·       Respond to at least two colleagues by expanding on their posts with an explanation of the bicultural conflict and tension, experienced by both the social work intern and Helen, as a result of their ethnic and racial identities.

 

·      Then, explain how you, as a social worker, might address Helen and her family’s bicultural socialization needs, given what your colleague described.

 

Colleague 1: Lea

 

Introduction

In order to provide competent and effective care, the social worker must be able to adapt and personalize treatment to the individual. When working with individuals from different ethnocultural backgrounds, a balance between cultural sensitivity and empirically proven methodology must be found and utilized (Bernal, Jiminez-Chafey, and Rodriguez, 2009). In the case of The Petrakis Family (Plummer, Makris, and Brocksen, 2014), the social worker is faced with providing services to Helen Petrakis taking into account her Greek heritage, culture and belief systems.

Helen’s Cultural Influences:

For Helen, family is “everything.” She reports the social work intern a number of identifiers of her ethnic identity. She states that she is Greek and practices the Greek Orthodox religion. From there she expresses her cultural practices by explaining that she, as the mother, is the primary caregiver to her husband, her children, and her mother-in-law.  In addition to caring for the family, she also holds down a full-time job and cooks and cleans.  She also relates to the intern that she and her husband support their adult children because they do not believe in taking money from them. Helen does not seem to think this is anything other than “how things are done.”

Intern’s Perception of Helen

The Intern appears to be surprised by the many roles that Helen plays in her family. She states that she understands why Helen would be showing symptoms of being overwhelmed. Though we are not informed of the cultural background of the social work intern, it is made clear that she is surprised by the cultural practices related by Helen. She is most likely a “modern” woman subscribing to the Anglo-based norms, values, and customs of the ethnic minority. It might be assumed that the intern was raised in a society where children are not supported by their parents indefinitely, working women share family responsibilities with their partners, and aging parents are cared for in retirement homes, or by in-home care. Those values held by Helen and her family are devalued by the dominant culture (the intern), therefore a “deficiency formulation” between the intern and Helen that may affect the efficacy of services provided to Helen (Robbins, Chatterjee, and Canda, 2012).

Dual Perspective Model

The social work intern will have to address Helen’s issues in a way that is in line with her cultural and ethnic identity while alleviating the stress and anxiety she is experiencing. In this case, the social work intern can utilize the Dual Perspective model to assist Helen in overcoming the obstacles she faces. Applying assessment skills in order to gain an understanding of the norms, values, and behaviors, as understood by Helen, will inform both the intern and Helen of the expectations she has placed on her by herself, her family, and her ethnic community. Another skill of importance will be assisting Helen to identify her nurturing (family, immediate community) and sustaining (society, educational, service) support systems so that she and Helen can advocate for and work toward additional services to assist in filling in the gaps. Furthermore, the intern can help identify skill building opportunities such as educational programs and cultural studies to help Helen “develop the flexibility necessary” to manage her cultural beliefs while caring for herself as well (Robbins, et. al., 2012).

References:

Bernal, G., Jiminez-Chafey, M. I., & Domenech Rodriguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Professional Psychology: Research And Practice, 40(4), 361–368.

Plummer, S.-B., Makris, S., Brocksen S. (Eds.). (2014). Sessions: Case histories. Baltimore, MD: Laureate International Universities Publishing.

Robbins, S. P., Chatterjee, P., & Canda, E. R. (2012). Contemporary human behavior theory: A critical perspective for social work (3rd ed.). Upper Saddle River, NJ: Allyn & Bacon.

 

Collegue 2: Dalicia

 

A summary of the cultural influences depicted in the video and explain how Helen and the intern’s ethnic and racial identities might be relevant to their interaction.  In the video Helen stated that she is from a Greek family that is very family orientated which means that Helen is the one that supposed to take care of everyone when they need help or is sick. Helen does seem overwhelm but is okay with being overwhelm because she is helping her family out. This may cause a concern with their interaction because the intern may not come from a culture where one individual has to take care of everyone and everything.  Having this concern can cause a disagreement between the intern and Helen because Helen may feel that what she is doing for her family that the intern should understand but due to the intern culture she may not be able to understand.

