socw6111wk10assgnstevea

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Walden University *

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Apr 3, 2024

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1 Practice Toolbox Allison Steve MSW, Walden University SOCW 6111: Advanced Social Work Practice I Dr. Kristie Abbs January 31, 2024

2 Practice Toolbox Child Assessment Why did you select the assessment tool? This writer chose the Strengths and Difficulties Questionnaire assessment tool. This assessment tool was chosen due to working with youth and adolescents in the mental health field. The clients that this writer works with not only have mental health diagnoses, but some clients have severe behavioral and emotional difficulties. Why might it be especially helpful for use with children? What is interesting about this assessment is that three versions are beneficial. There is a short form, a longer form that assesses the impact of difficulties on the child’s life, and a follow- up form (CORC, n.d.). Parents and/or teachers also fill out this questionnaire. Having formal and informal support participants gives an overview of how the clients' social environments impact who they are. This questionnaire can be used for different purposes, including clinical assessment, evaluation of outcomes, research, and screening (CORC, n.d.). What challenges or limitations might there be for this assessment tool? Clinical experiences have reported that the Strengths and Difficulties questionnaire may not be appropriate for youth and adolescents with severe learning difficulties (CORC, n.d.). According to Hall et al. (2019), “the factor structure of the assessment is subject to debate, and there is limited evidence investigating measurement equivalence invariance [ME/I] between treatment groups, informants, and across time.” There will be limitations and challenges with any assessment tools. It depends on the client's diagnosis and what they are seeking treatment for. Once the social worker can form a therapeutic alliance, they will gain more insight and know what assessments are beneficial and what assessments may not be.

3 Adolescent Assessment Why did you select the assessment tool? This writer's assessment tool of choice was Level 2- Anger- Child Age 11-17. After reviewing multiple assessment tools, this writer chose the assessment that would relate to the current clients she is working with. Why might it be especially helpful for use adolescents? Adolescence is an essential time in an individual’s life. They experience a great deal of change which takes place in the psychological, social, biological, and neurobiological domains (Brandell, 2020). According to Erikson’s developmental theory, adolescents seek a sense of self and personal identity (McLeod, 2023). If adolescents are not given the social freedom to explore who they are, they may become angry and confused as to who they are (McLeod, 2023). Emotions run high during the adolescent years due to hormonal changes, heavy reliance on acceptance of peers, and figuring out who they are. This writer has experienced that adolescents who present anger all the time have underlying issues that have not been addressed and have trouble expressing them to others. What challenges or limitations might there be for this assessment tool? A challenge or limitation is that there are only six questions on the assessment and only how a client felt within the past seven days (Psychiatry, n.d.). A significant life event could have happened during the seven days, but previously, the client was happy. There will always be strengths and barriers to any assessment. The therapeutic alliance between the social worker and the client can work together to find what would benefit the client’s issues.

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4 Adult Assessment Why did you select the assessment tool? This writer chose the level 2- Substance Use- Adult assessment tool. This writer would like to work with inmates, and many inmates have been arrested for selling drugs. After interning with the local police department, the drug sellers who were arrested started as drug users. This writer feels understanding the individual or inmate's history of drug usage would benefit the therapeutic services this writer would be able to provide. Why might it be especially helpful for use with adults? Adults face daily challenges such as work, family, and personal life. For example, if a client discloses a loved one has passed within the past month, the client could be using substances as an unhealthy coping skill. This gives the social worker better insight into the client and how they cope when difficult issues arise in their life. Furthermore, the social worker could practice behavioral therapy during the sessions with their client. According to Brandell (2020), clients who participate in behavioral therapy have significantly better outcomes than comparison populations. Some behavioral therapies include CBT, DBT, relapse prevention, and stages of readiness for change (Brandell, 2020). What challenges or limitations might there be for this assessment tool? A challenge or limitation could be the client answering the questions if they are having current withdrawal symptoms or other stressors occurring in their life that could affect their answers (Brandell, 2020). Another challenge is the therapeutic alliance has not been established, and the client is lying on the assessment. The assessment only covers the past two weeks of usage and not the history of the client regarding drugs, alcohol, etc. (American Psychiatric Association, n.d.).

