The term bio-psycho-social refers to the case relating to or concerned with the psychological, biological, and social aspects in distinction to the biomedical characteristics of a disease. Biological is the somatic caused susceptibility. Each of us is a person, and there can be some organic disparities, which can only be determined by distinct tests or examinations. Experts believe that each person has personal responses to the world and that we have different degrees of neurotransmitters in the brain. Psychological can be any transformation that may cause nervous tension to an individual. Nervous tension is a reaction of the body to any stimulation. Any psychological issues rely on the social relations and the environment.
This paper aims at coming up with relevant information from a client and formulating a five axes diagnosis based on the information. The will explain in detail a case bio-psycho-social case formulated from the information of the client. The first part of the paper will deal with identifying the client information and then the following section will deal with the case formulation. This presentation of theoretical knowledge will help the learner to apply the information to her diagnostic work with clients.
The case formulation will involve attempting to bring together a number of influential factors from the client information and creating a summary of the case and its many facets. For instance, a client comes to seek advice, and in the process, the social worker manages to get information from the client. The main factors should be from the client’s pedigree, history, functional status, and resource information. The cognitive behavioral therapy and Erikson’s theory on development will be adopted.
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Name: Joanne Welkins
Race/ Ethnicity: African American
On a Monday morning, a lady walks into the office and says “ I want to stop abusing my child.” Joanne Watkins had sent her ten-year-old daughter to the stores to purchase some groceries on a Sunday afternoon. On her way, the daughter – Susan met some of her friends who accompanied her to the stores. Being young girls and many of them, they started playing games and Susan lost track of time. She forgot that her mother was waiting for the items, as she was engrossed in the games. Unfortunately, while playing she misplaced the money she was to use in buying the groceries. She had to go back home late in the evening and without the groceries. This exceedingly upset Joanne and with an intention of disciplining her daughter hit her on the head making her lose consciousness. Susan had to be admitted to hospital. This event led to Joanne coming to the offices seeking the help of social work services.
Joanne Watkins, born thirty years ago came from a home of two sisters, and two brothers is the eldest of the family. The mother is a single mother and a stay home mother who relies on other family members for help. When Joanne’s mother was pregnant with her, she underwent an extremely painful rape case and assault. One day as she was walking home, she met three men who raped and assaulted her taking with them all her possessions. Luckily enough a Good Samaritan came by and rushed her to the nearby hospital where the doctors managed to save her pregnancy. This has been remarkably traumatizing to Joanne’s mother, and she has lived with the experience ever since. When growing up, Joanne lacked motherly love from her mother, as the mum was too depressed to take care of her. Most of her childhood Joanne spent at her grandmother’s place and since her grandmother’s income was not that much to sustain her through school. Her highest level of education is a high school, which she did not excel. Joanne’s pre-school was in the neighborhood of where the grandmother lived, and the institution was not that fabulous. Due to her low level of education Joanne’s employment record is not encouraging. For the last two years, Joanne has been serving at a café as a waitress, which has been her only source of income. Before that, she had been working at another café out of town. Joanne’s medical history is agreeable with no notable, serious illness or diseases. There are no records of any adverse health or hereditary diseases in their family either.
Joanne’s current family is a single parent family. A single mother raised her, and the extended family was present. The aunts, uncles, cousins, and grandparents played a significant role in Joanne’s life as she grew. She has two brothers and two sisters. Joanne is a single mother with one daughter- Susan, and she stays alone in the neighboring estate to her mother. Originally, Joanne’s family is from Mexico, and they have in the United States for the longest time possible. Joanne has never been to Mexico but gets these stories from her mother who has been at Mexico countable times. Joanne has no idea about the origin of the father as the mother refuses to disclose any information concerning the father. As far as her immediate families are concerned, there have been no reports of poor medical history. There are no notable hereditary diseases or chronic diseases in the family.
