The ability to reflect on your own growth and awareness is necessary for effective practice with diverse populations. As a social work professional, even after you graduate, you will learn many lessons from your clients. You will consistently be challenged to obtain new skills and knowledge to provide the most effective evidence-informed practice that demonstrates cultural competence. And you will consistently analyze your own reactions to clients as a means to explore potential biases or threats to the therapeutic alliance.
In your Practice Toolbox summary, you identified your preferred client population. Knowing your preferences and strengths in this area can help you steer your career to specialize in a particular demographic or age group. However, social workers don’t always get to choose with whom they work. In this final Discussion, you reflect not only on how you have progressed in knowledge and skills but also on a population with which you are less familiar. You then consider ways in which you might increase your comfort and familiarity with this population in order to further develop.
Reflect on what you have learned throughout the course and how you envision your future practice. What population are you less familiar and/or less comfortable with? Explain why. Then, identify at least one opportunity for personal or professional development that would enhance your comfort with that population. Finally, explain how elevating your understanding and comfort with a range of populations supports the NASW Code of Ethics.
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Practice Toolbox
Zuleika Rosa
MSW, Walden University
SOCW 6111: Advanced Social Work Practice I
10/30/2024
Practice Toolbox
The Strengths and Difficulties Questionnaire is what I chose for its goodness of fit between simplicity and comprehensiveness, covering strengths as well as difficulties. The SDQ is a behavioral screening questionnaire based on assessments of emotional and behavioral difficulties and prosocial behavior of children. It has versions for parents, teachers, and self-reports by the child; thus, it is versatile in gaining insight from different perspectives (Goodman, 2002).
The main reason that can be highlighted for the selection of SDQ is its comprehensiveness since it includes emotional symptoms, conduct problems, hyperactivity, peer relationships, and prosocial behavior. Such breadth gives an extremely well-rounded understanding of a child’s psychological and social functioning. Also, this questionnaire is brief and easy to administer, which is an important issue when working with children to avoid overwhelming them with extensive questionnaires. It is easy to use, and with follow-up versions, its ability to measure changes over time is especially useful in monitoring a child’s progress.
However, the SDQ also has some limitations: one challenge is that it may not delve deeply into specific areas of difficulty, which therefore means it is often best used as a screening tool rather than a diagnostic one; secondly, the reliability of the self-report version is variable and depends on the child’s age and cognitive ability, further limiting its usefulness in younger children.
Despite all these limitations, the SDQ’s focus on strengths and difficulties presents a very good initial assessment and tracking intervention for a holistic understanding of the child’s mental health and behavioral development.
Reference
Goodman, R. (2002). Strengths and Difficulties Questionnaire (SDQ).
Adolescent Assessment
The Severity Measure for Depression is one of the critical instruments used in the clinical evaluation of depressive symptoms in children aged 11 to 17 years (Levenson, 2020). I chose this tool for Tiffany because it aimed at ascertaining the severity of depressive symptoms, which is very important in adolescence when emotions, self-regulation and a healthy mind is at its most delicate stage. The age of adolescents is characterized by hormonal, cognitive, and psychological transformations; that makes them susceptible to mental health problems, including depression. This tool assists clinicians determine the severity of depressive symptoms before they make further recommendations. Depression is an element that highly likely affects Tiffani, bearing in mind the fact that she has a history of sexual abuse, substance use, and the need for inadequate shelter requires an assessment for the other factors that may require intervention.
Another advantage of this assessment tool is that it is very useful when assessing adolescents as they may appear jovial and happy when in fact, they have severe depression as a result of irritability, withdrawal or behavior changes (Randell, 2020). Some adolescents might have difficulties in finding the right words to express their emotions, and having instruments as these will allow for putting the adolescent’s emotions into numbers and establish a more objective conversation of emotions between the adolescent and the clinician. In addition, it is vital to diagnose and treat depression during adolescence as when it remains untreated, it results in adverse effects on the health of the subjects, including substance abuse, poor academic performance, and suicidal tendencies.
A notable advantage of this tool lies in the nature and content of the symptoms that are targeted, which include anhedonia, fatigue, worthlessness and poor concentration, which are typical features of adolescent depression. This makes it possible to provide an individual treatment plan that can deal with the presentations of depressive disorders in youths.
