Assessment part

ClientOverview2ndPart-.docx

5

Client Overview

This paper describes the client who is receiving services at Center to Rise Wellness Spa Studio in Arlington, Texas, and his struggles with generalized anxiety disorder and alcohol dependency. They are treated with dual diagnosis within the Mental Health and Substance Misuse specialization, and the overview sets the context for this treatment.

Practice Setting

The client practice setting is Center to Rise Wellness Spa Studio, Arlington, Texas. The specialty of this therapy clinic is mental health and substance misuse interventions with individual therapy, group support, and holistic wellness services like mindfulness and stress management. The agency’s multidisciplinary team provides a recovery-supportive environment, especially for individuals with co-occurring disorders, by using evidence-based practices to treat complex needs (Center to Rise Wellness Spa Studio, 2023). It focuses on dual-diagnosis treatment, which meets the client’s needs in a community-based setting.

Practice Situation

This is a client who is a 35-year-old person who has generalized anxiety disorder and alcohol dependency, which hinder the client’s employment and social relationships. Their anxiety is persistent, uncontrollable worry that interferes with daily functioning and causes emotional distress. Alcohol use is used as a maladaptive coping mechanism, which worsens social isolation and occupational instability and thus perpetuates the cycle of dependency (SAMHSA, 2024). This dual diagnosis is a complicated practice situation that requires integrated therapeutic interventions to deal with both problems simultaneously. The client’s challenges point to the interplay between mental health and substance misuse and the need for tailored, evidence-based strategies for recovery and enhancing quality of life.

Connection to Specialization

The mental health and substance misuse specialization directly relates to the client’s co-occurring disorders. But their challenges illustrate the importance of integrated care models that address mental health and substance use at the same time. Dual-diagnosis treatment, as SAMHSA (2024) states, can be effective only when it is comprehensive and includes therapy, motivational strategies, and relapse prevention. The specialization’s concentration on handling intricate situations involving the combination of anxiety and alcohol dependency, as found in the client’s situation, emphasizes the need for evidence-based approaches, for example, motivational interviewing and cognitive behavioral therapy (Lee & Sherman, 2024). Specialized knowledge of the client and the care system can be used in this case to create client-centered interventions, advocate for equitable care, and work to dismantle systemic barriers to recovery.

Social and Contextual Factors

The client’s low socioeconomic status and limited access to resources in Arlington only exacerbate their challenges, which are symptomatic of broader systemic issues in the access to mental health care. Ware (2025) notes that rural and underserved communities often have barriers to integrated treatment, which in turn reduces the client’s ability to consistently engage in care. Other cultural factors, such as stigma associated with mental health and substance use issues, complicate help-seeking behaviors. Culturally adapted engagement strategies are used by social workers in order to build trust and make sure that interventions are resonating with the client’s background (Lee & Sherman, 2024). These factors indicate the need for treatment planning that addresses social determinants of health.

Reason for Intervention Need

This client is in need of intervention due to the prevalence of co-occurring disorders. According to SAMHSA (2024), an estimated 9.2 million U.S. adults suffer from both mental health and substance use disorders each year, highlighting the public health importance of dual-diagnosis treatment. The client is impaired and using alcohol to cope with this impairment, which indicates the need for immediate intervention to avoid further deterioration. Through the Mental Health and Substance Misuse specialization, the social worker will be able to help the client to work towards recovery while utilizing evidence-based practices in order to provide sustainable results.

References

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

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

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

PolicyandSocialJustice3rdPart.docx

1

Policy and Social Justice

This section is an analysis of how a federal social policy can be applied to treat a 35-year-old client with generalized anxiety disorder and alcohol dependency in Center to Rise Wellness Spa Studio in Arlington, Texas. It is aligned with the mental health and substance misuse specialization through the policy analysis and recommendations, exploration of the social justice and ethical considerations, and rigorous policy analysis.

Policy Selected

The Affordable Care Act (ACA), which was implemented in 2010, is a federal policy that requires insurance coverage of mental and substance use disorder services to be on par with physical health services (CMS, 2023). This policy is essential to the client, who is a 35-year-old patient under dual-diagnosis treatment at Center to Rise Wellness Spa Studio in Arlington, Texas. The ACA allows one to access integrated care, including evidence-based interventions, including cognitive behavioral therapy (CBT) and motivational interviews, which can alleviate the client of occupational and social impairments due to the presence of persistent anxiety and alcohol dependency. Nevertheless, the policy is limited in its application by the fact that it faces implementation difficulties in rural settings such as certain areas in Arlington (shortage of providers and poor healthcare infrastructure), and, therefore, its effectiveness is limited to low-income clients (Patel & Jones, 2023). Such barriers contribute towards the inability of the client to get consistent care, which makes it hard to recover. The focus on mental health parity provided by the ACA is critical to helping the client receive the treatment he or she needs, yet there are improvements that need to be made in order to support the detailed needs of the client and enhance his or her overall quality of life.