5 Elderly/Aging Adult Assessment Why did you select the assessment tool? The assessment tool this writer chose is Severity Measure for Generalized Anxiety Disorder—Adult. After reading the provided literature, it appears that the elderly/ aging experience anxiety more than other mental health issues. This writer feels it is important to gain insight and knowledge on working with the elderly/aging population with generalized anxiety. Why might it be especially helpful for use with elderly/aging? This assessment would be helpful because the diagnosis of anxiety may be missed due to other medical conditions, prescription drug use, and/ or particular situations that the patient is coping with (American Association for Geriatric Psychiatry, 2022). What challenges or limitations might there be for this assessment tool? Challenges or limitations are the same as previously discussed assessment tools. The time frame is how the client has been feeling for the past seven days without taking into consideration any personal issues. American Association for Geriatric Psychiatry (2022) stated the elderly/aging population often goes untreated for anxiety disorders for several reasons. Some elderly adults may be reluctant to discuss their feelings and/or may not seek treatment because they have experienced these symptoms of anxiety for most of their lives and feel it is normal. What are two common mental health diagnoses associated with the elderly/aging population, and how might the assessment tool you identified assist with diagnosis? According to Brandell (2020), a high number of the elderly experience symptoms of excessive worry and fear. Anxiety disorders among the elderly/ aging population are associated with reduced physical activity, poor self-perceptions of health, a decrease in happiness and quality of life, and loneliness (Tampi & Tampi, 2020). According to the Centers for Disease

6 Control and Prevention (n.d.), another major mental health diagnosis in the aging/ elderly population is depression (mood disorder). Depression and anxiety can co-occur with each other (Brandell, 2020). If the client scores high on the assessment, it will give the social worker more insight into their mental health, and since depression can co-occur with anxiety, a depression assessment may be conducted as well. Child Intervention Why did you select the intervention? This writer chose play therapy because it is a good intervention to engage children. It is a way a social worker can observe a child’s interaction with toys and the correlation between play and issues going on with the child. Why might it be especially helpful for use with children? According to Wonderspring Early Education (2020), play supports children in practicing decision-making skills, resolving conflict, and learning self-advocacy skills. Young children may not know how to express their feelings, and this can be shown through behavioral issues. Children learn ways to express their feelings appropriately, ways to control their behavior, and how to solve problems through play therapy (Psychology Today, n.d.). Play therapy provides a safe environment for children to express themselves without any consequences. Play therapy can be conducted in multiple ways, which can include the social worker observing the child and parent play together (Psychology Today, n.d.). The play therapist can have a more direct approach and role-play a difficult situation with the child to help process the traumatic event (Psychology Today, n.d.).

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7 What challenges or limitations might there be for this intervention? There are challenges and limitations to play therapy. This intervention relies heavily on the therapist's skills and needs to be trained and certified along with supervision (Madsen, 2022). Some therapists may integrate play while doing talk therapy which is what this writer has done. Integrating play into talk therapy is not considered play therapy (Madsen, 2022). Another limitation is that play therapy does not work for every problem or child and can be a long process (Madsen, 2022). Adolescent Intervention Why did you select the intervention? This writer chose the Gestalt intervention to practice with adolescents. This writer has never heard of Gestalt therapy and, after researching, feels it would be beneficial for working with adolescents. Why might it be especially helpful for use with adolescents? Gestalt therapy will help adolescents focus on the present to help them understand what is occurring in their lives and how they are feeling in the moment as opposed to thinking about what happened in past experiences (Psychology Today, n.d.). Adolescents struggle to figure out who they are and process their emotions. Focusing on the present day's thoughts, emotions, and behaviors will eliminate questioning how their past affects them now. According to Brzozauskaite (2022), the main goal of Gestalt therapy is for the client to experience emotions in the present moment. There are many ways to practice Gestalt therapy with a client, for example, art, role-play, use of language, and locating emotions in the body. Gestalt therapy can be used in in-person therapy or online therapy (Brzozauskaite, 2022). Online therapy was discussed this

