Risk and Safety Assessment Case Study

I believe that we as social workers have to be a strong support for many individuals. Everyone is different in his or her own way, as we know in social work. In saying that, we have to be able to assess, facilitate, and terminate in an appropriate matter. If we as social workers can do that, it can promote a social change in our society. Mrs. Doe is a 36-year-old Caucasian woman who is currently married. Mrs. Doe has two children, whose ages are three and twelve years old. Mrs. Doe has been struggling to keep the family together since the recent death of her previous husband. Mrs. Doe received the agencies’ attention in regard toregards to a report made about her family. Mrs. Doe was alleged of recently getting married again and using drugs after the death of her husband. The husband committed suicide, and it is possible that Mrs. Doe was present. The mother has actively been using drugs since her remarriage and the death of her husband. It is noted, that the excessive drug use by the mother, brought the children in to state custody and placed in foster care. In the circumstances, the mother was cooperative and overall open about her use of drugs. Mrs. Doe does appear to be struggling with drug use and possible mental health issues. However, if Mrs. Doe is willing to use services provided to address her areas of need, there is belief that she can being an effective, helpful, and caring parent. In order for social workers to be helpful, measuring the needs for clients are very important. There are many ways of pinpointing the exact area of needs so the needs are measured and met. Areas of Mrs. Doe’s lives that are in particular focus are assessing the safety and risk of the children, substance abuse and mental health status. When we as social workers get involved, it is important to be on the same level as our clients so we can built a rapport and a understanding of the client. When discussing information with a client, appropriate services are identified, in order to meet needs and know the readiness of the client (Roberts, 1997). In doing this, it allows for the worker and the client to develop a plan that is appropriate for specific needs. Measures that that could be used to identify or assess clients’ needs could be safety and risk assessment, alcohol and drug assessment, and a psychological evaluation. Assessing safety and risk is an important tool for all child welfare workers. It allows us to have an immediate look at what is going on in the now and a sense of what could be in the future. Safety assessments identify an imminent threat of harm by using a checklist to assist workers on ensuring safety of a child (Wells & Correia, 2012). Furthermore, risk is long-term likelihood of maltreatment and this is addressed after the conclusion of a safety assessment evaluating the family (Wells & Correia, 2012). Moving on, another way to assess needs would be an alcohol and drug assessment. It is important for us to know the probability of a substance disorder if that is an issue that is present for the client. A common tool used to address this issue, is the Substance Abuse Subtle Screening Inventory (SASSI). The purpose of this tool, is to detect substance use based on validity regardless of honesty or motivation (Feldstein, S. W., & Miller, 2007). The final way to assess the area of focus could be through a psychological evaluation. There can be many reason to what causes mental health issues for an individual. Some causes for mental health issues could be hereditary, death, trauma, and so on. Regardless, mental health in a community is very important to address. When a psychological evaluation is conducted, there are two common tools used, Beck Depression Inventory and Beck Anxiety Inventory. The tools were developed for assessing and screening anxiety and depressive symptoms at a low cost and efficient rate (Eack, Singer, & Greeno). Using these tools can effectively make a diagnosis and provide needed recommendations. At the end of the day, assessment is an integral part of allowing our client to meet their goals. Assessment can affect the decisions and other aspects of life. When we are assessing, we are allowing them to have the potential to learn, make changes, and most importantly meet their specific needs. As stated above, Mrs. Doe is a 36-year-old Caucasian female with two children, ages three and twelve. Mrs. Doe currently resides alone due to her most recent husband’s incarceration and both her children currently in state custody. During Mrs. Doe’s Safety and Risk Assessment, found that Mrs. Doe does have appropriate housing, transportation, and no income. Furthermore, Mrs. Doe complains of feeling “stressed” and “unmotivated” due to the separation of her husband, losing her children, and having financial issues. However, Mrs. Doe does rely on her Southern