Social work Practice I:

Social work Practice I:
I am an intern in healthy families of NJ. This paper should have two parts.
The first part I: History about agency. (I don’t need from you to write about it). I will write on my own and client system.
II. Part:
1. Client description and engagement (about 2 pages)
a. Briefly described your client system. Include how your client system came to the attention of your agency or its social work unit. Identify the reason for the referral and/or the client system’s presenting problem.
b. Choose one of the woo issue below to further describe the context for engagement with the client:
(1) Evaluate the degree to which the agency the agency’s mission, services, and policies helped or hindered the client system’s ability to use the agency
(2) Examine concerns related to an ethical dilemma, diversity and/or societal institutional oppression, which were relevant to the engagement process.
This is brief assessment and history about my client whom I visit on weekly basis:
My client is Kathy. She is 36 year women. She identified herself as Russian because she was born and raised in Russia. She has one 5 years old son. Now she is 20 weeks pregnant by the same man. They live together, but they are not married.
As a child, she was growing up in happy and nurturing home. Her parents always got along, although her father had a drinking problem. She said that her father drank almost every day with his friends in garage or some other places but, his drinking habit never affect the family or interfered with work’s responsibilities. Her always have a sympathetic ear for Kathy However; Kathy said that growing up in Russia was different from here. It was communistic state and people believe in strict discipline. She said that whenever she did something wrong she would get spanked with the hand, usually by her father. And when she did something really bad he would hit her with a belt. She said that it happened more than six times in her childhood but she rarely had bruises or marks from it. Also, Kathy reveled that her parents would also take things away from her to disciple her. However, Kathy said that she doesn’t believe in corporal punishment as a way of discipline but she thinks being strict can help her gain respect from a child.
Kathy explained that she graduated high school and later on from college, it was hard to find job. Therefore she had to return to her parent’s house. Her parents owned farm and had a large property. Kathy recalled that she was working all day long outside. It was too hard for her. As of result, her friend and she left Russia for better life. It can’t find job due to language barrier. Therefore, she worked as an exotic dancer. At the same place, Kathy met her boyfriend Louis though the mutual friend in Brooklyn where she used to live. Kathy said that they started a relationship and she got pregnant with their five year old son shortly after. Kathy older son was not given Louis last name. She is afraid if something happen, Louis will take him away because Kathy is illegally in this county at this time. However, Kathy believes that Louis and she are getting very good relationship and she is comfortable with their current living situation not being married. She said that Louis is very patient and understanding.
Louis was born and raised in the Dominican Republic. At the age 18, he moved to the United States. He has two sisters and mother. His father died couple years ago. In addition, Louis has 13 year old son from previous marriage. He is seeing him every second weekend. Louse got divorce due to in marital problems. His ex-wife is diagnosed with bipolar disorder as well. Loui is working in New York City as It Tec.
After her first son, Stephan, was born Kathy started working at a local convenience store in Brooklyn for couple of years. However, when Kathy founded out that she is pregnant Louis persuaded her to move with him in New Jersey in his house. Kathy left her best friend and all familiar environments for new strange state, NJ. Her best friend never likes Louis because he is not Russian, he is divorced and he is not married to Kathy but he has one son with her and now she is expecting the second. Also, Kathy parents are not happy of current arrangement. Kathy has no friend and family members in New Jersey. Moreover, she is not familiar with environment. She seems very isolated because she has an adequate social support. However, Kathy has a good relationship with her neighbor, although they can’t communicate fully due to language barrier. Her neighbor is Arabic and she barely speaks English language. However, their kids play together and she has gone to her for questions regarding community resources. Also, her prenatal clinic provides Kathy with information about our agency Healthy Families to help her to obtain health insurance for her son and herself, food stamps and help her with isolation and issues associated with her pregnancy. Kathy mentions that she has two friends in Russia that she speaks time to time. Kathy prefers being home or going out to the park with her son when she can.
Kathy said that this was a planned pregnancy and she is happy about it. She said that she would like to have a girl but she wouldn’t really mind if she had another boy. Kathy explained that she hasn’t told anyone except her boyfriend about pregnancy because she has a miscarriage at 12 weeks of pregnancy two years ago. She will wait until she will be at least five months pregnant and she will know the sex of baby. Also, in her culture it is not acceptable to be pregnant or have the baby and not being married. This is sample of my process recordings:
The first Process recording:
AB: How are you today Ekaterina?