 

 Explain any video evidence of the intern’s perception of Helen’s culture and further explain how the intern’s cultural perception might reflect her level of intergroup competence.  From the video the intern really do not know anything about the Greek culture so her perception of Helens culture is not clear. Due to intern perception of not being clear in the video it was observed that the intern was trying to write down everything Helen was saying even the things that may not have been important and not really hearing what Helen is actually saying (Laureate Education, 2013). Also feel that since the intern do not know anything about the culture it would be hard for the intern to adapt to Helen issue and family base on the intern own values and beliefs.

 

 Explain what social work skills the intern might use to apply the dual perspective model in her approach to Helen. Robbins, Chatterjee, & Canda (2012) stated that “theterm culture change has traditionally referred to the modifications, revisions, and new manners of expression that result from the process of interaction between cultures.”One social work skill the intern need to use to apply the dual perspective model in her approach with Helen is to first get an understanding of the Greek culture their history and background. This would help the intern understand Helen more and have more understanding about Helen family. Also the intern should also reframe from being bias and have an open mind; every culture is not the same. Another social work skill the intern should use is to ask questions especially questions for the things she do not understand; just agreeing with the client will make it hard to help the client without having a clear understanding.

 

Reference

 

Robbins, S. P., Chatterjee, P., & Canda, E. R. (2012). Contemporary human behavior theory: A critical perspective for social work (3rd ed.). Upper Saddle River, NJ: Allyn & Bacon.

 

 

 

 

 

RESPONSE 2

 

Respond to at least two of your colleagues’ posts from the opposite group about their treatment choice by:

 

·       Discussing any additional important information that should be considered

·       Suggesting an alternative therapy and supporting your suggestion with evidence from the Learning Resources or other scholarly sources.

 

Colleague 1: Dawn

 

Treating Psychotic Disorders

In the case of Ralph who was diagnosed with Schizophrenia, he began to gain a lot of weight and what he thought was a tick (Tardive Dyskinesia, 2017). Taking antipsychotic medication for long periods of time can cause tardive dyskinesia (Tardive Dyskinesia, 2017). Tardive dyskinesia will cause random movements of muscles in different parts of the body (Tardive Dyskinesia, 2017). Some treated with antipsychotic medications will see the sign of Tardive Dyskinesia when taking Merrill for long periods of time (Tardive Dyskinesia, 2017). The current psychiatrist can test for this with “The Abnormal Involuntary Movement Scale” first they can decrease the medication they are currently taken (Tardive Dyskinesia, 2017). If that does not work then try and switch the medication to a milder medication such as Abilify (What Is Abilify ?, 2017).

Potential negative side effects with any of the antipsychotic medication are side effects and may not be right for the person. Most of the medication can cause side effects finding the right medication that will work for the person. Outweigh the person symptoms and the side effects to find the right treatment for them. Identify symptoms that may not be relieved by this treatment because Ralph continued to get the side effects and symptoms when off the medication. It seems as he should be on a medication if the symptoms are increasing worse but he needs to weigh the developing side effects of the Tardive Dyskinesia. Clinically with medication along with psychotherapy have shown to be more effective (Preston, O’Neal, Talaga, 2017).

 

One potential ethical concern related to Ralph’s treatment the Centers for Disease Control (2012) and Prevention research shows too often a client was inappropriate prescribed (Smith, 2012 ). Ralph could have given a test to see if the medication was given him negative effects related to the medication long before he started showing signs. Not to over prescribe or use lesss alternative medications for mental health (Smith, 2012).  The role of a mental health professional when the patient is stabilized on their medication is to monitor and give the “The Abnormal Involuntary Movement Scale” on a yearly basis. Also to ask questions and ensure the patient is taking the medication as prescribed. Also to monitor if there is anything else going on and they are not inappropriate prescribed medication.

 

References

 

Laureate Education (Producer). (2012g). Psychotic disorder case study: Ralph [Video file]. Baltimore, MD: Author.

 

Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., … Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209–1223.

 

Retrieved from the Walden Library databases.

 

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology     for therapists (8th ed.). Oakland, CA: New Harbinger.

