Running Head: EVALUATION OF PRACTICE REPORT

EvaluationofPracticeReport
JeliannCarrillo
SW4442
WayneStateUniversity

Running Head: EVALUATION OF PRACTICE REPORT

Biopsychosocial
IDENTIFYINGINFORMATION:SamanthaisavoluntaryclientattheNationalCouncil
onAlcoholandDrugDependence(NCADD).Sheisa60yearold,singleBlackfemale
withonesonwhois34.Samanthaisseekingtreatmenttodealwitha40yearcrack
addiction.
PRESENTPSYCHIATRICILLNESS/SYMPTOMS:Clientreportslossofappetite,
isolation,feelingsofloneliness,lackofmotivation,insomnia,anxiety,signsof
depression,helplessness,extremewithdrawalswhenattemptingtoquit,anduses
expressionsofguilt(Iportrayawellcomposedlawabidingcitizenbutbehindclosed
doorsImgettinghigh).
PASTHXOFTREATMENT:Clientreportsonepriorattempttoseekhelpforher
addictiontenyearsagoforwhichshesoughtanarcoticsanonymoushelpgroupwhich
shequitaweeklaterafterfeelinglackofconnectiontomembers.Shealsoreportsseeing
acounselorforafewtimesfollowingtheexpulsionofherjob.Clientdoesnothave
medicalcoveragecurrently.
MENTALHEALTHMEDICATIONS:Nocurrentuseofmentalhealthmedications.
MEDICALCONCERNS:Clientreportshavingfrequentheadaches,diabetes,andhigh
bloodpressurewhichsheisonmedicationfor(Motrin,Insulin,Diovanrespectively).She
denieshavinghistoryofsurgeries,terminatedpregnanciesordisabilities.

Running Head: EVALUATION OF PRACTICE REPORT

CURRENTMEDICATIONS:Clientreportstakingoverthecounterpainrelievers,
Insulin,andDiovan.Clientexpressedconcernaboutnotbeingabletoaffordmedication
withouthealthinsurance.
DEPENDENCY/ADDICTIONHISTORY:Clientreportsfirstuseofalcoholatage15,
drinkingatsocialgatherings.Shedeniesbeingdependentonalcoholbutreportsshe
drinksoccasionally.Clientopenlyadmitstocontinuingtoabusecracksincetheageof20
asherprimarydrug.Sheisadailyuserandsmokesatleasttworocksperday.In
addition,clientreportssmokingcannabisatage17.Shecontinuestoabusecannabisat
leastthreetimesperweek.
FAMILYHISTORYOFPSYCHIATRIC/ADDICTIONILLNESS:Clientreportsher
fathersufferedchronicalcoholismanddiedofkidneyfailure.Hermotherabused
cannabis.Bothparentsusedinherpresenceoftenifnotdaily.Clientadmittedto
believingthiswasanormalbehaviorwhengrowingup.
SPIRITUALITY:Clientwasraisedinanextremelyreligioushomeandattendschurch
regularly.ShefoundcomfortintheBaptistchurchandhascontinuedattendanceand
involvement.Shereportsbeingmoreactivenowinthechurchsinceshelostherjob.She
reportsguilttobeinvolvedsinceitishypocriticalofher(personalcommunication,
2015).Sheemphasizesthestrongsupportsystemshehasestablishedatchurchdespite
theguiltyfeelingsoflivingadoublelifenooneknowsabout.
PERSONALHISTORY:Clientistheoldestofsevenchildrenwhoseparentswerenot

