Medical Social Work in an Interdisciplinary Health Care Team

2

Comprehensive Assessment

Tolulope I. Moses

Master of Social Work, Walden University

SOCW-6111: Clinical Social Work Practice

Dr Kristie Abbs

October 2021

Comprehensive Assessment

Introduction

The Cortez family is made up of David, Miguel and Paula. In this comprehensive assessment, the client will be Paula. Miguel is Paula’s son, but she had to give up custody of the son due to her medical state, and as a result, she has been isolated from her family since she has been experiencing both emotional and physical abuse from them. Paula has been diagnosed with Hepatitis C, HIV, bipolar disorder and circulatory problems (Plummer et al., 2014). In this assessment, she becomes pregnant and is forced to decide in keeping the baby or aborting it. In this paper, therefore, two assessment models will be used to identify the client’s strengths as well as analyze two multidisciplinary approaches and the social worker’s mode in her case.

Paula’s Assessment Models.

The two assessment models that will be discussed in accordance with Paula Cortez’s case are as follows.

Psychosocial assessment. Paula is a 43-year-old woman living with HIV. She left her family in Columbia to come and live in the US. Paula has one child, Miguel, and she is divorced from the child’s father, David. Despite her financial challenges, Paula has both physical and mental illnesses (Plummer et al., 2014). She also has a history of not following the medical prescriptions to the letter. The client has a high school education, which helped her acquire a college degree, and she is also fluent in English and Spanish. Due to Paula’s health conditions, her ability to commute to work and do other daily activities has been constrained. She is diagnosed with Hepatitis C, HIV/Aids, and bipolar disorder (Plummer et al., 2014).

Strength-Perspective Assessment. Paula Cortez is a 43-year old Latina woman living in New York City. To help her be employable in the near future, Paula has a high school education as well as a college degree and is well acquainted with painting (Plummer et al., 2014). The client uses her painting skills to express her creative side by painting various fashionable designs that express her view of the world. Despite the brain infection that limited her mobility and paralyzed her dominant hand, Paula overcame that and learned to use her non-dominant hand in her creative arts. Above that, she received assistance from professionals to stabilize her state of mind and help her strive to achieve her desired goals.

Areas of Strength in Paula’s Case as per the Cowger Article

In this case, Paula portrayed various emotional and physical strengths; she also exhibited interpersonal skills and the ability to have positive thinking, a part of the multidimensional assessment (Cowger, 1994). Above that, Paula experienced external strengths from family, community groups, medical professionals and other organizations and institutions. Despite the medical predicament that Paula is in, she avoids rush decisions when contemplating on aborting or keeping the baby; instead, she thought it out carefully and had to keep the pregnancy even after getting doubts and scepticism from some medical professionals who thought that either Paula or the baby would not survive. Her good interpersonal skills made Paula a likeable person, hence why most medical practitioners at the hospital always wanted to be around her.

Perspective-Multidisciplinary team.

The medical professionals where Paula received treatment thought it wise for her to get rid of the pregnancy because of her medical conditions that might lead to giving birth to an unhealthy baby. Besides that, they also argued that Paula might get more health complications if she kept the pregnancy and gave birth. Additionally, the doctors believed that since she was paralyzed on her dominant hand and was also getting weak, she could not be in a position to take care of a newborn.

From the assessment above, the social worker did not exhibit any bias but displayed a (1.01) commitment to the client as per the NASW code of ethics (Simpson, 2020). Additionally, the social worker was supposed to ensure that Paula received adequate health care that she required and other social services such as in-home child care assistance, baby crib and other items, WIC, and Medicaid. Generally, besides the doctors’ advice and recommendations for Paula to terminate the pregnancy, the social worker was supported in Paula’s case, and in the long run, this helped her come into well-thought decisions to keep her pregnancy and give birth.

The model used by social Workers in the Assessment.

In Paula’s case, the social workers seem to be using the collaborative approach in their assessment. The social workers use various assessment models to understand the difficult and somehow complicated situations, such as what Paula is going through, to create an understanding and friendly environment between the professionals and the client (Berg‐Weger, 2019). A comprehensive client assessment was also utilized to understand important details about the client, such as asking about Paula’s mental status and health, physical health and capabilities, cognitive ability, and prior psychiatric related diagnosis.

Potential for Bias When Choosing an Assessment Model

While professionals always strive to choose the most suitable assessment models without any bias, there is a possibility of potential bias in some instances. For instance, potential bias during diagnosis may focus on the problem a client faces and then end up providing a treatment plan that is not well backed up by sufficient data. In other instances, there could be some bias in other assessment models where the clients have self-reported their diagnosis questions inaccurately, and if the doctors or the practitioners do not do proper diagnosis, then the treatment offered might not be evidence-based. Additionally, choosing only one assessment model might lead to bias since some instances might require both environmental and psychosocial assessment. For instance, Paula’s case requires an emphasis on the client’s strengths instead of self-diagnosis of the mental problems or reported medical problems. Therefore, a single approach will not be appropriate in most instances to avoid bias.

Strategies to avoid the potential for biases.

As a social worker, I will ensure that the biases mentioned above do not occur by employing a couple of following strategies. First, I will emphasize understanding what the client is going through both physically, mentally and emotionally. This way, I will employ various assessment models to avoid focusing on a single issue or, rather, just the reported pain points from the client. To ensure that the client gets appropriate attention, I will connect her to other good therapists and counsellors who will help her make informed decisions based on her health conditions before deciding whether to keep the baby or terminate the pregnancy. Being a strong and zealous woman, Paula has exhibited self-determination that needs to be maintained and protected by receiving a lot of encouragement from various people around her. This can be achieved by encouraging her to collaborate with a multidisciplinary team to offer proper care for her various medical needs. Above that, Paula needs to be helped to overcome and learn how to deal with stigma, especially if people become aware that she is HIV positive. Also, based on her history of not completing or adhering to medical prescriptions, as a social worker, I will notify her of the potential risks involved in not completing her prescriptions or not following them.

References

Berg‐Weger, M. (2019). Social Work Practice with Individuals and Families.

Cowger, C. D. (1994). Assessing client strengths: Clinical assessment for client empowerment. Social Work, 39(3), 262–268.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (2014). Sessions: case histories.Baltimore, MD: Laureate International Universities Publishing. Cortez Family (p23-25)

Simpson, J.E. (2020). New theories for social work practice: ethical practice for working with individuals, families and communities. Journal of Social Work Practice, 35, 112 - 114.