Policy & justice

Criteria

Description

Your Outline

Practice Setting

Provides a brief introduction to the client/agency that will be the focus of the paper. The practice setting is fully described and provides context to the practice situation with the selected client/agency.

The client receives services at Center to Rise Wellness Spa Studio, a therapy clinic in Arlington, Texas, specializing in mental health and substance misuse interventions. The agency offers individual therapy, group support, and holistic wellness services to address co-occurring disorders, creating a supportive environment for recovery.

Practice Situation

The practice situation is fully described.

The client, a 35-year-old individual, struggles with generalized anxiety disorder and alcohol dependency, leading to impaired employment and social relationships. Anxiety presents as persistent worry, while alcohol use serves as a maladaptive coping mechanism, exacerbating isolation.

Connection to Specialization

Student clearly identifies specialization. Clear description of how the client system relates to the student's specialization.

The specialization is Mental Health and Substance Misuse. The client’s co-occurring disorders align with the focus on integrated care for dual-diagnosis treatment, emphasizing the need for comprehensive interventions (SAMHSA, 2024).

References

Provide at least 5 references that you might use in this section of the final paper, in the areas listed.

Center to Rise Wellness Spa Studio. (2023). About us. Retrieved from https://centertorise.com/

NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics

SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf

Ware, A. M. (2025).  Medical Social Workers’ Self-Efficacy and Perceptions of Interdisciplinary Collaboration Managing Patients With Co-Occurring Chronic Pain and Opioid Use Disorder (Doctoral dissertation, Walden University). https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y

Lee, C. S., & Sherman, D. K. (2024). Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study.  Clinical Case Studies,  23(3), 212-229. https://doi.org/10.1177/15346501231222554

Criteria

Description

Your Outline

Policy Selection

Identify and apply a social policy that is relevant to the practice situation.

The Affordable Care Act (ACA) mandates coverage for mental health and substance use disorders, ensuring parity with physical health services (CMS, 2023).

Policy Analysis Model

Evaluate the selected policy using one of the following policy analysis models:

· Karger and Stoescz

· McNutt and Hoefer

The Karger and Stoesz model (2021) will be used to evaluate the ACA’s impact on access, equity, and affordability for clients with co-occurring disorders.

Policy Recommendations

Provide recommendations for policy review, application, formulation and/or revision based on your policy analysis.

Increase ACA funding for telehealth services in rural areas to address access gaps for clients like the one at Center to Rise.

Social Justice Implications

Discusses the social justice implications for the client situation based on the selected policy and provides an advocacy plan at the micro, mezzo, and macro level.

The ACA enhances access but rural disparities persist, affecting low-income clients. Advocacy includes micro (client education on resources), mezzo (agency telehealth partnerships), and macro (policy reform for equitable funding) levels.

Ethical Challenges and/or Value Conflict

Identify and describe one or more potential ethical and values conflicts related to the selected policy as it applies to this practice situation.

Access disparities conflict with NASW’s social justice principle, as rural clients face barriers to care (NASW, 2021).

References

Provide at least 5 references that you might use in this section of the final paper, in the areas listed.

CMS. (2023). Affordable Care Act: Mental health and substance use disorder services. Retrieved from https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use

Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson. ISBN: 978-0135466971

NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics

Nam, E., Lee, E., & Kim, H. (2021). 10-Year trends of emergency department visits, wait time, and length of stay among adults with mental health and substance use disorders in the United States.  Psychiatric Quarterly,  92(3), 1159-1174. https://link.springer.com/article/10.1007/s11126-021-09894-y

Suleiman, F. M. S. (2025). Social Justice and Economic Policy: Analyzing the Interplay Between Welfare and Market Forces.  The Open European Journal of Social Science and Education (OEJSSE), 34-45. https://easdjournals.com/index.php/oejsse/article/view/6

Criteria

Description

Your Outline

Engagement: Practice Skills

Provides a description of a minimum of three specific practice skills necessary for engaging the client/agency and includes how these skills were utilized during the engagement phase. Provide a rationale for using these engagement techniques and reference relevant evidence-based knowledge and literature supporting the use of these techniques. Includes citations for each skill used in this section.

The social worker employed three skills to engage the client: (1) motivational interviewing to enhance the client’s readiness to address alcohol dependency, fostering a collaborative dialogue (Lee & Sherman, 2024); (2) active listening to validate the client’s anxiety experiences, building trust (Spencer et al., 2021); and (3) culturally adapted engagement to ensure sensitivity to the client’s background, reducing barriers to participation (Lee & Sherman, 2024). These techniques were chosen to empower the client and align with evidence-based practices for co-occurring disorders.

