Integrative Theory to Practice #2

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1 Integrative Theory to Practice #2 Thalia Estevez Merrimack College Integrated Generalist Social Work Theory and Practice 1 James Howland MSW, Ed.D. October 18, 2021

2 Case Introduction Max, a 17-year-old teenage male from an affluent and abundant community. He lives at home with his parents and his younger brother and sister and is currently a senior in high school. Max’s mother is a physician, and his father works as a lawyer. After a significant drop in his grades and a decrease in effort both in the classroom and during swim practice, his teachers and coach noticed the significant change and referred him to the counseling center. Max’s parents agreed to have him see a counselor after concerns were raised by both his teachers and swim coach. Aside from his shift at school his parents reported that their once social son has been isolating himself from both his family and his friends. As a family that has always been heavily involved in their community and church and fortunate enough to vacation and travel the difference has not gone unnoticed in their tight-nit household. His parents also disclosed that he was presenting symptoms of irritability, disinterest in his usual activities, carelessness, decreased concentration, and an increase in hours to his regular sleep schedule. They also named that now he is not as concerned with his regular self-care and hygiene routine and will go days without bathing himself and will repeat the same clothes. A star athlete, Max is an Olympic hopeful who has been sought out by scouts to join their swimming team once in college. His parents have high hopes that he will follow in their footsteps and attend an ivy league school just like them. His teammates have caught on to Max distancing himself and have raised their concerns to their coach. Aware of the severity of his situation his coach met with Max on several occasions in an attempt to get him back on track with his academic and athletic goals. In addition, Max revealed to his social worker that he’s going through an internal struggle and is questioning his sexuality. When discussing his friendships and romantic relationships, Max disclosed that he feels that those

3 closest to him would not accept him if they knew about his struggle with his sexuality and the confused feelings he’s presenting. Even though he has never revealed his sexuality to any of his loved ones; the preoccupation surrounding his identity, conflicting feelings, and how he will be perceived by all is weighing heavily on him. While Max continues to still grapple with his issues of self-identification and identity disclosure, he appears motivated to change in the right direction. Max has exhibited many positive behaviors that should be particularly helpful in his treatment. He has established goals in the hopes of being “…happy and healthy again.” His goals include, feeling better again and doing well in school and in swimming. With the support and ongoing assistance from his social worker he can readily progress and work towards accomplishing all of his goals. Part of this work includes establishing and fostering a strong rapport with Max and form an effective helping relationship. To further support the ongoing engagement the social worker on the case may utilize the solution-focused brief therapy (SFBT) approach to focus on solutions, the possibility of change rather than the problem(s) at hand. (Ruffolo, 2016, p.85) Developing and maintaining a cooperative therapeutic alliance will allow incremental change facilitated by the use of present and future-focused questions, (Ruffolo, 2016, p.85) validating change through compliments, and building on the concrete things that are working with the client. Using the SFBT intervention to start will help evoke change in Max’s life through the use of strategic dialogue and emphasize the fact that he is the expert of his life and the trajectory that its going in. Currently Max is in the preparation stage of change and is fully aware of how his current mental state and behavior(s) are hindering his relationships, academics, and athletic career. He already knows why he wants to change and is ready to formulate a plan with the support of his social worker. What Max has shared over

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4 several sessions shows that he is mentally anticipating, ready to devise and formulate, contingency plans to handle unforeseen situations that might present obstacles to change. Planning how to change means choosing the appropriate actions to reach a specific goal and move closer to the action stage. Maintaining a solid relationship will work to fortify a pace that honors where Max is and empowering him to have autonomy over his thoughts and the ability to make sound decisions on his own behalf. Strengths Approach In order for his social worker to better understand the experiences he’s going through at the moment the practitioner and getting to know their individual client they must choose an appropriate approach to utilize in sessions and implement when continuing to strengthen their collaborative partnership. In Max’s case the strengths approach feels most appropriate because according to McCashen, it focuses on an individual’s self-determination and strengths. (Positive psych) It is an effective model because, “This type of approach builds the clients on their strengths, specifically seeing them as resourceful and resilient when they are in adverse conditions.” Not only will we assess Max as an individual, but it will serve to take a deeper dive into his environment as well. This method will also work to identity any potential constraints that might be limiting his own growth and emphasizing the need for, “…balance or the transactions between the person and their environment.” (Ruffolo, 2016, p.109) Collecting data from a variety of sources will prove to be helpful to fully comprehend what his strengths, resiliencies, and systemic issues look like. (Ruffolo, 2016, p.109) Beginning with open-ended/probing questions allows for a better understating of what he is willing to disclose and allows the client to view the positive in themselves and elicit change

5 talk when answering. When conducting a strengths-focused/resiliency assessment, Ruffolo (2016) names that there are three primary components and explore them within a specific set of system domains. (p.109) The three primary components are comprised of, “(1) currents strengths of the individual or family, (2) desires and aspirations of the individual or family, and (3) the individuals or family’s social and environmental resources.” (Ruffolo, 2016, p.109) Further exploration from the seven system domains should be collected to get a full picture of the innerworkings of Max’s life as is. Those domains include, “(1) home/daily living, (2) assets (financial/insurance),(3) employment/education/specialized knowledge, (4) supportive relationships,(5) wellness/health, (6) leisure/recreational activities, and (7) spiritual/cultural beliefs.” (Ruffolo, 2016, 109) This paradigm will work to gather relevant data on Max and engage with his parents on the same level to highlight his strengths and tangible resource(s), and supports to formulate a plan of action that is led by Max himself. Ongoing case management by the social worker is necessary to monitor, encourage, and reinforce concrete progress and favorable outcomes. Coupled with the strengths model should be a bio-psycho-social-spiritual treatment plan: Addressing his questioning his sexual identity Addressing depression symptoms, the irritability, oversleeping, isolation etc. Addressing the pressures, he has ex Olympic hopeful, pressures from his parents that are both ivy league graduates and both professionals, pressures to be perfect…is he self-sabotaging or rebelling due to pressures he feels from his parents? Max will Attain 3 coping skills for depressive symptoms Good Sleep hygiene … Aside from encapsulate the scope of

6 The strengths approach In addition, it allows for conversation about their environment, needs, and direct attention to their inherent resources and strengths are. His social worker will assess In conjunction with his social worker As a source of great concern At the recommendation of BIO psycho social Screening tools + rationale ECOMAp? Treatment plan SMART?

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7 References Ruffolo, M. C., Perron, B. E., & Voshel, E. H. (2016). Direct social work practice: Theories and skills for becoming an evidence-based practitioner . Sage.

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