Comprehensive Exam
COMPREHENSIVE EXAMINATION
CASE STUDY –Spring 2018
Summary of Intake Interview
Joan is a 38 year old woman who underwent carpal tunnel surgery six weeks ago and has just been released to return to work this week. You are a Rehabilitation Counselor/Case Manager/Vocational Rehabilitation Specialist that works for a nationally known private-for-profit case management/rehabilitation insurance company. Your company has been contacted by Joan's current employer, Marcus Machinery, to assist in facilitating Joan's rehabilitation plan and her return to work.
Joan has a high school education with one year vocational technical training as a medical secretary. Before she came to work for Marcus Machinery, she worked as a waitress at Shoney’s for one year. She quit this job complaining of the pay, hours, and having to walk/stand all day. After working as a waitress, she worked at Wal-Mart for almost three years as a stock clerk. She quit this job reporting that she was lifting/carrying too much weight, standing/walking too frequently, and did not like the odd hours she had to work. Joan also indicated that the physical demands of this job was "too painful" on her shoulders, arms, and back". After these two jobs, she attended vocational technical training as a medical secretary then worked in this occupation for about five years. She quit this occupation stating that "working the key board and looking at the computer screen was too much of a stress on her finger/wrist joints and eyes. She also stated that she hated working for medical doctors because they were very demanding.
Joan reports being married and divorced twice within the last ten years. She indicates that she divorced her past husbands because they drank heavily and physically abused her. Joan is a single parent with one 13 year old son from her second marriage. Her son Ian was diagnosed with an Intellectual disability, a severe learning disability, and Attention Deficit Disorder. She states that her relationship with her son is fair, but she experiences feelings of guilt regarding his disability. She reports feeling very depressed and isolated with her current situation. She has very little social or family support. Joan also expresses a lot of anxiety because of her back surgery, the pain associated with it, and the fact that she still must work so she can financially support her son along with her other debts (e.g., mortgage, car payment).
Joan has worked the last nine years for Marcus Machinery as a coating machine operator. Her job is to coat sheets of thin metal and then visually inspect each piece as it comes off the coating machine. Approximately two times per hour, she pulls a lever that drops the stack of coated metal on a pallet. Using a hydraulic hand dolly, Joan moves this stack of metal sheets to an area 25 feet away from her machine so that another employee can take this material to the warehouse. Joan then returns the empty pallet to her coating machine and begins this process again.
After Joan's surgery and her return to work, she expresses concerns to her supervisor about using the hand dolly. Basically, she tells her supervisor that her doctor recommended that she avoid this particular task for the next two weeks. The supervisor agrees to assign this task to another employee for the next two weeks. Near the end of this time, Joan states that she refuses to use the hand dolly because she is afraid that she might re-injure her hand and may even cause injury to her other hand. Her physician states that he believes there is no physical reason why she cannot return to using the hand dolly again. It is apparent to you, the Rehabilitation Counselor, that Joan has a strong emotional reaction and increased anxiety about using the hand dolly.
QUESTIONS
1. Medical Aspects of Disability. Using the information from the case study, choose ONE of the aforementioned injuries and/or illness (ADD, Alcohol Dependence, lower back injury, carpal tunnel syndrome, mental retardation, severe learning disability) and respond to items (a)-(e) below.
a. Describe the etiology and prognosis of the particular disability/impairment you chose.
b. Discuss specific diagnostic procedures and evaluations that would typically be associated with the assessment of this type of disability.
c. State specific functional limitations that are directly associated with this disability/impairment.
d. Discuss vocational concerns or factors related to employment of persons who have been diagnosed with this type of disability/impairment.
e. Describe specific treatment interventions/strategies for persons with this type of disability.
2. Theory and Techniques for Individual Counseling. Using the above case study, answer the following. Identify a counseling theory that you believe would be appropriate to use with Joan and write an essay that addresses a-e below. Then, identify a counseling theory that you believe would be inappropriate to use with the Joan and explain why the theory would be inappropriate.
a. Identify which theoretical perspective you plan to use as a foundation for your work with the client you choose and explain why this approach is the best way to address the issues and needs that are presented by the client. Include specific case-based information that you think justifies your choice of approach.
b. Identify the key concepts that define and describe this approach and that set it apart from other approaches.
c. Given the approach you chose, what do you see as your primary role(s) when working with this client; and what role(s) will you expect of your client?
d. Identify at least three specific counseling interventions (techniques and/or strategies) you will use to apply your chosen approach with the client, describe
how you will implement each of the interventions, and tell what outcome(s) you expect from each of them.
e. What multi-cultural or cross-cultural issues or concerns do you need to keep in mind as you work with this client, and how might you adjust your work to demonstrate cultural competence?
4. Group Dynamics. Discuss the type of group that you believe would provide the greatest gain for Joan. Be sure to explain why this group would be most effective. Then identify and discuss five of Yalom’s eleven therapeutic factors as they related specifically to Joan. Include a discussion of the pros and cons with regard to group work given the specifics of the client’s specific case.
5. Career and Lifestyle Development. Apply one theory of career development to Joan’s career development. Your application must include identifying and defining the theory’s key constructs.
6. Vocational Services in Rehabilitation. Using the case study, discuss the following:
a. What are the important issues to consider when planning a vocational assessment with the Joan? (Include issues that may be of concern when administering any type of assessment.)
b. Explain the process of job placement and how it fits into the overall rehabilitation process. What methods and procedures might you employ to assist Joan in finding a suitable placement? (Address transferable skills, job development and job placement strategies.)
7. Vocational Assessment. As Joan’s rehabilitation counselor, it has come to your attention that several of the instruments used during the vocational evaluation process may have been unreliable and invalid.
a. Given the above concern, please define and give an example of reliability and validity.
b. To assist in addressing your concern, you reviewed the test manuals to review the types of reliability and validity reported. You discover that the types of reliability reported included: test-retest reliability, alternative form reliability, split-half reliability, coefficient alpha, and inter-scorer reliability. Please define and give an example of each type of reliability.
6. You further discover that the test manual reported the following types of validity: content validity, face validity, criterion-related validity (including concurrent and predictive validity), and construct validity (including convergent and discriminant validity). Please define and give an example of each type of validity.
8. Introduction to Rehabilitation. Each member of the family has an impairment. (a) Discuss the implications of at least two public policies (i.e., federal legislation) for each family member. NOTE: A (discussion( involves more than simply making a statement along the lines of the ADA prohibits discrimination in employment setting. Furthermore, you cannot use the same specific public policy for more than two individuals. (b) Discuss the economic, medical, and minority group disability models in relation to how your
practicing from each model would impact, negatively and/or positively, each member of the family.
9. Human Growth and Development
Please identify Erik Erikson’s eight (8) stages of growth and development, and
identify the life task associated with each state.
10. Research
Briefly explain the difference between quantitative and qualitative research in:
(a) Purpose, (b) approach, and (c) results.