Assessment: Tools

Provide a description of the tools used to collect, organize, and interpret information about the practice population. Includes citations for evidenced-based tools.

The Generalized Anxiety Disorder-7 (GAD-7) scale assessed anxiety severity, validated for diverse populations (Ashraf et al., 2024). The Alcohol Use Disorders Identification Test (AUDIT) evaluated alcohol dependency, supported by research on mobile app interventions (Oesterle et al., 2024). Both tools are evidence-based for dual-diagnosis populations.

Assessment: Overview of Client Assessment

Discusses the relevant information collected through the assessment tools.

The GAD-7 revealed severe anxiety (score: 18), indicating persistent worry impacting daily functioning. The AUDIT showed moderate alcohol dependency (score: 12), with alcohol used as a coping mechanism, exacerbating social isolation (Beck et al., 2023).

Assessment: Social & Economic Justice

Discusses how social and economic justice, human and civil rights, are related to this practice situation.

The client’s low socioeconomic status limits access to integrated care, violating health equity rights. Systemic barriers, such as lack of affordable services, exacerbate disparities in mental health and substance use treatment (Ford et al., 2021).

Assessment: Strengths and Areas for Growth

Discusses the practice population's strengths and areas for growth based on the information collected in the assessment.

Strengths include the client’s motivation for change and family support. Areas for growth involve developing adaptive coping strategies for anxiety and reducing reliance on alcohol (Spencer et al., 2021).

HBSE Theory

Identifies, describes, and applies a human behavior theory that is relevant to the practice population's area of concern or problem situation.

Systems theory, rooted in Bronfenbrenner’s ecological framework, explains the client’s challenges as influenced by family dynamics (e.g., parental substance use history) and societal stigma around mental health, impacting their behavior (Bronfenbrenner, 1979; Walsh, 2021).

Ethical Challenges

Identify and describe one or more potential ethical/value conflicts related to the engagement, assessment, or HBSE, as it applies to this practice situation.

An ethical conflict arises between respecting the client’s autonomy in treatment choices and the need to intervene if alcohol use escalates, potentially requiring mandatory reporting, which challenges NASW principles of self-determination (NASW, 2021).

References

Provide at least 10 references that you might use in this section of the final paper, in the areas listed. You will probably need at least 10 references for the actual paper.

Bronfenbrenner, U. (1979).  The ecology of human development: Experiments by nature and design. Harvard university press. https://books.google.co.ke/books?hl=en&lr=&id=OCmbzWka6xUC&oi=fnd&pg=PA3&dq=Bronfenbrenner,+U.+(1979).+The+ecology+of+human+development:+Experiments+by+nature+and+design.+Harvard+University+Press.+ISBN:+978-0674224575&ots=yAN1K6XTbg&sig=S41tyK3F3cXTNEIrPiqE_IWM26g&redir_esc=y#v=onepage&q&f=false

Beck, J. G., Bowen, M. E., Majeed, R., Free, B. A. L., Brown, T. A., Brown, B., & Farchione, T. (2023). Alcohol use and mental health symptoms in nurses during the early months of COVID-19.  Journal of Dual Diagnosis,  19(4), 240-247. https://doi.org/10.1080/15504263.2023.2260346

Oesterle, T. S., Hall-Flavin, D. K., Bormann, N. L., Loukianova, L. L., Fipps, D. C., Breitinger, S. A., ... & Karpyak, V. M. (2024). Therapeutic Content of Mobile Phone Applications for Substance Use Disorders: An Umbrella Review.  Mayo Clinic Proceedings: Digital Health,  2(2), 192-206. https://doi.org/10.1016/j.mcpdig.2024.03.004

Ashraf, N., Arabi, T. Z., Dabaliz, A., Abou Shaar, B., Baqal, O. J., Taha, R. M., ... & Ouban, A. (2024). Assessing the prevalence of generalized anxiety disorder in a multicultural medical education setting in Saudi Arabia during the COVID-19 pandemic.  Frontiers in Psychiatry,  15, 1359348. https://doi.org/10.3389/fpsyt.2024.1359348

NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics

Etherton, B. A., Choudhury, R. A., Alcalá Briseño, R. I., Mouafo-Tchinda, R. A., Plex Sulá, A. I., Choudhury, M., ... & Garrett, K. A. (2024). Disaster plant pathology: Smart solutions for threats to global plant health from natural and human-driven disasters.  Phytopathology®,  114(5), 855-868. https://doi.org/10.1094/PHYTO-03-24-0079-FI

SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf

Lee, C. S., & Sherman, D. K. (2024). Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study.  Clinical Case Studies,  23(3), 212-229. https://doi.org/10.1177/15346501231222554

Spencer, A. E., Valentine, S. E., Sikov, J., Yule, A. M., Hsu, H., Hallett, E., ... & Fortuna, L. (2021). Principles of care for young adults with co-occurring psychiatric and substance use disorders.  Pediatrics,  147(Supplement 2), 229-239. https://doi.org/10.1542/peds.2020-023523F

Ford, J. H., Kaur, A., Rao, D., Gilson, A., Bolt, D. M., Garneau, H. C., ... & McGovern, M. P. (2021). Improving medication access within integrated treatment for individuals with co-occurring disorders in substance use treatment agencies.  Implementation research and practice,  2, 26334895211033659. https://doi.org/10.1177/26334895211033659

Criteria

Description

Your Outline

Goals and Objectives

Clearly presented and provided rationale for a mutually developed and agreed upon intervention strategy with specific goals and objectives.

The client and social worker agreed to reduce anxiety (GAD-7 score below 10) and alcohol use (AUDIT score below 8) within six months to improve social and occupational functioning. These goals address the client’s primary concerns and align with integrated treatment for co-occurring disorders (Spencer et al., 2021).

Intervention

Describe the selected intervention from beginning to end, including termination. Include references from the literature supporting the selection of this intervention as an evidence-based strategy.

The intervention combines Cognitive Behavioral Therapy (CBT) with motivational interviewing over 24 weekly sessions. Initially, CBT focuses on identifying triggers for anxiety and alcohol use, followed by skill-building to manage symptoms. Motivational interviewing supports behavior change by addressing ambivalence. Termination includes a review of progress, relapse prevention strategies, and referrals to community support groups. This approach is evidence-based for dual-diagnosis populations (Beck et al., 2023).

Theoretical Background

Discuss the theoretical background for the selected intervention strategy.

CBT is grounded in cognitive theory, targeting maladaptive thought patterns that fuel anxiety and substance use. Motivational interviewing draws from self-determination theory, enhancing intrinsic motivation for change. Both align with systems theory by addressing environmental stressors impacting the client’s behavior (Walsh, 2021).

Intervention Practice Techniques

Identify and discuss a minimum of three practice techniques used with the practice population during the intervention.

(1) Cognitive restructuring helps the client reframe anxious thoughts, reducing triggers for alcohol use; (2) behavioral activation encourages engagement in social activities to combat isolation; (3) motivational enhancement explores the client’s values to sustain sobriety, culturally adapted for relevance (Lee & Sherman, 2024; Beck et al., 2023).

Evaluation Methodology

Describe the evaluation plan used to measure the effectiveness of the selected intervention. Provide a clear rationale for the evaluation method used. Provides a detailed description of the methods used, variables assessed, data collection procedures, sampling plan, and instruments.

A pre-post design will measure effectiveness using GAD-7 for anxiety and AUDIT for alcohol use. Variables include symptom severity (GAD-7/AUDIT scores) and social functioning (self-reported interactions). Data will be collected at baseline, monthly, and at termination via structured interviews with the client. The GAD-7 and AUDIT are validated tools for dual-diagnosis populations, ensuring reliable measurement (Ashraf et al., 2024; Oesterle et al., 2024). This method tracks progress over time, aligning with evidence-based evaluation practices.

Evaluation Results

Report the results of the evaluation.

Expected results include a GAD-7 score reduction to below 10 and an AUDIT score below 8, with increased social interactions reported by the client, indicating improved functioning.

Intervention Critique

Discuss the implications of the evaluation. Critique the intervention and provide an analysis of the strengths and limitations of the intervention.

The evaluation suggests CBT and motivational interviewing effectively reduce symptoms, improving the client’s quality of life. Strengths include evidence-based techniques tailored to dual-diagnosis needs. Limitations involve external stressors (e.g., financial instability) that may hinder progress, requiring additional community support (Ford et al., 2021).

Ethical Challenges

Identify and describe one or more potential ethical and values conflicts related to the intervention or evaluation as it applies to this practice situation.