Policy Analysis Model

The Karger and Stoesz (2021) policy analysis model allows examining the ACA through the prism of access, equity, and affordability and provides a solid framework to examine its effect on clients with co-occurring disorders. Mental health and substance use services are also more accessible under the ACA, but the absence of providers in rural areas critically restricts the ability to provide the client with timely care, causing delays in treatment that only worsen the symptoms (Ware, 2025). Inconsistency in Medicaid expansion among the states is a violation of equity, which disproportionately harms the low-income and minority groups, such as the client, who experiences systemic factors that restrict long-term treatment involvement (Nam et al., 2021). Although the affordability has been enhanced due to the low out-of-pocket expenses, it is still a major issue, as deductibles and copays are too high and bring financial pressure on the client due to their low socioeconomic status (Priester et al., 2022). This discussion shows the improvements made by the ACA on expanding coverage and the key systemic obstacles that reduce its effectiveness to address the complex needs of the client, which require strategic measures to increase its effectiveness.

Policy Recommendations

To strengthen the ACA’s effectiveness, policymakers should implement strategic reforms tailored to the needs of clients with co-occurring disorders. Increasing funding for telehealth services would mitigate rural provider shortages, enabling clients like the one at Center to Rise to access remote therapy, ensuring treatment continuity and flexibility for those in underserved areas (Ford et al., 2021). Standardizing Medicaid expansion across states would promote equitable access to dual-diagnosis treatment, reducing disparities for low-income clients who depend on public insurance to cover essential services. Subsidizing copays and deductibles for mental health and substance use services would improve affordability, alleviating financial barriers for clients with limited resources and enabling consistent engagement in care (Patel & Jones, 2023). Additionally, enhancing workforce development programs to train more mental health professionals in rural areas would address long-term access issues. These recommendations target critical gaps in access, equity, and affordability, strengthening the ACA’s capacity to support recovery and foster sustainable outcomes for individuals with complex behavioral health needs.

Social Justice Implications

The ACA advances social justice by mandating mental health parity, aligning with the NASW Code of Ethics’ commitment to equitable care access (NASW, 2021). Nevertheless, rural disparities and socioeconomic barriers undermine health equity, disproportionately impacting low-income clients like the one described, who struggle to maintain consistent treatment engagement due to systemic limitations (Rodriguez & Green, 2021). These inequities contravene principles of fair resource distribution, necessitating a comprehensive, multi-level advocacy plan. At the micro level, the social worker can educate the client on ACA-covered resources, such as subsidized therapy and community support programs, to optimize their access to essential services. At the mezzo level, partnering with Center to Rise to develop telehealth programs and community outreach initiatives would enhance service delivery for rural clients, improving community-level access. At the macro level, advocating through NASW for increased ACA funding for underserved areas and policy reforms to address rural healthcare disparities would tackle systemic inequities, promoting equitable access across diverse populations (Suleiman, 2025). This multi-level approach empowers the client, fosters fairness within their community, and aligns with social work’s commitment to justice.

Ethical Challenge and/or Value Conflict

An ethical conflict emerges from disparities in ACA implementation, which conflict with NASW’s social justice principle (Standard 6.04) mandating equitable resource access (NASW, 2021). The client’s limited access to care, driven by rural provider shortages and financial barriers, challenges the social worker’s obligation to ensure fair treatment, creating a tension between providing immediate client support and advocating for systemic change (Reamer, 2021). This dilemma requires balancing the client’s autonomy with the need to address barriers that threaten their well-being, such as potential escalation of alcohol use. Resolving this conflict involves prioritizing client-centered interventions, such as connecting the client to available resources and support networks, while simultaneously advocating for policy reforms to enhance access, ensuring alignment with ethical standards and the NASW Code of Ethics’ emphasis on justice, dignity, and equitable care.

References

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

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

Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson. 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://doi.org/10.1007/s11126-021-09894-y

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

Patel, S., & Jones, K. (2023). The impact of ACA on mental health equity: A 10-year review. Health Affairs, 42(5), 620-628. https://doi.org/10.1377/hlthaff.2022.01523

Priester, M. A., Browne, T., Iachini, A., Clone, S., & Dehart, D. (2022). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 132, 47-59. https://doi.org/10.1016/j.jsat.2021.108047

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/

Rodriguez, M., & Green, T. (2021). Social justice implications of healthcare policy in the United States. Journal of Social Work, 21(3), 345-360. https://doi.org/10.1177/1468017320987654

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

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

ClientOverview2ndPart-.docx

5

Client Overview

This paper describes the client who is receiving services at Center to Rise Wellness Spa Studio in Arlington, Texas, and his struggles with generalized anxiety disorder and alcohol dependency. They are treated with dual diagnosis within the Mental Health and Substance Misuse specialization, and the overview sets the context for this treatment.

Practice Setting

The client practice setting is Center to Rise Wellness Spa Studio, Arlington, Texas. The specialty of this therapy clinic is mental health and substance misuse interventions with individual therapy, group support, and holistic wellness services like mindfulness and stress management. The agency’s multidisciplinary team provides a recovery-supportive environment, especially for individuals with co-occurring disorders, by using evidence-based practices to treat complex needs (Center to Rise Wellness Spa Studio, 2023). It focuses on dual-diagnosis treatment, which meets the client’s needs in a community-based setting.

Practice Situation

This is a client who is a 35-year-old person who has generalized anxiety disorder and alcohol dependency, which hinder the client’s employment and social relationships. Their anxiety is persistent, uncontrollable worry that interferes with daily functioning and causes emotional distress. Alcohol use is used as a maladaptive coping mechanism, which worsens social isolation and occupational instability and thus perpetuates the cycle of dependency (SAMHSA, 2024). This dual diagnosis is a complicated practice situation that requires integrated therapeutic interventions to deal with both problems simultaneously. The client’s challenges point to the interplay between mental health and substance misuse and the need for tailored, evidence-based strategies for recovery and enhancing quality of life.

Connection to Specialization

The mental health and substance misuse specialization directly relates to the client’s co-occurring disorders. But their challenges illustrate the importance of integrated care models that address mental health and substance use at the same time. Dual-diagnosis treatment, as SAMHSA (2024) states, can be effective only when it is comprehensive and includes therapy, motivational strategies, and relapse prevention. The specialization’s concentration on handling intricate situations involving the combination of anxiety and alcohol dependency, as found in the client’s situation, emphasizes the need for evidence-based approaches, for example, motivational interviewing and cognitive behavioral therapy (Lee & Sherman, 2024). Specialized knowledge of the client and the care system can be used in this case to create client-centered interventions, advocate for equitable care, and work to dismantle systemic barriers to recovery.

Social and Contextual Factors

The client’s low socioeconomic status and limited access to resources in Arlington only exacerbate their challenges, which are symptomatic of broader systemic issues in the access to mental health care. Ware (2025) notes that rural and underserved communities often have barriers to integrated treatment, which in turn reduces the client’s ability to consistently engage in care. Other cultural factors, such as stigma associated with mental health and substance use issues, complicate help-seeking behaviors. Culturally adapted engagement strategies are used by social workers in order to build trust and make sure that interventions are resonating with the client’s background (Lee & Sherman, 2024). These factors indicate the need for treatment planning that addresses social determinants of health.

Reason for Intervention Need

This client is in need of intervention due to the prevalence of co-occurring disorders. According to SAMHSA (2024), an estimated 9.2 million U.S. adults suffer from both mental health and substance use disorders each year, highlighting the public health importance of dual-diagnosis treatment. The client is impaired and using alcohol to cope with this impairment, which indicates the need for immediate intervention to avoid further deterioration. Through the Mental Health and Substance Misuse specialization, the social worker will be able to help the client to work towards recovery while utilizing evidence-based practices in order to provide sustainable results.

References

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

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

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

PolicyandSocialJustice3rdPart.docx

1

Policy and Social Justice

This section is an analysis of how a federal social policy can be applied to treat a 35-year-old client with generalized anxiety disorder and alcohol dependency in Center to Rise Wellness Spa Studio in Arlington, Texas. It is aligned with the mental health and substance misuse specialization through the policy analysis and recommendations, exploration of the social justice and ethical considerations, and rigorous policy analysis.

Policy Selected

The Affordable Care Act (ACA), which was implemented in 2010, is a federal policy that requires insurance coverage of mental and substance use disorder services to be on par with physical health services (CMS, 2023). This policy is essential to the client, who is a 35-year-old patient under dual-diagnosis treatment at Center to Rise Wellness Spa Studio in Arlington, Texas. The ACA allows one to access integrated care, including evidence-based interventions, including cognitive behavioral therapy (CBT) and motivational interviews, which can alleviate the client of occupational and social impairments due to the presence of persistent anxiety and alcohol dependency. Nevertheless, the policy is limited in its application by the fact that it faces implementation difficulties in rural settings such as certain areas in Arlington (shortage of providers and poor healthcare infrastructure), and, therefore, its effectiveness is limited to low-income clients (Patel & Jones, 2023). Such barriers contribute towards the inability of the client to get consistent care, which makes it hard to recover. The focus on mental health parity provided by the ACA is critical to helping the client receive the treatment he or she needs, yet there are improvements that need to be made in order to support the detailed needs of the client and enhance his or her overall quality of life.

