Clinical Intervention

In social work, a client system refers to a group of people that a social worker is responsible for helping. One of the primary agendas of social work is to provide complete and helpful services to their clients. This means that they are responsible for assisting the clients and those around them. Often, clients suffer because of their relationships with their family, friends, and co-workers. To provide helpful services to them, a social worker must establish the client system or people around the patient who affect their health conditions. The client system includes Maria, her two children, her mother, and her sister in this case. Even though they all need social work services, Maria needs them the most as she is affected the most. Her children, mother, and sister come into the picture because they are also affected as Maria is affected with a mental disorder. The case mentions that Maria experiences problems because of the behavior of her children, parents, and sister. It means that the client system must involve all the parties to help Maria deal with the condition.

Basic screening information will help in prioritizing intervention. In this case, screening can be done using two tools; an interview and ecomap. Maria’s condition needs to be looked at from the perspective of emotional symptoms, social problems, peer relationship problems, and family problems. Her screening focuses on interviewing her through basic questions related to her problem and conceptualizing her relationships on an ecomap. Screening for anxiety and irritability can be done by interviewing Maria using the Generalized Anxiety Disorder 7-item (GAD-7). This involved asking her some questions that assess her emotional symptoms of the disorder. An example of a question is how often she feels nervous, on edge, or anxious over the last two weeks. Another one is how constantly she worries too much about issues, her control level of worrying, and the things she worries about more often. For irritability, the question would be what makes her easily annoyed or irritable and to what extent. These questions would help analyze his emotional symptoms and the leading causes of her disorder.

Her peer, family, and social relationship are also vital screening information that would help her intervention. This is where the integration of an ecomap comes in to help assess the quality of connections Maria has with other members. For this case, it is the most crucial information because, as the case study mentions, Maria’s condition appeared because of the social behavior around her. Hence, understanding her relationship with them could help trace her condition’s cause. The connections that should be included in the ecomap are; mother, children, peers or lawyers, and sister. The relationship between Maria and these parties should be depicted as positive, tenuous, or stressful. The information obtained from her relationship with the members could be crucial because studies show that anxiety and irritability disorders are highly contributed by the social circle and the type of relationships a patient has with others (Galvez-Sánchez et al., 2019).

Diagnosing mental disorders can be challenging; however, the DSM-5 manual helps health professionals, including social workers, diagnose the disorders following a list of symptoms. Based on the case study, Maria continuously shows states of anxiety and irritability; thus, her diagnosis is based on anxiety disorders. According to DSM-5, there are several anxiety disorders associated with various symptoms. Examples include separation anxiety disorder, selective Mutism, social anxiety disorder, generalized anxiety disorder, and agoraphobia. Each type has specific symptoms that can rule out other types of disorders.

Based on Maria’s symptoms, and according to the DSM-5 guide, Maria’s anxiety disorder type could be Generalized Anxiety Disorder (GAD). Some of the common symptoms that patients with such anxiety disorder exhibit are; feeling restless, easily irritated, muscle tension, reduced concentration, frequent tiredness, and sleep problems (Kehoe, 2017). However, the two most critical symptoms that indicate they are really suffering from generalized anxiety are excessive fear, worry, or nervousness for not less than six months (Boston Anxiety Treatment, 2022). This worrying feeling must be there more than often within the six months. Out of the symptoms, if a patient shows at least three of them for six months, they are diagnosed with generalized anxiety disorder.

Based on that, it could indicate that Maria is suffering from generalized anxiety disorder since she shows more than three of the symptoms in the DSM-5 manual on GAD. Firstly, she shows signs of excessive worry, which is the primary symptom of GAD. The excessive worries could result from the development stage that Maria is currently in. She is in adulthood, where she has to work, cater to her children’s needs, her mother’s and sister’s, and perhaps deal with all the stressors associated with her career and adulthood. Secondly, she gets easily irritated, which is one of the primary symptoms of GAD. Even though the manual does not clearly state the specific sources of irritability or worries that could depict GAD, the fact that Maria has the symptoms shows she is suffering from GAD. Thirdly, she experiences muscle tensions, and the fact that she dreamed of the clinical social worker shows that she could be having sleep problems, which are symptoms of GAD. Therefore, Maria’s diagnosis indicates that she suffers from a generalized anxiety disorder.

The best treatment plan for Maria is an integration of psychotherapy, medication, and self-help. This is because the disorder could have affected her psychologically, mentally, and physically. Hence, approaching the treatment from the perspective of psychotherapy, medication, and self-care could help. The therapeutic procedures of the treatment plan start with sessions of psychotherapy. The first thing is to conduct cognitive behavioral therapy to help her cope with feelings, thoughts, and behaviors. This is one of the most used psychotherapies that has been proven to work in adults (Hans & Hiller, 2013). Another helpful talk therapy, in this case, is acceptance and commitment therapy to help her control uncomfortable sensations and anxious thoughts.

Besides therapies, Maria also needs medication in her treatment plan to help control anxiety by interacting with brain neurotransmitters. Some of the medicines to be included are; selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, anxiolytics, serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic. Although some medications would have some significant side effects, they effectively speed up the treatment process when integrated with therapy. The last therapeutic procedure in the treatment plan is self-help. It is equally vital as other treatment options because the disorder emanates from individuals who must take care of their mental health despite psychotherapies and medication. In Maria’s case, the best self-help procedure should reduce her worries and anxiety and control the stress that causes anxiety. In that case, she could read books on the same, listen to videos, eat healthily, and engage in mindfulness meditation and relaxation exercises.

Some ethical responsibilities or aspects need to be upheld in the therapeutic intervention process. The process involves talking with the client and asking for her personal information. In this case, confidentiality and the client’s request for independence are the leading ethical aspects that could be witnessed. The social worker should uphold the confidentiality of the client’s information and not share it with third parties (Reamer, 2018). However, the social worker may be forced to share some confidential information with peers through consultation in an effort to seek the best treatment plan. Also, the client could ask for independence, which she deserves. Howbeit, because she is a mental case patient, the social worker might not consider independence, posing an ethical issue. Nevertheless, the ultimate goal is to help the client deal with the anxiety disorder, which is the primary goal that should guide the ethical aspects of the process.

References

Boston Anxiety Treatment. (2022, April 17). ???? Generalized anxiety disorder (GAD) DSM-5 criteria: Symptoms, diagnosis, and treatment. https://bostonanxietytreatment.com/generalized-anxiety-disorder-gad-dsm-5-criteria-symptoms-diagnosis-and-treatment/

Galvez-Sánchez, C., Duschek, S., & Reyes del Paso, G. (2019). <p>Psychological impact of fibromyalgia: current perspectives</p>. Psychology Research And Behavior Management, Volume 12, 117-127. https://doi.org/10.2147/prbm.s178240

Hans, E., & Hiller, W. (2013). A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders. Clinical Psychology Review, 33(8), 954-964. https://doi.org/10.1016/j.cpr.2013.07.003

Kehoe, W. A. (2017). Generalized anxiety disorder. ASCAP. https://doi. org/10.1093/med/9780199937905.003, 2.

Reamer, F. (2018). Social Work Values and Ethics. https://doi.org/10.7312/ream18828