Client: I am fine. I just came from doctor’s office.

AB: Everything is OK?

Client: Yes. I had my ultrasound appointment today to find out the sex of the baby.

AB: I can’t wait!
Client: It is a baby boy!
AB: Congratulation to baby boy! I feel so happy for you.
Client: Thank you. You are the first person to know the sex of the baby.

AB: I am so honor to be first to hear about your baby boy.

Client: I purposely schedule my ultrasound appointment on this day because; I knew that you will come to see me.

AB: I am speechless Ekaterina. I don’t know what to say.
Client: You know. You come here to help me. You know almost everything about me. So, I felt that you should know the first.

AB: Thank you again, Ekaterina.

Client: Do you want to see ultrasound pictures?

AB: Of course, I like to see!

Client: Look, this his head, arms and legs. This dark circle is his heart. He was moving during ultrasound. Doctor had hard time to measure him.

AB: I guess, he will be very active. AS I am reading correctly, he is 19, 5 cm long. He is pretty big boy.
Client Same thing doctor said. I think, he will be tall as I am.

AB: I think so too. Matter of fact, I have here information associated with pregnancy, body changes and the baby development. The baby can be now 17 to 22 cm long. Your son is 19,5 cm long. It means that he is right there on his growing target. The interesting thing is that this is almost the half of his birth length. So, I as you mention, he will be probably tall as you are. Now, his weigh is almost 1 pound.
Client: I know that he is growing. Look at my belly! It is hard to hide. What do you think?

AB: I think that it is time to tell your parents and Louis’s mother about the pregnancy. As you said, it is very difficult to hide from the outside world.

Client: I think so too. Maybe will tell my mother tomorrow. The baby should be all right. Right?

AB: As far as I am concern, the baby doing just fine. Also, your doctor confirmed this. Look at you, you are so beautiful and baby is growing.

Client: Yes, you are right. But not only baby is growing. I am growing too. My belly button may pop out.
AB: As the uterus continues to compress upwards, your belly button popes out. The growing baby pushes up against your lungs and presses your tummy outward. You may have trouble breathing as your lungs become cramped with your other internal organs.

Client: I realized that if I am walking or playing with Stefan, I have to sit for while and catch my breath.

AB: Your chest will expand and your breasts will continue to become larger. Your nipples will grow softer and small bumps may appear around the nipples. These bumps are sebaceous glands that secrete a fatty lubricant called sebum. You may experience insomnia because of frequent bathroom visits and difficulty getting comfortable.
Client: Every time, I tried to lie down or sit down, the baby star moving from side to another and I have to go to bathroom, especially at night.

AB: It is normal. When you are walking, cooking or doing something, baby thinks that you are racking him and he is at sleep. The minute, you are resting, he is up and therefore he up to occupy his self to do something.
Client: I never know that. It makes sense to me now.

AB: I didn’t know that too before. We cannot know everything. Therefore, we have books and internet to learn about it.

Client: Yes, I agree.

AB: So, I will see you next week?
Client: Of course. See you next week.

The second process recording

AB: How are you doing today?

Ekaterina: I am fine. My baby and I, we are doing just fine.

AB: Tell me Ekaterina, what is new?

Client: I have another ultrasound appointment and doctor did 3D pictures of my baby. Would you like to see them?
AB: Of course.
Client: Look! At this picture, he is sucking his thumb.

AB: It is amazing. I can clearly see that he sucking his thumb.
Client: It is amazing.

AB: Too bad that you family is not here to see that. Did you have chance to talk to them about your pregnancy?

Client: Yes. I talk to my mother about it. I told her that I will have baby boy.