Baptist religion for comfort. This is not the first time Mrs. Doe has expressed having depressed feelings. Mrs. Doe has disclosed of suffering from witnessing the suicide of her father and the suicide of her second husband. Mrs. Doe has never received formal treatment for either loss. Before the death of her father, both her mother and father raised Mrs. Doe. Mrs. Doe has stated in the past that she had a close relationship with both her mother and father. Mrs. Doe does not have any siblings and both her maternal and paternal grandparents are deceased. Mrs. Doe has been married three times with her earliest marriage coming at the age of eighteen. Mrs. Does has not mentioned of having any close friends or major interests. Mrs. Doe has a high school education and had no interest of college after her early marriage. Mrs. Doe has never been in any legal trouble until now. Mrs. Doe recently loss custody of her children to Child Protection Services, due to drug use, and was arrested and charged with Child endangerment. During Mrs. Doe’s Alcohol and Drug Assessment, she revealed that her drug of choice is methamphetamine. Mrs. Doe has failed multiple drug screens in the past and has a high substance abuse disorder according to the assessment. Additionally, Mrs. Doe was requested to complete a Psychological Evaluation. At the conclusion of the evaluation, Mrs. Does was diagnosed with Post-Traumatic Stress Disorder and Major Depressive Disorder. Overall, Mrs. Doe is always well dressed and well oriented. Mrs. Doe is cooperative and willing to work towards rehabilitation and reunification of her children. Mrs. Doe is depressed at times, but always friendly and trying to put on a good face. There is a feeling that Mrs. Doe may not be aware to how bad her depression is. Although, Mrs. Doe has been diagnosed and shows signs of depression at times, we have to always continue to gain knowledge and insight. Because while remembering and matching criteria details in diagnosing is important, gaining clinical experience by itself may also increase the ability to judge clients on how they present themselves (Witteman, C. M., & Tollenaar 2012). Nevertheless, Mrs. Doe has been able to demonstrate that she has a good relationship and strong support from her family. Mrs. Doe seems willing to seek treatment to address her issues of depression and substance abuse, and has not mentions or signs of suicide. Mrs. Doe needs to continue to address her financial issues by seeking employment and remaining drug free. It is important that Mrs. Doe continue to try resolve the issues presented in an appropriate manner. Moving forward, I do believe that the issues presented for Mrs. Doe need addressing to improve her well-being and most importantly having a relationship with her children. Noted, above, Mrs. Doe has had issues with depression and substance abuse. If this continues to be a trend, what are the possibilities for Mrs. Doe, or have they already begun? Mrs. Doe experienced a traumatic event when she witnessed her father commit suicide. Due to her father committing suicide, it surely had an impact on her life. Consistent and recent evidence shows that childhood experience of violence can impact the adult wellbeing that include psychosocial problems such as depression, anxiety, aggression, and suicide (Hooven, Nurius, Logan-Greene, & Thompson 2012). As we can see, Mrs. Doe does presently suffer from a few of those issues and are at potential risk of the other. Along with mental health issues, is Mrs. Does substance abuse matter. Substance abuse can be for many reasons, whether it is for self-medicating or recreationally. Regardless, it is another issue, that if not address could have an effect on Mrs. Doe. Substance abuse is not always connected to a poor family environment, but may increase risk for poor parenting behaviors, increase likelihood of child drug use, and child abuse and neglect (Schroeder, Kelley, & Fals-Stewart 2006). This is important to note, because Mrs. Doe’s children are in state custody. If Mrs. Doe is unable to reach sobriety, then this could not only greatly affect her well-being, but ultimately have an impact on her children as well. In the end, everyone has areas that could use improving, whether it is mental health, substance abuse or many more, but if we chose not to address these issues, then there are always going to be risk. In beginning, it may not be noticeable, but overtime it can become evident and detrimental towards a healthy life. Transitioning to treatment, there are many types of intervention offered to address the discussed issues above. One treatment that I feel could be of good use for Mrs. Doe, would be Cognitive Processing Therapy (CPT). Mrs. Doe having a diagnosis of PTSD and Major Depressive Disorder, CPT is capable of addressing traumatic events and depression within her life. CPT is able to