Bio-Psycho-Social Assessment

Presenting Issue

Brandon is a survivor of sexual abuse and trauma. He provided information about repeated sexual assault by his father six years ago, when he was aged between four and six years. Upon the disclosure, his mother called the law enforcement authorities for immediate action, which was followed by incarceration of his father. As a result of the sexual assault, Brandon started participating in therapy sessions, which is common for sexual abuse victims. This was done with a view of challenging his behavior, namely physical aggression, the use of sexual overtone language in addressing female peers, and difficulties in following rules both at home and at school.

Demographic Information

Brandon is a 12-year-old Caucasian male.

 

Current Living Situation

Brandon is currently living with his mother and her boyfriend. He further receives medication for management of psychological trauma caused by sexual assault. He receives both home-based psychological assistance and community-based treatment that makes a particular emphasis on controlling his continuous impulsive behavior.

Birth and Development History

Brandon had various challenges regarding his social interaction with his female peers at different stages of his development. According to Kilpatrick, in normal circumstances, in the process of their development adolescents, tend to exert increasing attraction to the opposite sex. However, this was not the case with Brandon as he employed explicit sexual language while addressing and interacting with his female peers. His normal growth rate was impeded by traumatizing events resulting from sexual assault. Apart from this, Brandon has been growing with the effects of sexual assault, hence showing various characteristics of depression and trauma, such as a hyperactivity disorder. Furthermore, his development was influenced by anxiety since he lived in constant fear of the possibility of recurrence of sexual assault. As a result, he started keeping a gun under his pillow as a safety measure against any individual who would try to assault him sexually again. Brandon grew up having constant flashbacks and bad memories of sexual assault and spent a lot of time thinking about the ordeal.

School and Social Relationships

As a result of sexual assault, Brandon stated having problems with establishing social relationships both at school and outside the school facilities. For instance, he avoided any kind of sexual interactions and spent most of his time watching a television show that aired stories retold by individuals about their sexual assault perpetrators. As asserted by Spiegel, it is a common behavior among sexual abuse victims. In school, he had difficult relationships particularly with females, constantly using sexually aggressive language. Furthermore, he displayed physical aggressions in his interactions at school.

Family Members and Relationships

Initially, Brandon had deep affection towards his father and believed he was a very good father. However, after the incident, he experienced totally negative feelings towards the father. Apart from that, Brandon constantly quarreled with his mother. Moreover, he showed argumentative interactions with the mother’s boyfriend. Brown finds this to be a normal reaction in victims of sexual abuse.

Health and Medical Issues (Including Psychological and Psychiatric Functioning, Substance Abuse)

Brandon also had various health and medical issues. Particularly, Brandon suffered a psychological trauma, which was manifested in repeated flashbacks when trying to fall asleep and the feeling of floating outside his body while recalling the sexual assault incident. Consequently, his psychiatric functioning was affected by depression as well as post-traumatic stress disorder (PTSD). The psychiatric issues were manifested in Brandon’s failure to express his feelings in regard to his experience of sexual assault, thus he developed the strategy of copying aggressive behavior. Particularly, he feared expressing himself due to the fact that he was assaulted by his own father.

Spiritual Development

No information on spiritual development is provided.

Social, Community, and Recreational Activities

Brandon did not take part in any particular social, community and recreational activities due to poor social interactions with his peers and family members as a result of his aggressive behavior.

Client Strengths, Capacities and Resources

The client had various strengths, capacities and resources. Brandon’s mother was a crucial human resource for the client as she acted a support system for the client. The client’s strengths and capacities were based on the fact that he was willing to take part in the intervention measures developed to assist him in handling the situation.

Specific Intervention Strategies Used in Addressing the Client’s Situation

The first strategy employed as a part of addressing the situation of the client, was the use of trauma focused treatment. Reece et al. assert that a trauma-based cognitive approach in behavioral therapy led to the disclosure of information about sexual assault by the client. The early sessions of this approach laid particular emphasis on coping skills and emotional regulation. Hence, Brandon was able to utilize coping skills in the expression of his feelings and narration of the sexual assault history and its impact of his further life.

The second strategy employed was the collateral approach. In particular, the mother was also involved in the therapy session of her son as she received assistance in the identification of her feelings about the abuse incident and developing skills that would be crucial in supporting her son in the process of treatment. She was provided with psycho-education in respect to childhood sexual assault. Particularly, it challenged her belief that Brandon would eventually become a sexual offender with violent behavior because of his sexual assault experience.

The Theory to Be Used in Guiding the Practice

The particular theory that can be used in the practice of treatment is Maslow’s hierarchy of needs theory. The theory suggests that people are motivated towards the achievement of particular needs, some of which ought to be achieved first. Thus, the basic needs ought to be fulfilled before the other needs, such as psychological and self-fulfillment needs. The theory holds that there are five stages of individual needs, which are divided into the growth needs and the deficiency needs. The growth needs are represented by the top level of Maslow’s hierarchy of needs model while the deficiency needs are represented by the first four levels of the model.

In this regard, the theory can be used in guiding the practice by paying attention to the fulfillment of the most urgent needs of the individual in practice. Thus, lower level needs, such as the basic needs, ought to be fulfilled before the satisfaction of higher needs. Therefore, in Brandon’s case, first his lower needs, namely psychological needs, should be followed by safety needs and, finally, the esteem need. Satisfaction of these needs form the lower level eliminates the aspect of deficiency, hence helping the client in the satisfaction of his needs.