8 week as being beneficial for adolescents and incorporating Gestalt therapy would be an additional bonus for working with adolescents. What challenges or limitations might there be for this intervention? According to Brzozauskaite (2022), a challenge to Gestalt therapy is that it is more time- consuming than other types of interventions. This practice involves a strong therapeutic alliance between the client and the social worker. Adolescents can struggle with the lack of formal structure, which is normal in a Gestalt therapy session (Psychology Today, n.d.). Another challenge is that the adolescent may want to explore and resolve their issues from the past to move forward with their life (Psychology Today, n.d.). The social worker will work with their adolescent client to formulate the best treatment approach. Adult Intervention Why did you select the intervention? This writer chose Solution-Focused Brief Therapy (SFBT) to practice with adults. As adults, there is constant change with work, family, and personal issues that need to be addressed in a timely manner. Why might it be especially helpful for use with adults? Solution-focused brief therapy is an evidence-based approach that allows clients to implement change in their lives in the fastest possible time (Ferguson, 2023). SFBT can be incorporated into other types of therapeutic interventions. Goal setting is the foundation of this intervention, and it starts with asking the first question, which is called a miracle question (Psychology Today, n.d.). Social workers must assume their clients have the strength, wisdom, experience, and resilience to effect change in their lives (Psychology Today, n.d.). After asking the miracle question, the social worker will begin to explore with the client what they are doing

9 to initiate behavioral and lifestyle changes (Psychology Today, n.d.). The intervention would include specific questioning techniques, 0-10 scales, empathic support, and compliments to help the client realize their strengths and how they have gotten through the hard times in the past that could potentially help them with future problems (Psychology Today, n.d.). What challenges or limitations might there be for this intervention? The client may have more than one major issue to address, and SFBT is not a long-term therapeutic intervention (Psychology Today, n.d.). This intervention is not recommended for use with any client who has severe mental health issues (Ackerman, 2024). SFBT would not be appropriate for clients who want to focus more on their symptoms, behaviors, and how their pasts affect who they are today (Ackerman, 2024). Lastly, for SFBT to have a positive outcome, there must be a strong therapeutic alliance (Ackerman, 2024). Elderly/Aging Adult Intervention Why did you select the intervention? This writer chose Reminiscence therapy as an intervention for the elderly. The literature that was provided this week discussed this intervention benefiting the aging/elderly, especially if they have early or moderate dementia. Why might it be especially helpful for use with elderly/aging adults? Reminiscence therapy requires the social worker to listen to their client and encourage them to share their memories (Campbell, 2023). The social worker may use pictures, items, and/or music to help the client remember the memory better (Campbell, 2023). Reminiscence therapy is the most beneficial for the aging population with mild to moderate dementia (Campbell, 2023). Studies have found that “clients who participated in reminiscence therapy had better relationships with their families and/or caregivers, improved mood and mental health,

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10 functioned better, sociable, and less depressed (Campbell, 2023). Reminiscence therapy can unravel happy or sad memories as well as hobbies and activities the client once enjoyed. For example, an elderly client who once used to hike may be encouraged to take a walk outside. According to Campbell (2023), clients discussing happier memories reinforce their connection to the modern world and increase their feelings of self-worth. This intervention can be used as an aid to encourage relationships with family and develop friendships within their community (Campbell, 2023). What challenges or limitations might there be for this intervention? Reminiscence therapy requires the person to relive memories which can increase their well-being and happiness. However, the challenge may be that the memory is unpleasant and may cause them to relive the memory or become triggered. Reminiscence therapy does not treat other pre-existing or developing conditions (Good Therapy, n.d.). Summary This writer identified providing therapeutic services to inmates during week 1. Throughout this course, this writer’s perspective has not changed regarding the population to work with, and they will continue down the path to becoming a corrections or criminal justice social worker. After researching interventions that work best with inmates, research showed that Cognitive Behavioral Therapy (CBT), which we learned during this term, was the best fit for this population. CBT has been shown to reduce recidivism in juveniles and adults (National Institute of Corrections, n.d.). CBT is also effective with substance abuse and violent offenders, probationers, prisoners, and parolees. This type of therapy addresses multiple problems that are associated with criminal behavior (National Institute of Corrections, n.d.). According to the National Institute of Corrections (n.d.), “ most cognitive behavioral therapy programs, offenders

11 improve their social skills, means-ends problem solving, critical reasoning, moral reasoning, cognitive style, self-control, impulse management and self-efficacy.” An ethical challenge that may arise is a client’s right to self-determination. An inmate’s right to self-determination is limited by legal status, and if the inmate reports new offenses and/or suspected offenses, the social worker is obligated to report it to the proper authority, which can be detrimental to the therapeutic alliance. In this case, a social worker may limit their client’s right to self- determination due to a foreseeable and imminent risk to themselves or others (NASW, n.d.).

