Social Work Practice: Individuals and Families

This assignment discusses the social work assessment of a case study involving families dealing with alcoholic members. It explores the issues faced by the client, establishes a relationship with psychological theories, and proposes an intervention plan. The critical reflection identifies gaps in the intervention and assesses the situation.

Social Work Practice with
Individuals and Families
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Table of Contents
Introduction................................................................................................................................2
Assessment Report.....................................................................................................................2
Goal Setting................................................................................................................................4
Critical Reflection......................................................................................................................6
Conclusion..................................................................................................................................6
References..................................................................................................................................7
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Introduction
The purpose of this assignment is to discuss the social work assessment of the case study 1 in
helping families dealing with alcoholic members. The discussion of the case study will
identify the issues the client is facing and establish a relationship with psychological theories.
An intervention plan will be put forward to remedy the client’s situation. The critical
reflection will provide the gaps in the intervention and make assessments of the situation.
Assessment Report
The client in the first case study is a 74-year-old man with alcohol drinking issues. The man
has expressed to indulge in daily drinking after the passing away of his wife to cancer. Fours
prior to the client's grocery store had been handed over to his son, and the couple decided to
travel and enjoy their retirement. Shortly after the wife of the client was diagnosed with
cancer and passed away making the client lonely. The family and friends of the client are
involved in keeping the individual accompanied but inhibited by professional and personal
responsibilities. The eldest son invites the client for dinner on Sundays; the other two
children cannot visit but stay in touch through telephonic communication. The current
dependency of alcoholism might resurface the previous stomach and blood pressure problems
the client faced in his early 20s. Alcoholism has become the client's coping mechanism for
his wife's death and loneliness after his retirement (Blaine and Sinha 2017). A brief
conversation with the client shows that he has lost motivation for living and developed self-
destructive habits.
The immediate health and safety concerns that need to be dealt with are the cessation of
alcohol consumption. Diagnosis for any possible resurging of stomach or liver damage. There
is also a need for improving the quality of life of the client (Ngandu et al. 2015). The client
also needs to be informed about alcohol-related accidents. Given the age of the client, fall-
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related injuries can adversely impact the health of the individual. Therefore it is necessary to
help the client get back to better living conditions.
Kübler-Ross Model
This model was theorised to identify the stages of grief or bereavement in a person’s life. The
model elaborated the emotional state of the individual going through grief by expression of
denial, anger, bargaining, depression and acceptance (Stroebe et al. 2017). In the denial stage,
the individual denies the truth of the situation and takes help of a preferable reality and
believes the false reality without being able to cope with the situation. As per the case study
1, it is the loss of the client's wife to cancer. In the second stage is the expression of anger
when the false reality is shattered in front of the individual, and the reactions of the loss are
expressed in anger due to helplessness. The third stage is the bargaining for the grief where
individual undergoing loss like the client in the case study, negotiates a reformed lifestyle.
This is the reason for Sam, the client and his dependence on alcoholism as a bargain for
seeking a compromise (Hall 2014). The next is the current condition of the client's emotional
state, which is depression. In this stage, the individuals going through loss prefer isolation
and withdraw from family and friends which is the case for Sam's state. In conversation, Sam
stated that alcoholism is relevant for a widower indicating that he does want to improve his
quality of life.
Disease Theory of Alcoholism
This theory was developed by Jellinek towards the end of the 19th century when alcohol
dependence was seen as a disease by psychologists and care providers. The first stage of
alcoholism is the pre-alcoholic phase where the drinker is able to tolerate the drink through
social drinking for alleviating pain or stress relieving approach (Barnett et al. 2018). In the
next stage prodromal stage, the drinker begins consuming alcohol in isolation with or without
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the knowledge of family members. This stage increases the alcohol tolerance of the
individual towards alcohols, and the individual develops the drinking habit quite frequently.
In the third stage of the alcoholism which is the Crucial phase the individual shows
downward spiralling behaviour and drinks in daily life and shows signs of withdrawal. This
affects the relationships of the individual and brings about physical changes in the
individual’s body. This is the phase that the client, Sam in case study 1, is undergoing
currently. Sam is regularly observed to be drinking and refuses to meet his family and friends
indicating withdrawal symptoms from social interaction. If this stage of Sam continues, the
mental and physical health will be deteriorated. The intervention program will aim to revert
Sam to social life and help him cope with the loss of his wife (Kurtz 2014). The last stage of
the disease model needs to be avoided where the drinker has developed physical and mental
deteriorating sings; alcohol has become an important aspect of the drinker's life. The age of
the client suggests that the adverse effects of alcohol ill have increased negative impact since
he is an elderly adult.
Goal Setting
Goal: Verbalisation of the acceptance of bereavement and help the client take responsibility
for their addiction (Moylan 2018).
Objective 1:The social care professional would need to show an acceptance attitude in order
to separate the individual from alcohol dependence (Moylan 2018). This would facilitate the
client’s dignity and self-worth.
Objective 2: The care provider would need to establish a reason for alcohol abstinence for
the client and involve the family members for therapeutic sessions. This action would help
the client gain perspective into the responsible lifestyle and commit to under a behavioural
change that would last a lifetime (Lyons et al. 2014). The client might show signs of denial
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and resist the therapy and give in to the alcoholism during this time. The care provider would
need to be diligent in making sure that the client is away from the alcohol and reassure them
to come back to the therapy.
