Case Studies Flashcards
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You are assigned to assess Mrs X (unemployed) who claims that her husband suddenly left the family two months ago and she has no money to pay for the rental of the flat and utilities. She has two children (aged 2 and 3).
She is running out of money to buy milk powder and she wishes to apply to financial assistance. However, she starts to shout at you and accused you of being unprofessional when you ask if she has tried to contact her husband or her in-laws. She starts to hurl profanities at you when you try to calm her
down. It does not seem like she is going to ‘calm down’. You know you are not in the wrong and you have doubts about whether she is telling the truth.
Questions
1) What triggers a change in her behaviour?
2) How should you response?
3) Give reasons for your choice of actions.
The Case of Ruby Ong
The hospice social worker met three generations of the Ong family when she
visited their home in Serangoon Road. She was there because the family had requested hospice services for Ruby Ong, the 79 year old mother of Stephen Ong. Ruby had a recurrence of breast cancer that had metastasized to her lungs. She was no longer receiving aggressive treatment and her condition
was deteriorating.
Upon entering the Executive HDB flat, which is still under mortgage, the social
worker meets the following members of the family:
•
56 year old Stephen who lost his job as a bank officer 6 months ago. He
has a Diploma in Business Management in 1990. He has taken over the
caregiving role from his wife Mary after he became unemployed. He
applied for many jobs but was not successful. The reasons given were: his
salary expectations, his skills and knowledge were obsolete, and he may
not have many years to contribute to the company in the long run. He is a
free- thinker.
Stephen’s wife, Mary, who is 51 year old. She is a born Roman Catholic
and she stopped working when she gave birth to Bernice. Now that her
husband has lost his job, she took on two part-time jobs to help the family
to make ends meet. At the same time, she has to help out with the
household chores and cook for the family whenever she is home. Her take-
home pay is $1,800.
Bernice Ong, a 25 year old daughter of Stephen and Mary. She is a free
thinker like her father Stephen. She is single and unattached. She is a
graduate and works as an accountant with a small accounting firm. She
tutors a group of students on weekends to supplement her income of
$2,200.
•
•
Bernice took the social worker to the bedroom to meet her grandmother. The
social worker spent about 30 minutes with Ruby. Ruby knew that she was
receiving hospice care because she was dying. She related that she had lived
a good life and was not afraid of dying because she believes she will be
reincarnated in the next life. However, there were a few things that were
troubling her:
•
Her estranged daughter Alice, who is married to a Malaysian and is living
in Johor Bahru. Ruby had her home address all these while and she did
not want to die with unresolved grievances between them.
Her son Stephen, who lost his job recently and she hoped he could find
his passion again.
1 Read the case of Ruby Ong in Annex 1 and relate the theoretical concept of
human behaviour to understand how the Ong family members develop and
interact with one another.
2 Discuss the following and present your views to the class.
a
Analyse the dynamic interactions of the Ong family members with the
micro and mezzo systems in the social environment and how they
influence one another’s behaviour to improve the overall well-being of the
family?
Analyse the impact of the macrosystem on this family, particularly the
unstable labour market and the gaps in the healthcare system.
What is the role of the social worker in the macrosystem in this case?
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Jon John used to attend a government-aided school when he was young. He
was a very sociable person and a free–thinker. He was doing well in his life.
At the age of 35, he was already running his own business and he had an
apartment, a car and plenty of friends. He travelled a lot and he is single. Then,
he was diagnosed as HIV-positive and the doctor could tell him how long he
has left to live. His world crumbled: some friends avoided him and his business
suffers because his failing health. However, his parents and sister stood by
him. He started blaming God for his situation and his temper worsened each
other. A social worker was assigned to him.
The social worker could understand John better by using the key components of spirituality: The physical dimension (body): The psychological dimension (mind): The spiritual dimension (spirit):
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A 16 year old client was pregnant after having unprotected sex with her 26
year old boyfriend. She agreed with her boyfriend that she should have an
abortion since they were both young and not ready to settle down. She had
always spoken up against abortion because of her religious belief. She had
second thought about aborting the baby because she was feeling guilty that
she was ‘killing’ a life that was created in her womb. She told her parents and
they wanted them to get married but her boyfriend started to deny that the
baby was his. She decided to keep the baby and broke off with her boyfriend.
