A repeat drug offender is legally coerced to enter a therapeutic community (TC). Based on current research, what do you think is likely to occur?
A. The TC stands a good chance of effectively restructuring the
immature, addictive-prone individual into a strong, self-reliant,
drug-free person.
B. The TC stands a poor chance of effectively restructuring the
immature, addictive-prone individual into a strong, self-reliant,
drug-free person.
C. The individual will most likely remain an immature, addictiveprone
person, as TCs that cater to legally coerced individuals are
not very successful.
D. The individual will most likely return to drugs while staying at
the TC, as legal coercion is not very effective and the oversight
at TCs is generally poor.
A
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The inclusion of spiritual assessment in a social work interview:
a. The social worker should speak up about the benefits of his/her own beliefs b. Is advised if the client has mental illness c. Should be pursued even If the older adult does not find the topic unwelcome d. Should be prefaced by a question of interest in the topic
What distinguishes controlled narcotic users from compulsive narcotic users, addicts, and abusers? How do controlled users avoid addiction? What are some tactics that might distinguish them-but don't?
What will be an ideal response?
Are psychotic or mood disorders present among relatives?
DSM Diagnosis F20.9 Schizophrenia, Continuous Hypertension, Essential Rationale Emma meets the first of the basic criteria for the diagnosis of Schizophrenia, in that she experiences at least two psychotic symptoms that persist for more than a month. Emma has auditory hallucinations, although it’s not clear if this symptom is present for a significant portion of a month. Emma also has bizarre delusions. Emma also has the negative symptoms of flat affect and lack of volition. Emma’s symptoms emerged many years ago and she has been unable to work or take care of herself due to the illness. Schizophrenia further requires coding of course of illness after one year. Emma’s disorder is specified as “continuous” as there has been no remission of “A” symptoms. It is not possible to determine for certain if Emma’s behaviors are due solely to schizophrenia or if another disorder with some relationship to her behavior is present. The fact that she did not develop clear symptoms of a psychotic disorder until midlife is unusual. Risk and Resilience Assessment Emma’s onset of schizophrenia was unusually late in life. According to her son, there is no family history of schizophrenia. There was no information provided on Emma’s prenatal development, or her delivery, so the extent to which any complications might have played into the development of Emma’s illness is unknown. It is also unknown how well Emma’s son knows her history, but he claimed that there were no traumatic events in her childhood. There were reports of Emma being “whipped,” but whether this was outside the boundaries of what a child in her historical and cultural background experienced is not established. A traumatic event during adulthood, the end of her marriage, seemed to have acted as a trigger for the disorder. Emma comes from a low socioeconomic background, which also confers risk for the disorder. In assessing risk and resilience for the course of the illness, on the positive side, Emma had a relatively late age of onset and a good premorbid adjustment. From what we know, she was married and raised a son who went on to go to college. She had an identifiable precipitating event for the disorder rather than a gradual onset, which bodes well for her adjustment. She also has an unfortunate number of risk influences that include poor insight about the disorder, living in a large urban area, delayed treatment, repeated relapses, a history of non-compliance with medication, and the absence of a support system. Her son was involved with her care for a time, but he became “worn out,” and she doesn’t seem to have other supportive people available to her. On a more formal level, Emma receives support from the mental health facility in which she is housed. Her medication compliance is assured, although even so she continues to experience both positive (delusions and hallucinations) and negative (flat affect, lack of volition) symptoms. She receives daily supervision in living tasks, her housing is provided, and she also receives psychological interventions. Additional information needed Because it is unusual for schizophrenia to develop in one’s 50s, Emma’s professionals should be alert to any additional medical and psychosocial information that becomes available to make sure that she has been diagnosed accurately. It does not appear that any such information is available at present. Ways to assess for additional strengths in Emma 1. Emma is said to be generally pleasant when interacting with others. How could her pleasant nature be built upon to further develop interpersonal skills? 2. Emma did not develop the symptoms of schizophrenia until relatively late in life. What social and vocational skills did she develop prior to the onset of her illness that might still be available to her? 3. Emma has generally been non-compliant with medications, but now she takes them because the nurses give them to her. Are there times when she has been willing to use medications? Why was she more willing at those times? 4. Are there times when Emma has been aware of her need for medical treatment? Are there types of medical treatment with which she seems relatively comfortable? 5. What hobbies or interests does Emma have that can be encouraged as part of her rehabilitation? 6. Emma seems to enjoy certain aspects of her hospital program (going on outings, attending groups). What is about these structured activities that she enjoys? How might these elements be transferred to other areas of her life? Intervention Plan A major goal for Emma is stabilization of her symptoms, which will hopefully be achieved by finding an effective antipsychotic medication at an appropriate dose. Nursing staff and the doctor on her team will monitor her symptoms and the effect of the medication. Another goal is for Emma to participate in psychosocial interventions, which will include education about her mental and physical illnesses. At this time, Emma does not believe she has either a mental illness or hypertension. Greater awareness and management of her symptoms will be promoted through her participation in individual sessions with the psychologist, psychiatrist, and social worker on the team, and by participation in recommended treatment groups. A third goal is to maintain Emma’s physical health. She is currently taking anti-hypertensive for her hypertension. A final goal is for Emma to participate in her discharge planning. To meet this goal, as well a finding an antipsychotic that can stabilize her, Emma will meet with the liaison at the Community Services Board, the local public mental health, mental retardation, and substance abuse agency, on a weekly basis, to discuss discharge needs and options. Emma has been unable to meet this goal so far because she believes she has a home to go back to (when she does not). In helping her reach this goal, an intermediate step is to engage her in a five-minute, reality-based conversation in each group and with each nursing shift on a daily basis. Another part of the discharge planning is to find a living situation for Emma, perhaps a group home or subsidized housing. Critical Perspective Almost all mental health diagnoses are based on observable behaviors. This is often problematic due the subjectivity of the process, and it is particularly troubling when a diagnosis falls well out of the norm, in this case related to the client’s age at symptom onset. She will be treated for schizophrenia and there is evidence that such interventions will be helpful, although it is still possible that other processes are going on within her that account for her symptoms.
Answer the following statement(s) true (T) or false (F)
Despite the upsurge in the delivery of social work services, the need of social work education programs and social work professional training in China is still pronounced.