Running Head: EVALUATION OF PRACTICE REPORT

legallymarried.Theparentsremainedinthehomeuntildeathandthechildrenmoved
out,astheygrewolder.Shereportsherparentshavingastrainedrelationshipbecauseof
thefathersalcoholabuse.Sheremembersherfatherbeatinghermotheronmultiple
occasions.Motherwasaschoolbusdriverandfatherwasageneralassemblyworkerat
FordMotorCompany.Motherhadtwochildrenpriortoherengaginginarelationship
withtheclientsbiologicalfather.Bothparentsarenowdeceased.Shereportsbeing
excludedfromfamilyreunionsduetoheraddiction.Shedoesnotseehersiblingsvery
often.Hersonwhois34yearsoldhasdisaffiliatedhimselfandhisfamilyfromheralso
forthesamereason.
EDUCATION:Clientcompletedhighschoolandcollegewithabachelorsdegreein
education.
WORKHISTORY:Clientstartedoffasawaitressbeforepursuinghighereducationand
becominganelementaryteacher.Clientiscurrentlyunemployed.Shewasafifthgrade
teacherfor35yearsbeforeshewasterminatedforphysicallyassaultingoneofher
studentafterbeingcalledabitch.ClientwasterminatedinApril2013,threemonths
shyfromretirement.Shethenlostallofherretirementfundsandwasfacedwithmassive
courtcharges.
LEGALHISTORY:Clientiscurrentlyfacingassaultcharges.Thosechargesarestill
pending.
MARITAL/RELATIONSHIPS:Clientwasneverlegallymarried.Herlongest

Running Head: EVALUATION OF PRACTICE REPORT

relationshipwaswiththefatherofherson(3years),whichendedshortlyaftershe
becamepregnantwiththeirchild.Shereportsahistoryofbriefrelationshipsafterthat,
whichcametoanendbecauseofherpreferenceofdrugsoverrelationships.Sheadmits
toonephysicallyandverbalviolentrelationshipwhichendedafterthreemonths.Shestill
hasarestrainingorderagainsttheindividual.
MENTALSTATUS:Clientappearsverywellgroomedandprofessionallydressedfor
everymeeting.Sheiscalmandcooperative.Shedoesnotshowanysignsofphysical
withdrawals.Sherespondswellduringconversationsandisveryinsightfulinherreplies.
Hermoodisusuallypositive.Herspeechisverysternandherthoughtprocessappearsto
belogical.Theclientstonechangesdependingonthetopicofdiscussionandherpassion
towardsthetopic.Sheisoutspokenanddoesnotfearjudgment.
SUMMARYIMPRESSION:Samanthaisaisvoluntary60yearold,singleAfrican
Americanfemaleseekingtreatmentfordrugaddictionwithenvironmentalcontributing
factors.
SHORTTERMGOALS:Clientexpressesconcernovernothavinghealthinsurance.
TogetherwewillsubmitanapplicationforObamaCaretogetheraffordablehealth
insurance.Wewillalsoupdateherresumeandbeginjobsearching.Clientwillbe
educatedontheimportanceofselfcareandacquirenewhobbies.Clientwillalsotry
contactingherson.Nextsessionwewilldevelopatreatmentplan.
Interventions
AsprofessionalsocialworkersitisimperativethatweuseEvidenceBased

Running Head: EVALUATION OF PRACTICE REPORT

Practices(EBT).AccordingtoAGuidetoEvidenceBasedPractices,EBPisthe
integrationofclinicalexpertise;expertopinion;externalscientificevidence;andclient,
patient,andcaregiverperspectivessothatproviderscanofferhighqualityservicesthat
reflecttheinterest,values,needs,andchoicesoftheindividualsserved(2015).At
NCADDsocialworkersareexpectedtoengageinEBTbecauseitistakingempirical
researchandapplyingittoyourpractice.ItisimportanttouseEBTbecausethisisa
populationthathasbeenheavilystudiedformanyyears.Nowthatsubstanceabuseand
alcoholismisbeingviewedasachronicdisordermanystudiesarebeingdonetoalleviate
theissue.
Manystudieshavebeenconductedtoprovewhatinterventionsareeffectivewith
drugaddicts.AtNCADDthemosteffectiveinterventionmethodisacombinationof
grouptherapysessionsandmeetingwithacasemanagertomonitorgoalsandprogress.
ThismethodhasbeenproventoworkforNCADD.Theagencyusessurveystomonitor
theeffectivenessoftheinterventionandalsotolookforwaystoimprovethem.Thereare
twodifferentgroupclasses,intensiveoutpatientandoutpatient.Patientsarecategorized
aftermeetingwithasocialworkertodeterminetheirpersonallevelofdrugoralcohol
abuse.Forexample,Samanthawouldbeintheintensiveoutpatientgroup.Clientistogo
togrouptherapiesthreetimesperweekandeachsessionisthreehourslong.There,
Samanthaamongstothermembersdiscussdifferenttopicseverydayandreflectontheir
progresswithothermemberwhomaybefeelingthesameway.
AftergettingtoknowSamanthaItooknotethatsheisheavilyinvolvedinthe
communitychurchandthatishelpshercopewithhersituation.Duringheroneonone