AB: That’s great! What she said?

Ekaterina: She cried.

AB: I can only imagine how hard have to be for your parent, especially for your mother not be around you. To be able to help you. Can she get visa and come here?

Client: My parents will not get visa because of me. I am register in Russian system that I stayed in United States and I never return to home.

AB: I know that it is very hard. What your father reaction?
Client: My father doesn’t know yet. I told my mother to tell him, but she claimed he is sleeping. But I heard him walking.

AB: Why your mother didn’t share new about your pregnancy with your father?
Client: I don’t know.

AB: Because Louise is not Russian?

Client: O no? I will never date Russian man!

AB: Why?

Client Russian ne are drinking too much. They are doing all important decision by themselves and wives must go along. Women, they have not too much to say. They have to listen their husbands.

AB: So, where is the problem? Make me understand.

Client: My parents are living in small city. Everybody knows everybody and knows everything. And my father is old fashion man. He doesn’t agree with my lifestyle. He doesn’t understand.
AB: This is your life. You choose to have kids.

Client: Exactly. One day, I will get married to Louise. But know it is what it is. He is good to me, he provide everything what he can for me and Stephan.

AB: I understand what you are saying, but maybe your father doesn’t know that people are living like that in today society. He is living in small town all his life and he doesn’t know that people today are living together not being married.

Ekaterina: I think so too. He will never understand.

AB: I know, it heartbreaks your heart. But at least your mother understands your situation and can be happy for you.

Client: Yes. One day, I will get married and we all go to Russia to visit my parts and all my family.

AB: I think so. Let me Ekaterina. Did Louis tell his mother about your pregnancy?

Client: Yes. The last Sunday, he went visit her and he hold her about it.

AB: What was her response?

Client: Louis told me that she was happy. But I don’t know, if it is true. But Louis’s sister called and congratulated me.

AB: That is nice of her.

Client: Yes. She is nice. The problem is that she doesn’t speak English and I speak a little bit Spanish.

AB: It is tuff. Maybe in future, two of you will have same conversation.

Client: I hope so.

Kathy said she has been feeling well and she has barely had any morning symptoms of pregnancy or morning sickness. She is very happy that she will have the second child. Also, Kathy is glad that I am her family support worker because I can understand her culture and values because I am from Eastern Europe.

My goal s for Kathy are/were;
1. Help Kathy assist to get health insurance for her son and herself. At this time, Kathy and her son are on Medicaid and receiving proper health care.
2. Try to empower Kathy and help her to improve healthy self confidence. I am always giving her referral for food bag. In order to receive it, she has to travel by herself by bus to different town (not too far) to obtain these food benefits. To make social contact with other people. Also, Kathy participates in our Fall and Winter festival with her son, stepson and her boyfriend.
3. I encourage Kathy to go to library. Now, Kathy has a library card and participates in public activities with her son sponsored by local library or local city hall.
4. I taught Kathy how to use an internet. Now, Kathy she goes to library and using internet to call her parents and friend. She masters application of Skype.
5. Kathy is not focus anymore on the lost of her previous unborn baby. She is now enjoying her pregnancy, although she always asks me if she and her baby will be ok. She is looking for constant reinsurance.
6. After pregnancy, she likes to take classes to improve her writing skills in order to pass ESL and obtain certificate teacher assistant for kindergarten. She loves kids and sometimes, she is babysitting in neighborhood. I provide her with information about testing places and classes for free of charge. Sometimes, I bring her copy of exercises to do at home.