 

Colleague 2: Amber

 

Antipsychotic are potential dopamine blockers and were called neuroleptics and caused neurological issues these were the first generation of antipsychotics, the second generation of antipsychotics cause minimal neurological issues and have been known to reduce the extrapyramidal effects by incorporating a less potent antipsychotic (Preston, O’Neal, & Talaga, 2017). Perphenazine is an alternative that can be given to Ralph; it is a second generation antipsychotic that is used to treat schizophrenia. The benefit is perphenazine given in low dosage has the potential to be as effective as the first generation of antipsychotics but does not have as harsh of side effects (Preston, et. al, 2017).  This would be helpful to Ralph who still wants the tics to stop. Perphenazine helped diminish the frequency of extrapyramidal side effects (Lieberman, et al., 2005).

There are as with any medication the possibilities of side effects. The side effects of perphenazine include arm or leg jitters, confusion, seizures, drowsiness, and weakness. There is always the potential that the antipsychotic medication will have a negative impact on the person and make the schizophrenia symptoms worsen( Lichtblau, 2011). There is also the possibility of unpleasant withdrawal symptoms for those individuals who may have taken perphenazines for a long period of time (Preston, et al, 2017).

A mental health professional can use this information to help the client make an informed decision regarding the use of this medication. It is the responsibility of the mental health care professional to make sure the client has all the information needed to make the best decision based on accurate information (NASW, 2013).

The mental health professional should communicate with other professionals but only when a written consent form has been signed by the client. Upholding the client’s right to privacy is very important and obtaining permission to release information to other health care providers is just as important. This communication can help ensure the client is getting the best treatment and that all the professionals are on the same page. This can help eliminate possible medication interactions and reduce side effects (Lieberman, et al, 2005).

 

References

Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., … Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209–1223.

 

Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.  Chapter 4, “Antipsychotic Pharmacotherapy” (pp. 51–62)

 

Laureate Education (Producer). (2012g). Psychotic disorder case study: Ralph [Video file]. Baltimore, MD: Author.

 

National Association of Social Workers. (2013).  Code of ethics of the National Association of Social Workers  Washington, DC.  NASW Press.

 

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology     for therapists (8th ed.). Oakland, CA: New Harbinger

 

Manag. A.J.(2005). Anxiety Disorders in the 21st Century: Status, Challenges, Opportunities, and Comorbidity With Depression

RESPONSE

Respond to two colleagues who identified different empowerment strategies than you by assessing their likelihood of success

Colleague 1: Ladeisha 

Communication:

According to Toseland and Rivas (2017), “Verbal and nonverbal communications are the components of social interaction” (p.68). Communication is the process by which people convey meanings to each other by using symbols. Communication entails (1) the encoding of a person’s perceptions, thoughts, and feelings into language and other symbols, (2) the transmission of these symbols or language, and (3) the decoding of the transmission by another person (Toseland & Rivas, p.68, 2017).   Effective communication is good in areas where clients, co-workers, decision-makers, policyholders, etc, are concerned. Effective communication disrupts down barriers and allows team members to be able to work through their problems, so they can meet their goals.

cohesion

Group cohesion is the result of all forces acting on members to remain in a group (Festinger, 1950). According to Forsyth (2014), cohesion is made up of three components: (1) member-to-member attraction and a liking for the group as a whole, (2) a sense of unity and community so that the group is seen as a single entity, and (3) a sense of teamwork and esprit de corps with the group successfully performing as a coordinated unit. Establishing a group cohesion in a support group allows the participants to become whole and form some type of bond that will help them in their time of distress. The positive quality of a group who has cohesion is that it can solve challenging situations.

social integration

According to Toseland and Rivas (2017), “Social integration refers to how members fit together and are accepted in a group” (p.83). for a group to successfully work, the participants are able to be compliant with the rules and regulations; for example, confidentiality. The group should be able to accept the different cultures and belief system.

Influence

According to Toseland and Rivas, (2017), “In groups with strong social influences, members give up a great deal of their freedom and individuality” (p.83). there can be negative and positive influences to support groups. One negative factor if a person breaks confidentiality. The next negative factor would be not allowing members to express themselves in a positive fashion. A positive influence on a group would be surrounded by people with like issues and being able to be themselves.

Explain the interaction patterns and the level of group cohesion

According to Toseland, Jones, and Gellis (2004), “Interpersonal attraction contributes to subgroup formation and to the level of cohesion of the group as a whole” (p.16). The interaction patterns in the group and the level of group cohesion helps the participants to find themselves and be able to consider themselves powerful.