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therapysessionsthesocialworkerhasallowedhertobringherbibleandshareascripture
foreachweek.AfterconductingresearchIfoundthatholismisregardedasaneffective
meansofalternativetreatment,andtherehasbeenanincreaseinthenumberof
innovativeholistictreatmentinterventionsindiversefieldsofpractice(Adedoyin,2014).
Holisticpracticesinsubstanceabusetreatmentprogramsencompasstherapiessuchas
expressivetherapy,arttherapy,spiritual,orreligiousinterventions;osteopathictreatment;
acupuncture;andmore(Adedoyin,2014).Althoughthereislimitedresearchonthe
effectivenessanduseofholisminthefieldofsubstanceabuse,thereisconsistent
evidenceofitssuccessinotherareasoftreatmentorcounseling(Adedoyin,2014).A
holisticperspectiveexplainsthenecessityoftreatingallaspectsoftheselftoimprove
successintreatmentandalteredlifestyles.Areviewofthebenefitsandtypesofholistic
interventionsinsubstanceabusetreatmentisprovided,alongwithsuggestionsforfuture
research(Adedoyin,2014).Samanthahasreallybenefittedfromthisintervention
spiritually.
Anotherinterventionthatisbeingusedmoreandmoreisacupuncture.NCADD
hasacertifiedacupuncturetherapist.Shecomesinduringtheirgrouptherapiesand
appliesacupunctureneedlesintheclientsearsthathelpsthemreducecravingsandgain
selfcontrol.Samanthareportsthatsheenjoysthisandthatithasbeenhelpingher.Both
pharmacologicalinterventionsandseveralbehavioraltherapieshaveshownpromising
resultsintreatingcoexistingconditionsamongdrugabusers(Wang,2015).
Complementaryandalternativetreatmentssuchasacupuncture,hypnosis,andmeditation
alsohavebeenusedasatreatmentand/oranadjunctivetreatmentforsubstanceabuseas

Running Head: EVALUATION OF PRACTICE REPORT

wellaspsychologicalillnessintheseclients(Wang,2015).
NCADDalsousesCognitiveBehaviorTherapymodel(CBT)tohelpclientslearn
methodstoavoidsubstanceabuse.CBTisashortterm,focusedapproachtohelping
addictedindividualsbecomeabstinentfromdrugsandalcohol.CBThasbeenshownto
beaneffectivemethodofcounselingindividualswhosufferfromaddiction(NCADD,
2012).StudiesshowthatCBTmodelsareoneofthemostextensivelyevaluated
interventionsforalcoholorillicitdrugusedisorders(Magill,2009).CBTusesfive
strategiesfortreatmentofalcoholordrugs:Identifyingintrapersonalandinterpersonal
triggersofrelapse,copingskillstraining,drugrefusalskillstraining,functionalanalysis
ofsubstanceuse,andincreasingnonuserelatedactivities(Magill,2009)
ValuesandEthicalDilemmas

WorkingwiththispopulationImustreallyunderstandthesocialworkvaluesand
applythemtomypractice.WhenworkingwithSamanthashediscussedthingsabout
drugsandusedslangthatIwasnotfamiliarwith.AfterourinitialencounterIresearched
aboutthatparticulardrugtofamiliarizemyselfwithitandunderstandwhatmyclientis
sayingandfeeling.Iassociatethisasprovidingcompetentcare.AsasocialworkerIhave
toknowalittlebitabouteverythingtobeabletoconnectwithmyclients.Socialworkers
continuallystrivetoincreasetheirprofessionalknowledgeandskillsandtoapplythemin
practice.Socialworkersshouldaspiretocontributetotheknowledgebaseofthe
profession(Socialworker.org,2015).
Anothervaluethatisvitaltotheclientsrecoveryisdignityandworthofthe