Her family decided to the next best thing and that was to give the baby up for
adoption. To save their ‘face’, they put her in a welfare home for unwed
teenage mothers. At the centre, the social worker started to counsel her
because she getting lonely and depressed. During her conversation with the
social worker, she started to blame her ex-boyfriend for refusing to use the
condom, blamed herself for being so weak and her family for abandoning her.
At the same time, she felt so useless for letting her parents and herself down
now that she had to drop out of school to give birth. She was a straight ‘A’s
student and she had always wanted to be medical doctor. During the
conversation, she was going through the whole guilt trip without a closure.
Questions:
1. Explain the role of spirituality and religion in the client’s behaviour.
2. How should be the social worker help the client to identify issues related
to spirituality, in this case abortion, to better engage and handle her
behaviour (moody, regret, blame, guilty and so on)?
CASE 2: Rick, age 15, Secondary 3 (Express) in a Government-Aided School
In the school, the other children had whispered about Rick’s rituals. He had placed his books under his chair in the same spot every day. His pencil always had a sharp point and was positioned at the top of his desk, exactly in the middle. An eraser was kept on the upper right had corner, not too close to the edge. His papers always were
arranged carefully in the middle of his desk. This has continued in secondary school.
As a secondary school student, Rick has few friends. He doesn’t like having visitors to his house because it takes too much effort to put things back in order after they leave. He experiences a lot of anxiety at school when furniture and equipment are
moved in his classrooms, or there is an unanticipated change in routine. Rick takes a long time to get from one class to another and is frequently late for the start of class. He is easily upset when other students come close to his desk; some of the other
students have noticed this and take pleasure in teasing Rick by threatening to mess
up his papers. Consequently, he frequently watches the clock and begins to pack up
his belongings several minutes before the end of the period. Lately, he has been
missing a lot of his classes, reporting that he “wasn’t feeling well”. Formerly a high
achieving student (on the work that he handed in), he is now handing in even less
work than previously and is in danger of failing his end-of- year examination. The
teacher decided to refer his case to you, the school counsellor.
- How do you assess Rick to determine his needs / issues?
- Select the appropriate intervention support to assist Rick. What specific steps will you take to assist him?
- Who should be involved? Why?
- What would you do to follow up?
CASE 3: Robert, age 76, has ‘social emotional issues’
Robert has been coming to Senior Activity Centre (SAC) for the last several weeks
wearing the same clothes, not showering, and high on alcohol most of the time. He
demonstrated extreme behaviours at the SAC. He would hide out in the washroom for most of the day, refused to take part in any activities, and he began to smoke (something which he had not done for more than 30 years ago). When staff tried to remove him from the washroom, he would purposely drop his pants in front of them. The centre decided to refer his case to you, the centre counsellor. Lots of attention has been given to help Robert but there was little support from his family.
How do you assess Sarah to determine her needs / issues?
Select the appropriate intervention support to assist Sarah. What specific steps will you take to assist her?
Who should be involved? Why?
What would you do to follow up?
Jessica, 11 years, cerebral palsy
- what are some of the stressors that jessica is facing / the mother is facing / possible reactions they are exhibiting / issues you see in this case - special needs - verbal comm issues / does not want to attend school / has no friends
- what is cerebral palsy. how would it affect jessica’s normal behaviour (see from point of 11 years old, having cerebral palsy. going to school normally. one to one support - no opportunity to interact with others)
- how would you work with j and mother? who else would you involve in the intervention?
- underlying issue - don’t want to go to school hence no friends. have difficulty speaking.
Gerald, 14 years, male
- Using erick/pia, explain how would you explain gerald? At this stage according to theory, he should be xxx. His parents are not so supportive and negatively speaking with him.
- What are the behaviours he is exhibiting? As a professional, what should some of your considerations be?
- Be mindful of approach with him. First session, get to know him, no blaming, without parents
- Multi-dimensional: Micro - talk about his current issues only. Mezzo - poor relationship with parents, not performing well in school. Macro - legal system, what sort of assistance he can get, legal policy.
- How would you intervene? / what are some of the intervention strategies you will use? - Intervention strategy: counselling - role - enabler
