Topic: Case study
1. Select ONE case study from the three provided below.
2. Outline your chosen social work interventions, identifying core concepts and steps of the interventions, and interagency collaborations as a social worker from the agency.
3. Discuss the reasons for choosing the interventions in relation to the case and illustrate how you would apply the interventions to the case.
4. Examine how the interventions are aligned with social work values and theories such as person-in-environment, strengths, recovery, ecological and/or systemic approaches.
5. Evaluate the interventions and reflect on their usefulness and limitations.
6. Discuss the current development and evidences of the chosen interventions in social work.

Case study 1:
Agency:
The agency is a public community mental health team providing intensive case management to people with severe mental illness. The small multidisciplinary team consists of a consultant psychiatrist,
two psychiatric nurses and two social workers.

Client:
Laura, female, 34 years old, was diagnosed with schizoaffective disorder 7 years ago.

Background:
She has been on numerous types of antipsychotics and mood stabilisers for a long time. Her late husband, Nick had been ensuring that Laura took her medications regularly. When he was her carer,
Laura’s psychiatric condition had been well managed. However, Nick committed suicide one year ago. He was the main breadwinner of the family. Since then, Laura has been using his savings to support
herself for the last year. She also has not been taking her medications as prescribed. Sometimes, she would solicit sex at her place for money. Neighbours had reported to the police many times that
Laura had been threatening them verbally and throwing rubbish at them.

Laura has two boys, Rick, 12 years old and Shawn, 7 years old. They live in a public two-bedroom apartment in Sydney. The neighbours also complained to Housing NSW that Laura’s place was infested
with insects and their apartments were affected as well. Laura and her family moved from East Cape, New Zealand to Sydney 8 years ago. East Cape is one of the most deprived areas in New Zealand.
Laura has no contact with her family members for the last 10 years except her sister, Janice. Janice occasionally visits them to see how they are coping. However, Laura is paranoid of her and
believes that Janice is spying and plotting to harm her.

Presenting problems:
A FACS worker visited the apartment three weeks ago and found the place to be very dirty. The worker also noticed that the boys had not been going to school for the last five days. Laura was
verbally hostile to Mary, the FACS worker, when she asked whether the children had been going to school. Laura started yelling vulgar words at Mary and throwing things at her. Mary ran off and
reported the case to the police. The police came shortly after and arrested Laura. Laura was then brought to the psychiatric ward for treatment. Meanwhile, Janice helped to look after the boys
while Laura was in the hospital.

The inpatient psychiatrist is discharging Laura today as she has responded positively to oral medications. A referral is made to the community mental health team to manage the case in the
community. The psychiatrist has assessed that Laura will not harm her children physically and she has the capacity to be a responsible parent. The FACS worker has opposed the discharge as she
believes that Laura needs a longer hospitalisation and questions the ability of Laura to look after her children herself.

Although Janice would like to help, she is worried that Laura will be mistaken that she is taking the children away from her. Janice is also worried that Laura’s paranoia against her will grow and
may eventually harm her. John, a Housing NSW senior manager wants the mental health team to manage the case properly and expresses his intentions to evict Laura if she continues not meeting her
responsibilities as a tenant.

Case study 2:
Agency:
The agency is a public psychiatric inpatient unit located in a general hospital. The inpatient unit is staffed by a team of psychiatrists, nurses and one full-time social worker. A part-time
psychologist and part-time occupational therapist work on alternate days providing additional services to the unit.

Client:
Trang, female, 24 years old, born in Australia, was diagnosed with borderline personality disorder and Bipolar disorder. She had attempted suicide several times by cutting her wrists and taking
sleeping pills. She also takes amphetamine with her boyfriend. She has a family doctor who has been managing her family’s health for several years. The family doctor, Dr Ferguson has good rapport
with both Trang and her mum. However, mum has problems bringing Trang to see Dr Ferguson to treat her mental illness. Her mum, Binh who has been caring for Trang many years, expresses frustrations
over Trang’s multiple self-harm and suicide attempts. Trang recently lost her part-time waitressing job due to some customers complaining about Trang’s poor customer service and attitude.