12 References Ackerman, C. (2024, January 18). What is solution-focused therapy: 3 essential techniques . PositivePsychology.com. https://positivepsychology.com/solution-focused-therapy/ Anxiety and older adults: Overcoming worry and fear . American Association for Geriatric Psychiatry. (2022, October 27). https://www.aagponline.org/patient-article/anxiety-and- older-adults-overcoming-worry-and-fear/ Brandell, J. R. (Ed.). (2020). Theory & practice in clinical social work (3rd ed.). Cognella. Brzozauskaite, G. (2022, April 6). The benefits of gestalt therapy . DoMental. https://domental.com/blog/benefits-of-gestalt-therapy#:~:text=In%20fact%2C%20the %20only%20real,increased%20sense%20of%20self%2Dregulation Code of Ethics . NASW, National Association of Social Workers. (n.d.). https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English Cognitive behavioral therapy . National Institute of Corrections. (n.d.). https://nicic.gov/resources/resources-topics-and-roles/topics/cognitive-behavioral- therapy#:~:text=Cognitive%20behavioral%20therapy%20has%20been,and %20probationers%2C%20prisoners%20and%20parolees. DSM-5-TR Online Assessment Measures . Psychiatry.org - DSM-5-TR Online Assessment Measures. (n.d.). https://www.psychiatry.org/psychiatrists/practice/dsm/educational- resources/assessment-measures Ferguson, G. (2023). Solution Focused Brief Therapy (SFBT). Salem Press Encyclopedia of Health. GoodTherapy. (n.d.). Reminiscence therapy (RT) . Reminiscence Therapy. https://www.goodtherapy.org/learn-about-therapy/types/reminiscence-therapy Hall, C., Guo, B., Valentine, A., Groom, M., Daley, D., Sayal, K., & Hollis, C. (2019, June 19). The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms . PloS one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583960/#:~:text=The%20Strengths %20and%20Difficulties%20Questionnaire%20(SDQ)%20is%20a%20brief%2C,years %20%5B1%2C%202%5D. Madsen, H. (2022, November 17). Solution focused brief therapy vs. play therapy. which is better? . Briefly Counseling. https://brieflycounseling.com/solution-focused-brief-therapy- vs-play-therapy-which-one-is-better/ Mcleod, S. (2023, October 16). Erik Erikson’s stages of Psychosocial Development . Simply Psychology. https://www.simplypsychology.org/erik-erikson.html#Stage-5-Identity-vs- Role-Confusion

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13 Play therapy . Psychology Today. (n.d.). https://www.psychologytoday.com/us/therapy-types/play-therapy Strengths and difficulties questionnaire (SDQ) . CORC Child Outcomes Research Consortium. (n.d.). https://www.corc.uk.net/outcome-experience-measures/strengths-and-difficulties- questionnaire-sdq/ Sussex Publishers. (n.d.). Gestalt therapy . Psychology Today. https://www.psychologytoday.com/us/therapy-types/gestalt-therapy Sussex Publishers. (n.d.). Solution-focused brief therapy . Psychology Today. https://www.psychologytoday.com/us/therapy-types/solution-focused-brief-therapy Tampi, R. R., & Tampi, D. J. (2020). Psychiatric Times, 37 (7), 44–45. https://www.psychiatrictimes.com/view/most-prevalent-psychiatric-disorder-older-adults The power of play . Wonderspring Early Education - Learning All Ways. (2020, October 20). https://wonderspring.org/the-power-of-play/? gclid=CjwKCAiAqY6tBhAtEiwAHeRopRmxowGHJbKDl63aGJrlcVbSybRqhoH1d7Z3Y RRcHutadR5D217aHRoCTs0QAvD_BwE The State of Mental Health and Aging in America . Centers for Disease Control and Prevention. (n.d.). https://www.cdc.gov/aging/pdf/mental_health.pdf

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