Running Head: EVALUATION OF PRACTICE REPORT

person.Thisisapopulationthatisextremelyneglectedandjudged.Accordingtothe
NCADD,Socialworkersrespecttheinherentdignityandworthoftheperson(2015).My
clientalreadyhasfeelingsoflonelinessandisbeingjudgedbyherownfamilymembers,
sheneedsasupportsystemthatwillhelpbuildherupandseesherasahumanbeing.
Lastly,toproperlyserveatthisagencyasocialworkermustunderstandthe
importanceofhumanrelationships.Socialworkersunderstandthatrelationshipsbetween
andamongpeopleareanimportantvehicleforchange.Socialworkersengagepeopleas
partnersinthehelpingprocess.Socialworkersseektostrengthenrelationshipsamong
peopleinapurposefulefforttopromote,restore,maintain,andenhancethewellbeingof
individuals,families,socialgroups,organizations,andcommunities(Socialworker.org,
2015).
Whenworkingwiththispopulationitisdifficultnottobetemptedtostrayaway
fromthecodeofethicstohelpyourclient.Wearesocialworkersandourjobistohelp
people,ourclientalwayscomesfirst.Thesafestwaytohelpourclientsistofollowthe
codeofethicsanddocumenteverything.Anethicaldilemmamanysocialworkersfaceat
NCADDisfailuretoreportclientprogresstoprobationofficer.Manysocialworkers
wanttohelptheirclientsnotrealizingthattheyareenablingthem.
SomethingIpersonallystruggledwithinSamanthascaseisherreadinga
scripturefromthebible.Personally,Ibelievethereligiousaffiliationandbeliefsshould
beseparatedfromtherapy.However,Idoacknowledgethisissomethingthatshetruly
benefitsfromandashertherapistIallowitforherbetterment.Afterreadingthestudyon
holisticinterventionsanditssuccessitissomethingImbecomingmoreopento.

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10

AnotherdilemmaIamfacingisdefiningthesocialworker/clientrules.Itendto
beextremelyfriendlywithmyclientsandsomeofthemevenhavemypersonalphone
number.Afterspeakingwithmyfieldinstructorshetoldmeonecallcouldsavesomeone
fromrelapse.ThisleftanimprintinmybrainthatifImissoneofmyclientscallsthey
mightrelapseanditwouldbemyfault.AfterspeakingtootherprofessionalsinthefieldI
decidedtomakerulesformyself.IdonotanswerlatecallsandIdontentertain
conversationsthatarenotanemergency.Clientsmustlearntotakeresponsibilityfortheir
actionsandselfcontrol.Allowingthemtocallmeeverytimetheyreintroubleis
cripplingthemfrombeingabletofigurethingsoutontheirown.
Lastly,workingwiththispopulationcanbeveryfascinating.Clientshaveshared
withmethingsIhaveonlyheardaboutinmovies.Ifounditverydifficulttocontain
myselffromtellingfriendsandfamilymembersstoriesofclientsatmyinternship.I
struggledwithkeepingmyclientsstoriesconfidential.Confidentialityisextremely
importantwhenworkingwithanypopulation.TheNASWhasformulatedalonglistof
codesunderthePrivacyandConfidentialitysectioninthecodeofethics.Irefertothat
sectionwhenIhaveanyquestionsofwhatinformationIamabletodiscloseandwhenit
isappropriate.Whensocialworkersprovidecounselingservicestofamilies,couples,or
groups,socialworkersshouldseekagreementamongthepartiesinvolvedconcerning
eachindividualsrighttoconfidentialityandobligationtopreservetheconfidentialityof
informationsharedbyothers(Socialworker.org,2015).
.

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Adedoyin,C.,Burns,N.,Jackson,H.M.,&Franklin,S.(2014).Revisitingholistic
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