Background:
She was raised by her mum in a single-parent Vietnamese family. She was physically abused by mum’s boyfriend when she was young. She told mum before but mum did not do anything. Binh eventually
broke up with her boyfriend when Trang was 16 years old.

Trang’s brother, Simon is an IT engineer. He is married and has a two-year old child. Simon seldom talks to Trang because of her behaviour and frequent readmissions to the hospital. He however
visits mum regularly.

Mum is currently looking after Trang’s 5-year-old daughter, Megan. Megan has just started pre-school this year. Her teacher notices bruises on her limbs. Megan also displays disruptive behaviour in
class, often snatching toys from other children and spitting at them. Her teacher, Jan is concerned about Megan’s behaviour. She met up with both Trang and Binh last month. Binh apologised for
Megan’s behaviour but Trang was crossed with Jan for interfering with non- school related areas.

Presenting problems:
Trang was recently admitted to the psychiatric hospital for relapse. She was shouting loudly outside Megan’s pre-school during pre-school children pick up time. Jan was worried over the safety of
Megan and other children and called the police. The police questioned Trang and assessed that Trang might be experiencing hallucinations. The police brought her to the inpatient unit for admission.

At triage, Trang said that she broke up with her boyfriend two weeks ago. Her boyfriend is a street drug peddler. She has not been taking her medications regularly. Regarding the incident outside
the pre-school, she denied shouting at anyone and said that the police arrested her wrongly. She said that the police should have arrested Jan instead as Jan was accusing her. The psychiatrist
believed that Trang’s illness is stable and an admission is not necessary. Trang thinks that she is fine and wants to go home soon. She wants to send Megan to another pre-school. She was referred
to the unit social worker for counselling and case management.

Case study 3:
Agency:
The agency is a non-governmental organisation which provides one-to-one counselling services, home-based outreach and case management to youth with relationship, behavioural and/or mental health
problems. Most of the staff are social workers and counsellors.

Client:
Michael is 18 years old and currently in year 12. He was first seen by an early psychosis team two years ago. Since then, he had multiple admissions to the psychiatric unit. Being small in size, he
was constantly bullied by bigger boys in his primary school. One day, he was so frightened that he avoided school and hid in a drain. His diagnosis has been revised to schizophrenia recently. When
unwell, he has auditory hallucinations of a lady calling him names. He also believes that the bigger boys are tracking him and will return one day to hurt him. Regarding his illness, he believes
that he is not mentally ill and does not take his medications regularly. He has started taking ecstasy six months ago.

Background:
He is the eldest child of the family. His father, John works long hours as an accountant. His mother, Susan works part-time in a bakery. Michael’s two siblings are David, 10 years old and Pauline,
7 years old. His parents have high expectations for them to excel academically and be successful in life. Due to Michael’s illness, Susan has recently been experiencing frequent headaches, insomnia
and fatigue. John continues to work long hours to support the family. John thinks that Michael is lazy and needs to think more positively to get out of his condition. Michael’s teacher, Mrs
Hamilton wants to know the progress of Michael’s treatment and his plans for his studies. She also wants to know how she can support him in school.

Presenting problem:
Michael does not have many friends. He recently met a girl, Charlotte. They got along very well. Charlotte was from a well-to-do family. She was also doing very well in school before knowing
Michael. After meeting Michael, she started to skip school and taking illegal drugs. Two weeks ago, after taking illegal drugs together, Charlotte committed suicide. Michael was devastated and had
a relapse. He was admitted to a psychiatric hospital for treatment. His condition improved and he was discharged home.

His parents wanted him to continue his education. John felt that Michael had already brought much embarrassment to the family and it would bring further shame to the family if Michael dropped out
of year 12. Although Susan wanted Michael to complete his studies, she is also worried that he would have difficulty coping with his studies and may experience another breakdown. As for Michael, he
is not too concerned about his studies now. He feels guilty that he caused Charlotte to die. Since discharge, he has been lying in bed at home and staring into the ceiling. He still feels very sad
over her death and misses her very much.

The hospital social worker referred Michael to the agency to provide counselling and manage his case in the community. Michael has outpatient appointments with the psychiatrist to review his
illness. In view of his safety and treatment issues, his psychiatrist plans to put Michael on a community treatment order. Mum is keen for him to see a counsellor but he is hesitant to do so.