Policy Analysis Model

The Karger and Stoesz (2021) policy analysis model allows examining the ACA through the prism of access, equity, and affordability and provides a solid framework to examine its effect on clients with co-occurring disorders. Mental health and substance use services are also more accessible under the ACA, but the absence of providers in rural areas critically restricts the ability to provide the client with timely care, causing delays in treatment that only worsen the symptoms (Ware, 2025). Inconsistency in Medicaid expansion among the states is a violation of equity, which disproportionately harms the low-income and minority groups, such as the client, who experiences systemic factors that restrict long-term treatment involvement (Nam et al., 2021). Although the affordability has been enhanced due to the low out-of-pocket expenses, it is still a major issue, as deductibles and copays are too high and bring financial pressure on the client due to their low socioeconomic status (Priester et al., 2022). This discussion shows the improvements made by the ACA on expanding coverage and the key systemic obstacles that reduce its effectiveness to address the complex needs of the client, which require strategic measures to increase its effectiveness.

Policy Recommendations

To strengthen the ACA’s effectiveness, policymakers should implement strategic reforms tailored to the needs of clients with co-occurring disorders. Increasing funding for telehealth services would mitigate rural provider shortages, enabling clients like the one at Center to Rise to access remote therapy, ensuring treatment continuity and flexibility for those in underserved areas (Ford et al., 2021). Standardizing Medicaid expansion across states would promote equitable access to dual-diagnosis treatment, reducing disparities for low-income clients who depend on public insurance to cover essential services. Subsidizing copays and deductibles for mental health and substance use services would improve affordability, alleviating financial barriers for clients with limited resources and enabling consistent engagement in care (Patel & Jones, 2023). Additionally, enhancing workforce development programs to train more mental health professionals in rural areas would address long-term access issues. These recommendations target critical gaps in access, equity, and affordability, strengthening the ACA’s capacity to support recovery and foster sustainable outcomes for individuals with complex behavioral health needs.

Social Justice Implications

The ACA advances social justice by mandating mental health parity, aligning with the NASW Code of Ethics’ commitment to equitable care access (NASW, 2021). Nevertheless, rural disparities and socioeconomic barriers undermine health equity, disproportionately impacting low-income clients like the one described, who struggle to maintain consistent treatment engagement due to systemic limitations (Rodriguez & Green, 2021). These inequities contravene principles of fair resource distribution, necessitating a comprehensive, multi-level advocacy plan. At the micro level, the social worker can educate the client on ACA-covered resources, such as subsidized therapy and community support programs, to optimize their access to essential services. At the mezzo level, partnering with Center to Rise to develop telehealth programs and community outreach initiatives would enhance service delivery for rural clients, improving community-level access. At the macro level, advocating through NASW for increased ACA funding for underserved areas and policy reforms to address rural healthcare disparities would tackle systemic inequities, promoting equitable access across diverse populations (Suleiman, 2025). This multi-level approach empowers the client, fosters fairness within their community, and aligns with social work’s commitment to justice.

Ethical Challenge and/or Value Conflict

An ethical conflict emerges from disparities in ACA implementation, which conflict with NASW’s social justice principle (Standard 6.04) mandating equitable resource access (NASW, 2021). The client’s limited access to care, driven by rural provider shortages and financial barriers, challenges the social worker’s obligation to ensure fair treatment, creating a tension between providing immediate client support and advocating for systemic change (Reamer, 2021). This dilemma requires balancing the client’s autonomy with the need to address barriers that threaten their well-being, such as potential escalation of alcohol use. Resolving this conflict involves prioritizing client-centered interventions, such as connecting the client to available resources and support networks, while simultaneously advocating for policy reforms to enhance access, ensuring alignment with ethical standards and the NASW Code of Ethics’ emphasis on justice, dignity, and equitable care.

References

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

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

Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson. 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://doi.org/10.1007/s11126-021-09894-y

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

Patel, S., & Jones, K. (2023). The impact of ACA on mental health equity: A 10-year review. Health Affairs, 42(5), 620-628. https://doi.org/10.1377/hlthaff.2022.01523

Priester, M. A., Browne, T., Iachini, A., Clone, S., & Dehart, D. (2022). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 132, 47-59. https://doi.org/10.1016/j.jsat.2021.108047

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/

Rodriguez, M., & Green, T. (2021). Social justice implications of healthcare policy in the United States. Journal of Social Work, 21(3), 345-360. https://doi.org/10.1177/1468017320987654

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

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

ClientOverview2ndPart-.docx

PolicyandSocialJustice3rdPart.docx

ClientOverview2ndPart-.docx

PolicyandSocialJustice3rdPart.docx

ClientOverview2ndPart-.docx

PolicyandSocialJustice3rdPart.docx

ClientOverview2ndPart-.docx

PolicyandSocialJustice3rdPart.docx

Policy & justice

Intervention

Conclusion