Describe the social worker’s role in empowering members of the group.

“(Empowerment) suggests a sense of control over one’s life in personality, cognition, and motivation. It expresses itself at the level of feelings, at the level of ideas about self-worth, at the level of being able to make a difference in the world around us (Social Policy, 15, 1985. p. 15-21). As a social worker, I would empower members by helping to realize their strengths. Strengths are something they are good at and or do well such as being a truck driver, barber, mother, etc. The social worker would become involved in what in the engage of the group to ensure no rules are being broken and by doing this, this would empower the group to become bigger and better.

Explain the importance of empowerment in group work and strategies of empowerment that you might implement with this group.

It is important for empowerment to be in a group because the clients are there because they are lacking something whether it is self-worth, love, etc. Or they are there because they are struggling with an ongoing issue. Strategies for empowerment are provided so that resources and interventions are given that will work for the client.

Resources

Festinger, L. (1950). Informal social communication. Psychological Review, 57(5), 271–282. doi:10.1037/h0056932

Forsyth, D. R. (2014). Group dynamics (6th ed.). Belmont, CA: Wadsworth Cengage Learning.

Rappaport, J. (1985). The power of empowerment language. Social Policy, 15:2:15-21.

Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.

Toseland, R. W., Jones, L. V. & Gellis, Z. D. (2004). Handbook of Social Work with Groups, Charles D. Garvin, Lorraine M. Gutierrez, Maeda J. Galinsky: Guilford Publications.

Colleague 2: Damian

Leading group is an essential element of social work practice. As a clinician, there will be many instances were leading or formulating a group will be a huge part of your work. Understanding group, the different types of groups, and how they operate is paramount. Support groups are very popular in social work practice. Especially since they have been demonstrated to provoke fundamental change in client progress, and provide tools that are not received from anywhere else. According to Price, Butow, and Kirsten (2006), although participants in support groups may gain support from family, and friends, but their interest and participation in the support group essentially suggests that there are specific support needs being met in these groups, that are not being met elsewhere. Support groups allow individuals who are dealing with similar conditions, come together, share their difficult experiences, and support each other through it. Often, when individuals deal with severe health issues such as cancer, HIV, etc., or mental health needs, they become isolated and try to deal with these difficult situations on their own. Support groups have shifted this way of thinking, and has demonstrated its effectiveness.

Support groups are a form of evidenced based treatment, and are utilized by social workers, and other mental health providers for various issues. However, developing a support group is not always easy. Understanding group typologies and dynamics are critical. As a group leader, and an expert on the group issue, it is your job to set the tone and develop the dynamics. There are very serious elements to consider: Communication, cohesion, social integration, and interaction.  Group is bigger than sitting in a circle, talking; but it is having the ability to develop relationships, have effective communication about real issues, and work together to synthesize real issues.

Group member’s ability to communicate and interact is a crucial component of group practice. In fact, it is very challenging to lead a group who does not communicate or interact. This is why the leader is responsible for setting the tone, and ensuring all participants feel safe, and comfortable. According to Price, Butow, and Kirsten (2006), the role of the group leader is to encourage the development of group cohesion and structure, to moderate any difficulties and provide any information.

Cancer patients, and other participants of support groups attend these groups because they have a desire to escape their current state of feelings and emotion. This can be fear, anxiety, sadness, depression, etc. This is why the social worker must have the ability to empower the group, and help them overcome their battle with fear and depression. This requires for the social worker to be knowledgeable, and have an engaging personality.  Empowerment is an immense aspect of leading the support group. Clients present with an expectation, and that expectation is to gain some optimism, encouragement, and relief (Price, Butow, and Kirsten, 2006). Knowing that participants have an expectation could be a great way to help with shaping group cohesion, and dynamic. In the beginning, it may be a good idea for the social worker to discuss the purpose of group, but to also include the participants on the goal setting and hopes for outcomes. This ensures that there are no gray areas, and can also help with the reduction of fear.

Reference

Price, M., Butow, P., & Kirsten, L. (2006). Support and training needs of cancer support group leaders: a review. Psycho-Oncology, 15(8), 651-663.