2. Assessment ( about 4 pages)
I gave you the brief history about Kathy. An assessment has to have 4 pages. I hope that you have enough information in brief history to write an assessment about Kathy.
a. Describe on problem-for-work (presenting problem) of your client system. (Note : there may be several problems on which to work: summarize the situation and problems generally, and then focus on one for the purposes of this analysis.) Include an analysis of the problem as the client sees it, as defined by significant other systems, and as you see it. Provide at least 2 plausible hypotheses for the cause (etiology) or maintenance of the problem. Make sure that your hypotheses reflect at least two levels: intrapersonal, interpersonal, or environmental. Refer to theory (role, cognitive behavioral, psychodynamic or system) to frame your prospective.
b. Literature Review: Access a sufficient amount of empirical research to help you to understand the cause or maintenance of problem. In other words, develop your case theory based on theory and evidence. This is critical part of your paper. Please review at least articles in the peer-review literature. (Note about 3 pages). Wikipedia is not acceptable.
c. Discuss strengths and resources of the client, which became apparent in the process identification and assessment. Describe how at least one of these strengths or resources could be pivotal in the development of an intervention plan. (Note: about 1 page)
3. Contracting and Planning for Intervention ( about 3 pages)
a. Describe the process of moving from problem identification to contracting and goal setting with your client system. Illustrate how you and the client system participated in the contracting or goal setting process by providing short selection of dialogue from field process recordings. (Remember to introduce each segment of the conversations with a statement which includes session or meeting # and additional clarifying information that will help the reader to comprehend the significance of the dialogue (e.g. the skills that you used and the purposes of the communications. Use of Bisman is recommended here.) Single space (and indent) dialogue.
b. How would you evaluate the status of your bonding ( Bsiman, 1994) How will you maintain ( or if needed improve ) it?
-At first Kathy did not mention that she worked as an exotic dancer. In all her documents, her job descriptions: cleaning houses and later on that she worked in convenience store. Only, after 6 home visits, we were talking about her coming to United States and she mention that she was an exotic dancer. Kathy is very pretty, tall, skinny, blond hair and blue yes. However, when Kathy said it, she was suddenly quit and waiting for my reaction. I said to her that it is OK with me. That sometimes, we are going to Geltman’s club with my friends and I am friendly towards girls from Ukraine, Bulgaria or Russia. I don’t judge them. It is their job like any other job. She was so happy that I do understand her and I am not judging her for her pass and her choice she made. However, I had to promise her that I will not mention to nobody about her previous job. I think, she is shame of it. Even, her parents do not know about it.
c. Any missteps in contracting and goal-setting interventions? If so, how did you recover?
Kathy is not very skilled in writing in English language. At the beginning my supervisor gave me the exercises for Kathy to write about her dreams for her unborn baby as her work assignment. At first, she said that she didn’t have time, the second time that she lost it. After that, I figure out that she probably is not comfortable to write. So at the 3rd home visit, I told her that if she is not comfortable with writing she doesn’t have to do it. A said that I don’t like to write in English because it is my second language. Then Kathy said that she is not very skilled at writing and she would like to take some ESL classes to improve her writing. It took me two and half weeks to figure out the problem because Kathy is very responsible. She always is on time, if we have meeting, she is very precise what she want to talk about it, she fallows prenatal nutrition information I gave her and follow exercises. She complied with all her prenatal visits.
d. Specifically, describe the contract and goal that you a have developed or developing to address the problem identified in 3a. In particular, comment on the nature of the contact establish (verbal, written, implicit, explicit) and the rationale for your choice. Evaluate the quality of your goals ( e.g Are they measurable? Mutually develop with the client?) ( use of Hepworth and Larsen is recommended).
1. Kathy likes to obtain health insurance for herself and her son.
2. Register at library and participate in public events and agency events with her son.
3. To know how to navigate and use internet, especially Skype.
4. Stay healthy for herself and her unborn baby.
5. Kathy likes to prepare, take and pass ESL classes
6. Prepare room for unborn baby.
These goals were developed mutually and Kathy signed her signature that she agree with it and will try to accomplish with my assistance in 6 moths.
e. How will you know the goals are met?
-Kathy and her son have a health insurance. Kathy has a library card and knows how to use an internet and Skype. She is using Skype to communicate with her friends and family. Kathy participated in Fall and Winter festival in our agency. Kathy took her son to Halloween party organized by city hall in library. So far Kathy has no health problems and baby is developing properly associated with developmental stages.


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