David Story Case Story 2022

The case study, David’s Story
Norma Mallouk
S- HCS310
student number: 11633927
Words count: 2044
Scenario 1:
David is 18 years old and has just completed year 12. He is an only child and lives with
his parents. He has recently recovered from a first episode of psychosis and is being
supported in the community by the community mental health team. His mental health
has shown moderate improvement in response to oral Olanzapine (antipsychotic
medication), but he has marked weight gain which is concerning him. You are David’s
social worker and a member of the community care team.
Question 1:
You are meeting David for the first time. When commencing your professional
relationship with David, (1) what would be the key issues/areas that need to be initially
discussed with him? In your answer consider your role/responsibilities as a community
team member. (2) In your ongoing work, and support to David, what theories of
practice would you look to draw upon (for this you can refer to materials from HCS202
and HCS200 and pages 56-68 of the prescribed text look at issues around therapeutic
relationships).(350 words)
On the first meeting, during the initial professional interaction, the things that the community
worker needs to discuss with David are – first of all, the confirmation of not disclosing the
information of David with others, that is following the basic conception of confidentiality and
safety. Secondly, during the session, no means of any pressure or force should be given on
David and he should be given the space and freedom to discuss his emotions and feelings. An
environment that gives David a feeling of safety and protection must be created by the
community workers to build the bond of trust amongst them. Finally, a discussion on the
influence of societal pressure and criticism experienced by David can be discussed to make
David comfortable and allow him take control on his fears and consciousness. (Hungerford,
Hodgson, Clancy, Monisse, Bostwick & Jones, 2015, pp. 61-107).
A formation of therapeutic relationship should be encouraged to make David comfortable and
by this way, David can easily discuss his problems and medical concerns with the
professional. It is observed that medication exhibit to certain side effects and this may affect
the confidence level of David, hence, a plan to help David manage the side effects of
medicines can be made, at the same time constant motivation to continue the treatment and
improve his health condition should be provided to him. Thus, all these will be the stepping
stones that will take him to his final goal. Furthermore, discussion on david’s personal life
including his family should be initiated and along with the emotions of anxiety of david, the
community workers should also empathize and try to show support so that his motivation and
trust remains constant. On the discussion of such topics, it will give an insight of the stage or

condition of psychosis that David is undergoing, resulting in better designing and
development of intervention planning for him. This in future will help David to achieve his
goal on self-control and wellbeing, both physically and mentally. (Hungerford, 2015, p. 8-
111).
Hungerford, C., Hodgson, D., Clancy, R., Monisse Redman, M., Bostwick, R., & Jones, T.
(2015). Mental Health Care: An Introduction for Health Professionals in Australia (2nd ed.).
Milton, Qld: John Wiley & Sons Australia, Ltd.
Scenario 2:
You have been meeting with David regularly for some months, but he has begun to
avoid your meetings together. The last time you met with him it was clear to you that he
no longer takes his medication regularly. It has continued to be hard to connect up with
David because he forgets your arrangements to meet. In the course of visiting another
community client near where David lives, you encounter him walking alone in the street
and can see that there has been a deterioration in his mental state - that is, he appears
withdrawn, has some low grade persecutory beliefs, and tells you things that might
mean a worsening of auditory hallucinations.
Question 2:
How would you describe David’s current presentation and what strategies/methods
might you use to engage with him? In assessing David, what physical, cognitive and
behavioural risk factors are important to identify? In undertaking this on-site
assessment how would you approach the assessment and what assessment tools would
you employ to guide your observations? As a community team member, what would
you need to do with this information? (400 words)
From the current situation of David, it was quite obvious that David has discontinued the use
of medications and this has led to major hamper in the process of the medical observation and
treatment. Some of the potent and concerning symptoms include depression, isolation and
illusions. One of the major concern or threat associated with the current situation of David is
self-harm due his feeling of being harmed by the community workers. Hence, in such
scenario, the community workers should focus on these problems and make necessary plans
to control the situation.
The necessary actions that needs to be employed by the community workers includes meeting
with David outside the medical premise as this may improve the feeling of comfort and
protection instead of making him feel like a patient. Moreover, there are high chances of
violence that can be caused by David due to his present medical condition, hence, certain
measures such as listening, motivating and empathizing with David can be employed which
will ultimately help in bringing the positive nature of David. Further, to provide more
protection and improve David’s condition, professionals from outside can also be
approached.
To reach the objectives, there are three assessments that can be done- judgement of the
overall appearance and characteristics for better examination of the mental state, evaluation

of the possible causes of isolation from the society and the potential risks associated with it.
Moreover, discontinuation of medication is also commonly seen as weight gain is observed
with consumption of these medications. The community workers may play a major role
controlling the condition of the patients by incorporating activities like education on
psychosis, skills improvement and others. Certain skills or plans can be designed such as
teaching David the importance of continuing medications. Finally, a session on the analysis
and comparison between the previous and current state of conditions can be conducted to
evaluate the steps required to improve their conditions.
As family is an integral part of one’s life, hence involvement of family members in treating
David by the means of showing encouragement and motivation, thereby increasing the rate of
recovery. Moreover, more accurate information about David’s current situations and
symptoms can be obtained from his by conducting interview sessions. This may help in
planning the required strategies for his treatment, based on his current condition. (Hungerford
et al., 2015, p.59-312).
Hungerford, C., Hodgson, D., Clancy, R., Monisse Redman, M., Bostwick, R., & Jones, T.
(2015). Mental Health Care: An Introduction for Health Professionals in Australia (2nd ed.).
Milton, Qld: John Wiley & Sons Australia, Ltd.
Scenario 3:
Six months later David's parents contact you. There has been an incident where David
was caught driving dangerously whilst intoxicated, and his parents report escalating
aggression in their relationship with him. His family has been told by a friend that
David has 'personality issues'. David's family are increasingly contacting your service
and the hospital with concerns about David's mental state and risk, but feel unheard.
Question 3:
In looking at David’s situation, what actions need to be considered to assess David’s
safety and what would consider an appropriate response to the parents? In discussing
this you will need to consider your responsibilities as David’s worker. Also, identify
duty of care/legal issues and that may exist and ethical factors that may arise? (350
words)
On analysis of the current situation of David, it can be observed that there are a lot of
negative effects that are seen in David which includes, driving while being intoxicated,
increased tension and conflict in relationship with his parents and change in behavioural
attitude such as aggression. The possible reasons that is leading to such conditions might be
discontinuation of medicines and therapies. Moreover, isolation from others may also be one
of the reasons of his behavioural changes. Hence, in such scenario the actions that can be
implemented by the community workers can be reanalysis of David’s previous assessments to
understand the reasons behind such changes and thus based on that, the further medical
treatment planning can be done. Moreover, David can be counselled to motivate him to
continue his treatment and medications.