Objective 3:Utilisation of confrontational techniques by the family members to rationalise
the client's action. In this case, the confrontation by the friends and family of the patient
would be a good counteraction for the resistance. This would also help the acceptance of
reality more quickly by the client and preserve the self-concept at the same time.
Goal 2:The care provider needs to identify the ineffective coping behaviour of the client
along with the establishment of alcohol dependence as a coping mechanism.
Objective 1: Exploration of alternative coping strategies would help distract the client form
the immediate self-destructive activity. The patient needs to be educated about the ill-effects
of alcohol dependence and help them manage their condition (Root and Exline 2014). The
patient can be advised to join a group therapy session to share the pain with other people
facing similar issues. Empathetic therapy might help the patient come to accept much more
quickly.
Objective 2: The care provider can assist the patient in finding relaxation techniques through
visualisation, meditation and guided imagery. Meditation is known to facilitate the mental
stability and decrease stress levels which can be used for the betterment of the client. The
social bonding formed in newer activities will also keep the client busy and inhibit alcohol
indulgence.
Goal 3:The care provider needs to immediately plan the lifestyle changes to help the client
come to adopt a better life quality (Best et al. 2016).
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Objective 1:Involvement of the family and their involvement in the client’s life. Regular
visitations and helping the patient to come out of isolated living might help his condition.
This would improve the survival of the client without alcoholism under constant supervision.
Objective 2:Travelling to nearby destinations might help the client fulfil his unfinished
desire. This would help the client in getting better and enjoying life.
Critical Reflection
In this report, I gained knowledge that there are other neurological and biological factors that
regulate the dependence of alcohol. This would widen my perspective in developing better
evidence-based research. It would help me widen the client consideration and open doors for
strategizing alternatives for treatment. Throughout the case study and report assessment, I felt
that the client's family was not as involved to actually help him recover from his addiction. I
would have suggested for the client to stay with his nearest family member. I am able to draw
this conclusion from my own perspective since I believe in the family values and how it helps
individuals live in a society (Root and Exline 2014). It is usually observed that elderly clients
are prone to accidents when they live alone and given the grief that Sam is facing now. It
might be counter-effective for him to live alone and succumb to depression (Ngandu et al.
2015). There are professional boundaries that will need to remind myself while working in a
similar situation. Although it is my job to conduct an intervention, I would need to make sure
that I am overstepping my authority. I would need to stop taking matters or situations
personally and avoid developing relationships outside of my profession. I would need to keep
in mind the perceptions of culture and religion in case of the patient before conducting an
intervention. This is why the involvement of family is an important step in such cases.
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Conclusion
In summary, the psychological implications of alcohol dependence in social care practices are
not the only perspectives. Understanding other implicative factors help broadening of the care
treatments and intervention strategies. It is important to develop the action plan from before
considering the current situation of the client and involvement of the family. The critical
reflective approach helps to identify the gaps in the care service for the social care workers
and to improve the competency in general.
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References
Barnett, A, I, Hall, W, Fry, C L, Dilkes‐Frayne, E. & Carter, A, 2018,‘Drug and alcohol
treatment providers’ views about the disease model of addiction and its impact on clinical
practice: A systematic review’, Drug and alcohol review, vol. 37 no.6, pp.697-720.
Best, D, Beckwith, M, Haslam, C, Alexander Haslam, S, Jetten, J, Mawson, E&Lubman, D,
I, 2016,‘Overcoming alcohol and other drug addiction as a process of social identity
transition: The social identity model of recovery (SIMOR)’, Addiction Research &
Theory, vol.24, no.2, pp.111-123.
Blaine, S K,&Sinha, R, 2017,‘Alcohol, stress, and glucocorticoids: from risk to dependence
and relapse in alcohol use disorders’, Neuropharmacology, vol.122, pp.136-147.
Hall, C, 2014,‘Bereavement theory: recent developments in our understanding of grief and
bereavement’, Bereavement Care, vol. 33, no.1, pp.7-12.
Kurtz, E, 2014,‘Alcoholics Anonymous and the Disease Concept of Alcoholism’, Alcohol
Problems in the United States: Twenty Years of Treatment Perspective, p.5.
Lyons, E J, Lewis, Z H, Mayrsohn, B G&Rowland, J L, 2014,‘Behavior change techniques
implemented in electronic lifestyle activity monitors: a systematic content analysis’, Journal
of medical Internet research, vol. 16,no.8, p.e192.
Moylan, R.A, 2018,‘Learn to Effectively Minimize Regression and Relapse in Patients with
Emotional Core Therapy’, Acta Scientific Medical Sciences, vol.2, pp.103-108.
Ngandu, T, Lehtisalo, J, Solomon, A, Levälahti, E, Ahtiluoto, S, Antikainen, R, Bäckman, L,
Hänninen, T, Jula, A, Laatikainen, T& Lindström, J, 2015,‘A 2 year multidomain
intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control
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to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled
trial’, The Lancet, vol.385, no.9984, pp.2255-2263.
Root, B L,&Exline, J J, 2014,‘The role of continuing bonds in coping with grief: Overview
and future directions’, Death Studies, vol.38, no. 1, pp.1-8.
Stroebe, M, Schut, H&Boerner, K, 2017,‘Cautioning health-care professionals: Bereaved
persons are misguided through the stages of grief’, OMEGA-Journal of death and dying, vol.
74,no.4, pp.455-473.
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