One of the notable life events in Joanne’s life is when her grandparents passed away in a greasy road accident. It was sudden death for the two as it happened while they were travelling and their car was involved in a greasy road accident. They did not manage to come out of it alive. This was traumatic to Joanne as her grandparents were the best thing in her life. They had raised her, taken her to school, and they were still providing for when they passed away leaving her in the darkness. She had to find a way of raising her own income by looking for employments so that she can survive. Her economic situation is average as she manages to pay her own bills, educate her daughter, and support her mother and siblings. According to Joanne, she gains her emotional strength and spiritual support from a nearby church where she has been attending from a tender age. She participates in many church activities including being on the church choir.
From the above information, from the client, it is evident that she is suffering and her problem originates from her childhood. The fact she never had a maternal connection with her mother makes her react negatively to her own daughter. The constant physical and verbal abuses she hurls at her daughter Susan are what she underwent as a young girl. The mother was never caring and did not ever apply the dialogue method in solving any dispute they had. When she did something, wrong the mother would discipline her physically and verbally, regretting she never died when she was raped and assaulted. Her economic stresses are affecting the way she handles her daughter. She has too much pressure from both ends to meet the needs of the family, as well as the needs of her mother and siblings. The death of her grandparents is also a contributing factor as from then she has lacked people or someone she can confide in and seek help.
According to Erikson’s, developmental theory each stage in a growing person is vital as it helps in the development of various traits that a person requires in life (Child Development Institute, 2004). For instance, the first stage is of trust versus mistrust where a child builds up a sense of trust with the people around especially those feeding the child. The next stage of autonomy v. shame and doubt are when the child needs to build a sense of personal power over physical skills and logic of autonomy. The initiative v. guilt stage a child explores its surrounding and the children start to emphasize control and supremacy over their surroundings. Industry v. inferiority stage is when children start to cope with new academic and social demands (Child Development Institute, 2004). Following this is the adolescent stage where most children tend to be confused and in need of an identity. There is also the stage of intimacy v. isolation, which involves young adults urge to create intimate, loving relationships. Later on in life there is the generatively and stagnation stage that is all about work and parenthood.
In Joanne’s case, there were several impacts as she grew up, and this is evident in what she has become as a parent and adult- an abusive mother. At the first level where she was in need of trust from her mother, the mother was in depression and did not have time for her as an infant. Her extended family members were the only people who were there for her as a child, but, they were too preoccupied their own families and lives. What she picked from this was negligent motherhood traits and we can see this in the way she is raising her daughter. Some of the conflicts that are present in this case due to developmental stages are identity issues, parenting tactics, which involve how to discipline a child, and lack of dialogue between children and parent.
In this respect, the cognitive behavioral therapy (CBT) model will be adopted. This model attempts to address the patient’s thoughts and mainly lays emphasis on personal interpretation. Such distorted perceptions are mainly the root cause of emotional turmoil. This particular patient has had a troubled childhood. Consequently she normally suffers from spans of depression and self pity. Adoption of the CBT is highly appropriate as she will be assisted to change her thoughts (CARMH, 2007). The patient needs to overcome her past problems and realize that her present life can be pleasant. Moreover, she should be empowered to feel optimistic. Shutting off disturbing thoughts and instead embracing peaceful, rational thoughts, is going to lead to recovery. As it stands, her bitter childhood experience is adversely affecting her relationship with her children.
The available resources that can help the client are counseling sessions and forums where she can learn some parenting tactics and methods. There are various seminars and workshops that the client can engage in and learn how to raise her child without having any negative impact on her. Some of the primary defense mechanisms that the client used in justifying her case are that her mother raised her in the same way, and she turned out just ‘fine’. In addition, she claims that her mother’s way of raising them made her, and her siblings to fend for them in this cruel and difficult world.
The most reasonable recommendations for Joanne are that she first attends counseling sessions as the incident where she almost killed her only daughter has traumatized her. In the process, she will learn to accept that it was an accident and that her way of disciplining the child was wrong. In addition to counseling, Joanne needs to attend parenting classes, seminars, and workshops where she will get more information on how to raise her child. The support of parents and friends is another significant element that will see to her resolving of parenting issues.