focuses on and detect traumatic events that are hindering a client’s recovery. Doing this, therapists allow clients to assess their own lives so they can do it, rather than being told what to do. The program looks for the client to understand, accept, feel, decrease, and improve daily living in regards to their PTSD and depression. The program can be completed in twelve weeks and can be done in a group and individual setting. The program consist of homework to prove understanding of the program. The program can be done in a community setting and is offered in multiple languages (Resick, 2013). Not only is this program able to address the issues for Mrs. Doe, but it allows her to work towards her recovery in a time appropriate manner. Furthermore, the program does appear to have success in regards to other women that have struggled with symptoms of PTSD and depression. Regarding treatment for PTSD and depression when using Cognitive Processing Therapy, a study was done in comparison to prolonged exposure (PE) and a minimal attention condition (MA). All subjects were women with a mean age of thirty-two. They were randomized, into three different groups, and results showed that CPT had a slight advantage over time in comparison to the other two. The limitation being that all the subjects were rape victims (Resick, Nishith, Weaver, Astin, & Feuer, 2002). Although this study was done on just rape victims, rape is a traumatic event nevertheless and with that, appears it could be an effective treatment for other traumatic events in the life of an individual. In addition, Mrs. Doe could also look for support drug AA and NA meetings, while also being randomly drug screen, so that she could work towards her sobriety. This may not be the most exact treatment plan for Mrs. Doe, but it is one that could effective her areas that need to be in focus. In conclusion, Mrs. Doe has been through a lot in her life whether it has been in her childhood or in her present adulthood. In saying that, Mrs. Doe is not the only client that has these presenting issues, but she is unique in her own way, as are all clients. In order to continue to help Mrs. Doe, she will need to continue towards her rehabilitation based on the treatment plan that have been provided for her while also having an understanding of the risk if of not completing her treatment. Along the way, services can be provided to Mrs. Doe by being referred to local agencies as needed. It is believed, that if Mrs. Doe is open and willing to accept the help and actually want the help, there is a capability of being an effective individual for herself and loved ones.

Work Cited

• Eack, S. M., Singer, J. B., & Greeno, C. G. (2008). Screening for anxiety and depression in community mental health: The Beck Anxiety and Depression Inventories. Community Mental Health Journal, 44(6), 465–474. https://doi-org.libezp.lib.lsu.edu/10.1007/s10597-008-9150-y
• Feldstein, S. W., & Miller, W. R. (2007). Does subtle screening for substance abuse work? A review of the Substance Abuse Subtle Screening Inventory (SASSI). Addiction, 102(1), 41–50. Retrieved from http://libezp.lib.lsu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=s3h&AN=23848091&site=eds-live&scope=site&profile=eds-main
• Hooven, C., Nurius, P., Logan-Greene, P., & Thompson, E. (2012). Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health. Journal of Family Violence, 27(6), 511–522. https://doi-org.libezp.lib.lsu.edu/10.1007/s10896-012-9438-0
• Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C, & Feuer, C. A. (2002). A comparison of Cognitive-Processing Therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Counseling and Clinical Psychology, 70(4), 867-879. doi:10.1037/0022-006X.70.4.867
• Roberts, K. (1997). The impact of social work intervention on the experience.. Journal of Visual Impairment & Blindness, 91(6), 516. Retrieved from http://libezp.lib.lsu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=f6h&AN=9711264979&site=eds-live&scope=site&profile=eds-main
• Schroeder V, Kelley ML, & Fals-Stewart W. (2006). Effects of parental substance abuse on youth in their homes. Prevention Researcher, 13(4), 10–13. Retrieved from http://libezp.lib.lsu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106251940&site=eds-live&scope=site&profile=eds-main
• Wells, M., & Correia, M. (2012). Reentry into Out-of-Home Care: Implications of Child Welfare Workers’ Assessments of Risk and Safety. Social Work Research, 36(3), 181–195. Retrievedfrohttp://libezp.lib.lsu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=eric&AN=EJ984555&site=eds-live&scope=site&profile=eds-main
• Witteman, C. M., & Tollenaar, M. (2012). Remembering and diagnosing clients: Does experience matter? Memory, 20(3), 266–276. https://doi-org.libezp.lib.lsu.edu/10.1080/09658211.2012.654799

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