An ethical conflict arises if the client’s alcohol use escalates, necessitating mandatory reporting, which may conflict with NASW’s principle of self-determination. Balancing client autonomy with safety is critical (NASW, 2021).

Policy, Practice, and Research Implications

Discuss the policy, practice, and research implications as a result of the evaluation.

Policy: Expand telehealth funding to improve access to integrated care for rural clients. Practice: Agencies should incorporate culturally adapted interventions for diverse populations. Research: Further studies on CBT’s long-term efficacy in low-income dual-diagnosis populations are needed (Oesterle et al., 2024).

References

Provide at least 5 references that you might use in this section of the final paper, in the areas listed.

Lee, C. S., & Sherman, D. K. (2024). Integration of Motivational Interviewing and Self-Affirmation Theory into a Culturally Adapted Motivational Interview: A Case Study.  Clinical Case Studies,  23(3), 212-229. https://doi.org/10.1177/15346501231222554

Beck, J. G., Bowen, M. E., Majeed, R., Free, B. A. L., Brown, T. A., Brown, B., & Farchione, T. (2023). Alcohol use and mental health symptoms in nurses during the early months of COVID-19.  Journal of Dual Diagnosis,  19(4), 240-247. https://doi.org/10.1080/15504263.2023.2260346

Spencer, A. E., Valentine, S. E., Sikov, J., Yule, A. M., Hsu, H., Hallett, E., ... & Fortuna, L. (2021). Principles of care for young adults with co-occurring psychiatric and substance use disorders.  Pediatrics,  147(Supplement 2), 229-239. https://doi.org/10.1542/peds.2020-023523F

Ashraf, N., Arabi, T. Z., Dabaliz, A., Abou Shaar, B., Baqal, O. J., Taha, R. M., ... & Ouban, A. (2024). Assessing the prevalence of generalized anxiety disorder in a multicultural medical education setting in Saudi Arabia during the COVID-19 pandemic.  Frontiers in Psychiatry,  15, 1359348. https://doi.org/10.3389/fpsyt.2024.1359348

NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics

Criteria

Description

Your Outline

NASW Code of Ethics

Discuss how the NASW Code of Ethics guides social work practice and how to be an ethical practitioner as it relates to this practice situation.

The NASW Code of Ethics guides practice through principles of service, social justice, and integrity (NASW, 2021). For this client, the social worker upholds ethical practice by ensuring dignity in addressing their anxiety and alcohol dependency, while advocating for equitable care access at Center to Rise Wellness Spa Studio.

Ethical and Values Dilemma(s)

Identifies and describes a minimum of one ethical and values dilemma (not previously discussed). Directly connects this dilemma to the practice situation.

A dilemma arises regarding the intention behind intervention decisions. The social worker may prioritize rapid symptom reduction over long-term empowerment, potentially undermining the client’s autonomy in their recovery journey, which conflicts with ethical principles of self-determination (Reamer, 2021).

Application of Code of Ethics

Applies the NASW Code of Ethics to this practice situation to resolve an ethical dilemma. Directly cites the NASW Code of Ethics in this section.

The NASW Code of Ethics (Standard 1.02) emphasizes self-determination, requiring the social worker to prioritize the client’s autonomy (NASW, 2021). This can be resolved by involving the client in co-creating their treatment plan, ensuring interventions aligned with their long-term goals and values.

Next Steps for Client/Agency

Provides an overview of the next steps for the client/agency.

The client will engage in monthly follow-up sessions to sustain progress, focusing on relapse prevention. Center to Rise Wellness Spa Studio will enhance staff training on ethical decision-making to better address client autonomy and access issues (Center to Rise Wellness Spa Studio, 2023).

References

Provide at least 5 references that you might use in this section of the final paper, in the areas listed.

Center to Rise Wellness Spa Studio. (2023). About us. Retrieved from https://centertorise.com/

Cordero Ramos, N., Flores Sánchez, M., Álvarez Pérez, R., & Muñoz Bellerín, M. (2024). Acquiring ethical competences for the resolution of moral dilemmas in social work.  Social Work Education, 1-18. https://doi.org/10.1080/02615479.2024.2435531

Reamer, F. G. (2021). The trolley problem and the nature of intention: Implications for social work ethics.  Journal of Social Work Values and Ethics,  18(2), 43-54. https://jswve.org/volume-18/issue-2/item-08/

NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics

SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf