Carla Washburn’s case study :Micro Intervention, Evaluation, Termination Plan

Develop a micro-level intervention aimed at ameliorating the client issues or problem (or aspects of) that you have identified as important. Considering client strengths and challenges, you will identify the specific (measurable) actions and objectives in order for the client goals to be attained. You will describe what you imagine execution of the identified plan would entail; the rationale and process for your micro/mezzo-level intervention, services identified to accomplish client goals; the key outcomes you hope to achieve for your client, and the key activities involved. Remember that the client system may be influenced by social, physical, economic and environmental sources. Consider the client’s perception of the problems or needs. Explain why you think the selected activities and/or services from these sources will result in the desired outcomes, using research evidence to back up your claims.

  • Next, you will propose an Evaluation Plan aimed at measuring the effectiveness of your intervention(s). You will describe the intervention being measured, how success (meeting of goals) will be determined and measured, the data needed and the process for collecting it.
  • Lastly, you will discuss in detail how you will end/terminate your relationship with the client. The ending phase occurs when goals are reached, the specified time for working together has ended, or the client is no longer interested in working with you. Address when you will begin the termination process and why.

 

Instructions

Based on your assigned case study, please be sure your paper includes the following:

 

INTRODUCTION:

who is Carla Washburn and why does she need services. Who referred her to your agency and what are their concerns with your client (Carla)?  Provide a background of your client\’s life including the town and the issues in the community.

 

Assessment

 

  • Describe the micro-level issues/problems you and your client system you find most relevant and pressing when assessing their overall well-being. What is/are the micro-level issues/problems and describe in detail. (Identify at least 2)
  • How does it affect the client? Why is this important to client well-being?
  • Using outside evidence/research discuss the issues/problems, their incidence, background, and associated knowledge in the real world in detail.

Act as if this was a real session you had with the client and create a ecomap.

 

Intervention

please use at least 3 different types of intervention plan. What the intervention is (if it will consist of a questionnaire such as the Beck Depression Inventory then describe in detail how you as the social worker will utilize it with the client).  Please ensure that at least 1 of the interventions utilized is focused on the client diabetes and how it can help.

  • Based on the problems you identified, describe your micro-level solutions to the issues/problems and the identified goals and services. Be sure to identify your interventions in time-limited/ measurable goals (e.g., The client will engage in a support group by 7/1/2017.) How will you address the issues/problems you and the client have identified? Be specific. Be specific on the intervention utilized and how it will help your client.
  • How would you work with the client to identify these solutions and to create needed change?
  • What would be your role as a change agent? (e.g., broker, advocate, etc.)

 

Evaluation

  • How will you measure the success of your interventions. Discuss what you envision success to look like and why (based on the interventions used).
  • How will you specifically measure success? (Which goals would have been met?)
  • What data will you need to collect and what is your plan/the process for collecting it?

 

Ending/Termination

  • Consider how you have planned to end your relationship with your client. Discuss when you will begin the termination process and why you have chosen this time.
  • Develop an aftercare plan or “toolbox” to help the client have supports and resources once your relationship has ended in detail.

This paper should be able to tell who Carla Washburn is, verify if the client was willing to participate in the intervention plan. This should be written as if you are the social worker that had a sessions with your client.

 

Answer

Carla Washburn’s Micro-Level Intervention Plan

The client, Carla Washburn, is an African American woman aged 74 years. She has lost her close family members over the last two decades. Carla lives in Plainville, a small town whose majority of occupants are the aging population. The town lacks sufficient resources, services, and activities for youth. Community members also face health concerns, lack social support, face discrimination, are isolated, and need financial assistance. Before retirement, the client worked as an administrative assistant in the school district, from where she receives a small pension and social security. However, her benefits are minimal. The client lives alone with little to no social support. Her sister lives in a different city. Carla has only a few friends and is dealing with particular health concerns. Carla has diabetes that may not be effectively managed. The client’s sister, Anna, contacted the agency with concerns that Carla is isolated, has difficulty coping with her loss, and recently had a fall that has made walking difficult, yet she refuses to seek medical attention. Anna has contacted the agency since Carla insists that she does not need help. Although reluctant, Carla has agreed to take part in the intervention plan.

Assessment

Carla is exposed to diverse issues that impact her life positively and negatively. In order to improve Carla’s quality of life and promote her overall well-being various issues need to be addressed. First is the micro-level issues affecting the client and which are accessibility and acceptability of healthcare and the lack of social support for the aged population. The client’s health is the most pressing issue. Various health conditions affect Carla’s physical and mental wellness. Although the client’s diabetes is a cause of concern, the fact that it complicates her health in other ways makes it a pressing issue that needs immediate intervention. Besides diabetes, Carla has also been experiencing pain following a fall, for which she has refused to seek medical attention. The impact of the fall, coupled with her underlying medical condition, has made walking difficult. Beyond the physical health concerns, the client appears to be experiencing grief, has difficulty coping with her loss, and may be depressed (Routledge, n.d.). The client’s state of mind is also concerning. Carla seems forgetful and is concerned she may fall again. Although multiple other issues affect the client’s overall well-being, her health status is the most pressing and addressing it will help better her physical and mental state.

Access to healthcare, as a micro-level issue, is a primary cause of concern for many older persons. Rosnu et al. (2022) elaborate that accessibility and acceptability are the two most essential enablers or barriers to healthcare for older adults. Other factors such as family and social support, finances, and transportation also impact healthcare access among older adults. Besides being an older adult, Carla’s racial background may hinder healthcare access. Older African American adults face disparities in healthcare. Aaron et al. (2021) explain that unlike their white counterparts, older African American adults are likely to have insufficiently managed chronic illnesses and die from them. Such disparities can affect access to healthcare, the willingness to seek medical intervention, and the lifespan of minorities.

Another significant micro-level problem is Carla’s lack of social support. The client has lost her close family members, lives alone, and has no connections to her neighbors (Routledge, n.d.). Although Carla and Anna have been close friends all their lives, they do not communicate as often as they used to since Roland Jr. died. Besides cutting down communication with her sister, Carla does not interact with many people in her community. This issue affects Carla since she lacks social support to help her cope with her losses. It is critical to the client’s well-being because it affects her mental wellness, causing her to experience depression, isolation, and grief.

Interpersonal relationships and socialization are essential for humans especially for older adults. Socialization helps maintain older adults’ physical and mental health, improves memory, and promotes longevity by reducing isolation and stress. Mohd et al. (2019) established a relationship between social support and depression among older adults. The lack of social support remains a persistent problem among many elderly individuals. In a study, Czaja et al. (2021) established that approximately one-quarter of adults above 65 years living within communities are socially isolated. However, community organizations are keen on offering social support to members of this population.

Client Ecogram/Ecomap

 

 

Intervention

Several interventions will help address the identified problems. First, for the client’s health concerns, the interventions will include; the client will check into a medical facility by 6/26/2023 for treatment to manage the pain in her foot, and Clara will also schedule and attend a preventive medical appointment by 6/28/2023 to manage her diabetes and keep it under control. These interventions will enhance her physical health and ensure she is fit for social interventions. The interventions will also help improve the quality of her life. For the second issue of concern, the lack of social support, the client will engage in a support group by 7/4/2023. The support group will increase her interactions with other community members, promote her mental well-being, improve her memory, and enhance her access to helpful community resources. I will also help the client create an ecomap by 7/2/2023 to establish and visualize her social and personal relationships. The eco-map will help foster her social relations and rebuild her relationship with her sister. These interventions will help improve the client’s physical and mental well-being, improve her social life, and increase her social support.

The attainment of these goals will require the client’s involvement and cooperation. I will work with the client to identify solutions and create change. I will also engage the client and seek her ideas on what she believes could help her situation. Actively engaging her in all steps, from the assessment to the development of interventions to the evaluation, will ensure she remains in charge of the process and hence greater cooperation. Additionally, I will use motivational strategies to strengthen her commitment to change. Finally, I will design interventions that align with the client’s goals and talk to her about them.

My role as a change agent is crucial to ensure the timely and effective attainment of set goals. As a change agent, I will gather information about the client and interventions that best address the identified issues. Secondly, I will source resources within the community, such as financial assistance programs, social support for the aged, and wellness programs that may help the client. I will also engage her through milestones, help her embrace change, and support and encourage her. Moreover, I will promote and enable change through these initiatives, allowing the client to attain better physical fitness and mental wellness. Therefore, I will improve the client’s life through my actions.

Evaluation

The success of the intervention should be evaluated in order to determine its effectiveness. As such, I will measure the success of the interventions to determine whether we have implemented the required change. At the basic level, I envision certain components to characterize success. First, I expect the client’s diabetes to be under control and the pain in her limb to be managed, allowing her to walk without a limp. Secondly, I expect her to engage more with people her age, be socially involved, and overcome her grief and depression. I will thus use the patient’s physical, mental, and social state to measure the success of the interventions.

More specifically, I will measure the success of the three interventions in several ways. I will engage a healthcare expert to measure the client’s blood sugar levels several times over one a period of month to determine whether the client’s diabetes has been managed. I will use the numeric rating scale before and after the intervention to assess pain levels. Additionally, I will consider her interactions with other members of her community and her relationship with her sister, especially their communication patterns, to determine the efficiency of the ecomap strategy. Finally, I will use the Beck Depression Inventory to determine the impact of social support on her mental wellness.

Certain information and data sets are crucial to determine the success of the interventions. To that effect, I will need to collect this information for the evaluation process. The information includes health records, behavioral patterns, and the client’s emotions. I intend to coordinate with the client’s healthcare providers to access some of this information. For the client’s health data, I will seek her consent and then observe the client’s behaviors, especially her interactions with other community members. I will engage her in interview-like conversations to further assess any improvements in her relationships and social life. Finally, I will use questionnaires to gain in-depth information about her feelings, emotions, perceptions, and state of health. The plan is to engage her through the process so that she is confident and comfortable enough to share her experiences. The information will facilitate the specific measurement of the success of the interventions.

Ending/ Termination

I intend to terminate the relationship with the client once her diabetes has been well-managed and she has gained adequate social support. I will also ensure progress in other areas and measure the client’s readiness. I believe this will be an ideal moment for termination for two reasons. First, with her diabetes under control, her physical health will improve, and she can address any arising issues. Secondly, adequate social support will mean she gets people to look up to for help and this will reignite her social life and ensure her mental wellness.

I plan to discuss the termination with the client early on in counselling. Kress and Marie (2019) explain that openly discussing termination from the beginning can help motivate the client as it becomes apparent that it is only a temporary process to help them reach certain goals. I believe this would work in Carla’s case, considering her reluctance to engage in counselling. I will keep up the communication throughout the intervention period, carefully remaining thoughtful and sensitive and ensuring she does not feel neglected or abandoned.

Based on the client’s problems, the aftercare plan will include embracing a healthier diet, monitoring blood sugar, and taking medications. These measures will keep her diabetes in check and ensure she does not suffer the health complications arising from diabetes. I will also include selfcare, grief counseling, and interacting and maintaining social ties to ensure mental wellness. The plan aims to ensure the client sustains the changes over time.

 

References

Aaron, S. P., Gazaway, S., Harrell, E., & Elk, R. (2021). Disparities and Racism Experienced Among Older African Americans Nearing End of Life. Current Geriatrics Reports, 10(4), 157–166. https://doi.org/10.1007%2Fs13670-021-00366-6

Czaja, S. J., Moxley, J., & Rogers, W. (2021). Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial. Frontiers in Psychology, 12, 1-14. https://doi.org/10.3389/fpsyg.2021.728658

Kress, V., & Marie, M. (2019, October 2). Cunseling termination and new beginnings. Retrieved from Counseling Today: https://ct.counseling.org/2019/10/counseling-termination-and-new-beginnings/

Mohd, T. A., Yonus, R. M., Hairi, F., Hairi, & Hairi, N. N. (2019). Social support and depression among community dwelling older adults in Asia: a systematic review. BMJ Open, 9(7), 1-12. doi:10.1136/bmjopen-2018-026667

Rosnu, N. S., Singh, D. K., Ludin, A. F., Ishak, W. S., Rahman, M. H., & Shahar, S. (2022). Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review. International Journal of Environmental Research and Public Health, 19(12). https://doi.org/10.3390%2Fijerph19127351

Routledge. (n.d.). Carla Washburn Case Files. Retrieved from Routledge New Directions in Social Work: https://routledgesw.com/interactive-cases/washburn//engage/case-files

 

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