Week 8 6215C Methods of Practice: School-Based Interventions
Beginning at age 4 or 5, children spend most of their waking hours at school. Most states include social workers in the school setting and even require specialized training for school social workers.
This week, you examine school-based interventions. You also discover that working in a school, even if only as a contract social worker, will require skill in dealing effectively with multiple professions and perspectives.
• Webb, N. B. (2019). Social work practice with children (4th ed.). New York, NY: The Guilford Press.
o Chapter 9, “School-Based Interventions”
• D’Agostino, C. (2013). Collaboration as an essential school social work skill. Children & Schools, 35(4), 248–251. Note: You will access this article from the Walden Library databases.
• Quinn-Lee, L. (2014). School social work with grieving children. Children & Schools, 36(2), 93–103. Note: You will access this article from the Walden Library databases.
• Working With Children and Families: The Case of the Rodao Family (PDF)
© 2019 Laureate Education, Inc. 1 Working With Children and Families: Case of the Rodao Family Michael was a 10-year-old African-American male. Michael lived with one younger brother, age 8, and an older brother, age 17, who was in and out of the home due to educational problems at the nearby University. Two additional older siblings did not live in the home: one brother, 23, and one sister, 26, who also just had a baby of her own. Michael and his family lived in middle-class suburban community. Michael was a fourth-grade student at the local city magnet elementary school. He was referred to the school-based mental health provider by the assistant principal. Michael was becoming increasingly defiant and unwilling to comply with the rules and regulations of the school. Michael experienced drastic mood and behavioral swings from day to day. He would be a model leader one day, and then the next refuse to follow any directions and be a distraction to the entire class. Michael argued with his teachers and refused to complete assignments. During class, Michael would beat pencils on the table, attempt to talk to anyone around him, or try to engage the entire class. At times, he became physically and verbally aggressive with peers. Michael would be intentionally annoying to others and spent more than 50% of the school day in the office 2 to 3 times a week. Michael had not received mental health services before being referred, and it took several months to foster buy-in from Michael’s mother. Michael’s home life had always been chaotic, with many moves and instabilities. Michael did not know his biological father growing up, but he did have a stepfather in the home until he was 9 years old, when his stepfather died from an opioid overdose. After this, the family moved closer to Michael’s mother’s family at this time, and Michael’s biological father began to reach out © 2019 Laureate Education, Inc. 2 for a relationship. Before his stepfather died, there were several instances of domestic violence in the home. Michael’s mom always believed that the children never saw any of the violence, but they lived in the same home and heard the fights and arguing. Before Michael’s stepfather died and the family was forced to move, Michael was a “model” son and student in previous schools, according to his mom, school staff, and by self-report. He was a leader in his class and was on the A/B honor roll. Since starting at his new school, Michael was emotionally dysregulated and outraged. He was no longer able to focus and became easily irritated. Michael still wanted to be a leader, but his erratic moods and aggressive behaviors hinder his ability to do so. Michael has also watched his brother go through student court, dean’s review, and eventually be expelled from his educational program due to getting caught drinking while underage. After the move, the family struggled to find stability and security. Michael’s mom had a difficult time finding a job, and because of this, after 6 months in the area, the family found themselves in a situation where their house was being foreclosed on and they had to move in with extended family. This move put the family in the middle of one of the most rural parts of the area. Michael’s level of insight into his behaviors and thinking patterns was very high. He was able to process cognitively appropriate and inappropriate responses to situations when he is in a calm state of mind. Michael was an intelligent young man and was able to use that intelligence to connect his thoughts and his feelings. He wanted to be a good role model to younger kids and was helpful in working with kindergarteners in the mornings at school. The recommended treatment was outpatient therapy within the © 2019 Laureate Education, Inc. 3 school, as well as family sessions to address the stressors in the home setting. Michael’s goals for treatment were to increase his ability to maintain appropriate interpersonal relationships and regulate his emotions as evidenced by participating in cognitive-behavioral therapy, identifying 5 contributing factors to his “bad attitude”; complying with adults 4 out of 5 times on the first prompt; processing past traumatic events; learning, practicing, and implementing 5 emotional regulation skills; and learning self-regulation. Therapeutic rapport building was the first step I took with Michael and his family. The family needed support to be able to process events and talk about emotions. Michael responded to the positive attention, but his mother remained guarded and unwilling to participate actively. Cognitive-behavioral therapy (CBT) was the modality of choice. Michael was able to connect to the thinking strategies and identify how thoughts and feelings are linked to each other. Michael and his family struggled to open up about personal emotions and the history of violence and abuse within the household. I spent a lot of time during family therapy sessions discussing appropriate and inappropriate ways of communication. Just a few months after Michael began services, the family moved away. To find a job, mom moved the family out of state with a month left in school. The family did not engage in any mental health services while living in another state. At the beginning of the new school year, the family had moved back and intro a lower income neighborhood and reentered mental health services in the school. The family’s new neighborhood was not as chaotic, but was a home to one of the city’s major gangs. Upon Michael’s return, his symptoms were more severe, including becoming more © 2019 Laureate Education, Inc. 4 physically aggressive with peers. Therapeutic rapport had to be reestablished, and my consistency and follow-through became an important factor in that development. After returning to services, Michael’s mom refused to acknowledge that there were any concerns at home and be directly involved in treatment. The interventions at this point were directly focused on Michael individually, but I still attempted to call his mom