The Challenge Faced by the Client

The challenge faced by the client was being a victim of abuse. In this regard, the client was a victim of sexual assault, an experience inflicted on him by his biological father. The client experienced sexual assault during the period of early childhood development. As a result, sexual assault negatively influenced his behavior and actions at the following stages of development.

The Identified Strengths of the Client

Brandon possessed the strength of being able to work with the treatment team. When the treatment approaches were used with a view of assisting the patient, he showed maximum cooperation and aimed at ensuring success of the process of treatment. Apart from that, the client portrayed the strength of being able to follow medical instructions provided to him. After being prescribed antidepressant medication, the client took the medicines, taking into consideration every aspect of instructions. Furthermore, the client had the strength of heading towards recovery at high speed. This is because his symptoms of depression and post-traumatic stress disorder reduced steadily in the course of treatment. The last strength possessed by the client is his willing to receive psychiatric assistance, both home and community-based, after the completion of the treatment session. Consequently, these strengths facilitated modifying his ongoing impulsive behavior.

The Agreed upon Strengths to Be Met in Addressing the Concerns

In addressing the concerns, the first agreed upon strength is the acceptance of the trial as well as imprisonment of the father, the perpetrator of sexual assault. Particularly, Kilpatrick finds it extremely difficult for a child to accept his/her parent to be imprisoned due to existence of family ties between the two. The second agreed upon strength is the termination of trauma-focused treatment after eight months of successful completion of the trauma narrative. This was after the client was able to discuss the issue of sexual assault, his experiences and feelings after the painful encounter. Consequently, he agreed to continue psychiatric treatment both at home and at the community level. This is particularly a powerful strength towards addressing the issue since trauma patients are required to undergo medical interventions in the process of treatment apart from participating in psychiatric counseling. Home-based psychiatric treatment along with community-based psychiatric treatment is crucial for the patient to return to his/her everyday activities and move on.

Issues around Cultural Competence

No information on possible cultural issues is provided.

Any Policies that Impact the Situation

The policy that can impact the situation is that public schools are required to implement a program that aims at preventing sexual abuse in children. The program should teach students any appropriate methods of recognizing sexual abuse in children and thus provide information to a trusted person, as emphasized by Kilpatrick (2014). The program should also be informative about sexual abuse on children and thus educate the school personnel on the issue. The program should also aim at teaching parents and guardians the warning symptoms and signs of sexual abuse in children and the measures to take in supporting children that are sexually abused and their families.

The policy influences the situation as it stresses on all the crucial elements of sexual abuse in children as portrayed in the case study. These elements include identification of the signs and symptoms of child’s sexual abuse, interventions to be taken to discover incidents of children sexual abuse, and treatment of these children and support of families in a sexual abuse environment.

How I Would Advocate for Social Change to Positively Impact This Case

With a view of advocating for social change in order to positively impact this case, I would develop a plan that advocates for the provision of education on the effects psychological trauma has on children and the importance of helping children cope with trauma, depression and post-traumatic stress disorder (PTSD). The advocacy plan will be initiated at the community, federal and state level. In this case, individuals will be provided an insight into the causes of trauma and its effects on children. Particularly, developing resilience or rather coping strategies is a crucial element in dealing with trauma, depression and post-traumatic stress disorder.

Therefore, parents, caregivers and the community at large will be taught on the identification of signs and symptoms of trauma and depression in their children and specific ways of handling the situations, as asserted by Spiegel. Apart from that, the advocacy plan will aim at ensuring that community-based trauma treatment centers are properly equipped with the necessary resources, particularly human and material resources that are crucial in helping these children. Furthermore, parents and caregivers will be educated on the ways of ensuring that they do not expose their children to traumatizing experiences.

Legal Issues Present in the Case and How Were They Addressed

In this case, the legal issue concerns child abuse, particularly sexual abuse of children. This legal issue involves contact abuse, whereby the perpetrator engages in physical sexual contact with the child. This legal issue is punishable by the law as it is a violation of the rights of children.

How Can Evidence-Based Practice Be Integrated into This Situation

Evidenced-based practice can be integrated into this situation by handling the situation. In particular, information can be borrowed from the evidence-based practice and applied to this situation. Additionally, the evidence-based practice can help in influencing important decisions in this situation, thus leading to the provision of effective and efficient solutions to the situation.

Additional Information or Material that Is Important to the Use of the Case

I strongly believe that the provision of a favorable environment for the adolescent in the presented case by the mother is crucial apart from the information that would be of use in the case. According to the information provided in the case, the adolescent portrayed aggressive behavior wherever he was in the presence of his mother’s boyfriend. Thus, if the mother was supplied with the information in regard to the value of providing a good environment to the adolescent, further exhibition of aggressive behavior could have been managed.

Any Personal Reflection Regarding the Case that I Think Would Be Relevant to the Course

In my opinion, providing help to various individuals, particularly helping them go through the most difficult situations in their lives successfully, is the most crucial part in engaging in social work. Hence, a course in social work should assist the learner in enhancing the community along with improving various aspects of life of particular individuals in the community. Hence, the course should provide the learners with the basic values in regard to social work. These values include social justice, service to humanity, competence, integrity and human dignity. The above-mentioned values will help social workers to function well in their area of practice. For instance, the value of service to humanity aids social workers in putting the interests of other individuals first rather than being egocentric and concentrating on their own desires and needs. Therefore, social workers are able to discover that serving others is very crucial and hence the interests of the clients are prioritized. The element of competence aids social workers in ensuring that they provide the required services to the clients in the best way possible and in a professional manner that does not lead to the violation of the rights of the clients.

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Apr 27, 2020 in Socioligy
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