and interventions were formulated to assist Con in developing ways to cope with his problems more effectively. . References Adolescent Psychology, 2004-2008. Available from . [12 May 2010] Crisis intervention in child and family social work, 2006. Available from: < http://www.another- way.co.uk/crisis_intervention.htm>. [ 12 May 2010]. Mulhauser, G n.d., An introduction to cognitive therapy and cognitive behavioral approaches. Available from . [12 May 2010] Richards, T 2010. Cognitive Behavioral Therapy. Available from < http://www.anxietynetwork. com/hcbt.html>. [12 May 2010] Sussman, N 2006. In Session with Judith S. Beck, PhD: Cognitive-Behavioral Therapy. Available from . [12 May 2010]. Read More