every other week to engage her in Michael’s progress and discuss any concerns from home. Michael was engaged during therapy sessions, initially learning selfregulation activities such as blowing up balloons to practice deep breathing, muscle relaxation through trying to move walls, and coloring Mandalas. After engaging in the self-regulation activities, Michael and I began to focus on CBT techniques. Michael learned to process a situation and identify how automatic thoughts affected his feelings and behaviors when separated from the situation and in a calm state of mind. Michael was able to identify some of his automatic negative thoughts. He was unable to talk specifically about traumatic personal events or any related feelings, but did engage in discussions about trauma and trauma responses as well as the effects of trauma on thoughts and feelings. I showed Michael how trauma can affect the brain using the diagram of our brain as a fist with our fingers being cognitive processing, our thumb as the trigger to fight, flight, or freeze, and our palm as the survival part of the brain. Michael related to this demonstration and was able to identify being in the survival part of his brain when he is angry and that he is unable to access the cognitive part of his brain. Michael was unable to meet his goals, and his behaviors in the school setting continued to be out of control. Michael was unable to identify and acknowledge any © 2019 Laureate Education, Inc. 5 trauma experiences in his past. He will continue working toward his goals and being able to transfer the strategies he has learned to times when he feels out of control. Michael’s family will be the biggest challenge moving forward, and getting their involvement is a crucial factor in the success of treatment. It would be beneficial for the family to become involved in a higher level of care, such as intensive in-home or possibly multi-systemic therapy. Reflection Questions 1. What specific intervention strategies (skills, knowledge, etc.) did you use to address this client situation? There were many different strategies that I used. The first was to provide consistency for the client’s life. I also utilized my knowledge and training in trauma services a lot with this client. He presented with a lot of indicators of trauma, so it was important to use this knowledge throughout all of the treatment. 2. Which theory or theories did you use to guide yourpractice? Cognitive-behavioral therapy was the theory that guided most of the interventions, along with the Aim Forward model of trauma-informed care. 3. What were the identified strengths of the client(s)? The client was smart and compassionate and possessed good leadership skills. He likes helping others and working with younger children. 4. What were the identified challenges faced by the client(s)? © 2019 Laureate Education, Inc. 6 The client’s mother was a challenge because she was not trustworthy of others. There was a history of violence in the home as well as substance use. Other challenges included the family’s transiency and making multiple moves during treatment, including to another state. 5. What were the agreed-upon goals to be met to address the concern? The primary goal was to regulate the client’s mood and behaviors. The client’s mother was less agreeable to goals that involved processing past events and relating to emotions. 6. Did you have to address any issues around cultural competence? Did you have to learn about this population/group before beginning your work with this client system? If so, what type of research did you do to prepare? The family was African American, and so I was aware of many cultural differences from personal experience and school. In this case, the mother, in particular, appeared to be not as open to having a white woman work with them, although this was never stated. It became necessary to be honest and ask the family to teach me about things that may be different culturally for them from me. 7. What local, state, or federal policies could (or did) affect thissituation? This family was impacted by poverty and the criminal justice system. The state and federal policies that govern welfare, food stamps, and housing played a significant part in the family’s ability to stay in one place. 8. How would you advocate for social change to positively affect this case? © 2019 Laureate Education, Inc. 7 In this case, I would advocate for better education within low socio-economic neighborhoods in order for those communities to have a better understanding of mental health concerns and help to destigmatize receiving therapy services. I would also advocate for more programs to assist and work with youth that have a parent that is incarcerated. This is a unique population that does not get the support that they need. 9. Were there any legal/ethical issues present in the case? If so, what were they and how were they addressed? There were legal issues that were involved with the family, but at this time, there have been no legal concerns directly with the client. The client’s stepfather was dead due to an overdose, and the client’s older brother was expelled from college due to possession. This was an open topic of discussion during therapy sessions to assist the client in processing how their involvement with substances affected him. 10. How can evidence-based practice be integrated into this situation? All the interventions used were evidence-based practices, from cognitive-behavioral techniques to breathing exercises to trauma-informed care. 11. Is there any additional information that is important to the case? It is important to note that this client’s younger brother was involved in mental health services. The mom did not trust the school and being a therapist in the school was a barrier that had to be addressed. The mom was more engaged when she understood that I did not work for the school. 12. Describe any additional personal reflections about this case. © 2019 Laureate Education, Inc. 8 This case is a complicated case because the family was not very involved and at times resistant and destructive to therapy. Some families are difficult to engage, but that does not mean that continually trying to build that rapport is not important. It was important for me to remember that poverty, in this case, was generational and that this mom has also had a difficult life. This case is a good example of meeting a family where they were, and that meant being supportive and working one on one with the client until the mom is ready to buy into treatment and not forcing family therapy because I thought that would help.
School-Based Social Work: A Case Analysis
Review the Case of the Rodao family from this week’s Learning Resources.
submit a 2- to 3-page paper addressing the following:
• Briefly summarize the case.
• Identify the specific social work roles demonstrated by the social worker.
• Identify at least two additional community professionals you would invite to support the Rodao family once the social work services have terminated and what you hope they could offer.