However, a weakness of the Severity Measure for Depression is that the tool is mainly dependent on the clients’ report and this can be a major issue when working with adolescent clients who may not be in a position to describe their feelings accurately due to a number of factors such as stigma or fearing to face consequences of their actions. Furthermore, the ways through which adolescents express their concerns may not be the same across cultures, and hence can affect the reliability of such an assessment (Krause et al., 2021).
In conclusion, the Severity Measure for Depression, Child Aged 11 to 17 is quite useful in the management of adolescent patients. Despite its weakness regarding self-reporting and cultural concerns, this tool’s ability to identify and measure depression makes it vital for practice.
References
Levenson, J. (2020). Translating trauma-informed principles into social work practice Links to an external site. Social Work, 65(3), 288–298. https://doi.org/10.1093/sw/swaa020
Randell, J. R. (Ed.). (2020). Theory & practice in clinical social work (3rd Ed.). Cognella.
Krause, K. R., Chung, S., Adewuya, A. O., Albano, A. M., Babins-Wagner, R., Birkinshaw, L. … & Wolpert, M. (2021). International consensus on a standard set of outcome measures for child and youth anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder. The Lancet Psychiatry, 8(1), 76-86.
Adult Assessment
The PHQ-9 is my chosen adult assessment tool because of its wide usage, efficiency, and its applicability to a few screenings for depression. It is a self-administered quick tool with great validation for the symptoms of depression and, therefore, applies well both clinically and non-clinically.
The PHQ-9 is especially useful for adults, as it probes into some relevant life domains that are usually affected by depression, such as sleep and appetite disturbances and interest in activities. Adults may go through a variety of stressors, such as work, family responsibilities, and health-related concerns, which the PHQ-9 may be able to capture well. Besides, it has a straightforward scoring system, interpretation by healthcare providers being readily available, making it ideal for initial screening and monitoring the severity of depression (et al.,2001).
However, there are a few shortcomings and limitations in its application. The PHQ-9 is a self-report tool that may be prone to symptom underreporting or overestimation due to associated stigma, denial, or other psychological barriers. The fact is, although it is a useful screening tool, it is not a diagnostic tool per se, which further implies that clinical verification is necessary for confirmation of depression. With these limitations, the PHQ-9 has remained one of the commonly used, reliable tools in the assessment of adult mental health.
References
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613.
Elderly/Aging Adult Assessment
CBT works very effectively for kids because it consists of clear and real strategies. Techniques like cognitive restructuring and behavioral experiments are designed in such a way that children understand and apply them quite easily in everyday life. Creative and interactive exercises, such as role-playing or drawing related to the exploration of thoughts and feelings, are also incorporated into CBT in a child-friendly manner. This model further empowers children in active participation within their own process of healing. It builds resilience and problem-solving skills well into adulthood (Koles,2012).
There are some challenges and limitations to using CBT with children. One important limitation is that younger children may have difficulty grasping the abstract concepts involved with cognition and emotions. This can make them more resistant to engage in cognitive restructuring. It also relies heavily on the child’s verbal and cognitive potential; hence, it may not be all that effective in cases of developmental delays or speech problems.
References
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.
Koles, J. (2012). Cognitive Behavior Therapy: Basics and Beyond Edited by Judith S. Beck Guilford Press, 2011, 386 pp.,
The Educational and Developmental Psychologist, 29(1), 78-79.
Child Intervention
I identified Cognitive Behavioral Therapy (CBT) as an intervention for children because of the effectiveness in the treatment of several mental health disorders such as anxiety, depression, and behavior disorders. CBT mainly involves teaching children how to change the way they think that is interpreted through emotions to behavior. This approach also proves relevant for the child and helpful because it offers them practical means of thinking about their thoughts or feelings and behavior. CBT in fact enables children to learn how to distinguish between such unhealthy thinking so that they can adopt healthier ways of dealing with them, which in childhood is important (Chand et al., 2023).
In addition, CBT is both directive and Time-Limited, which fits well with children’s need for clear direction and organized treatment. According to Koulouris’s et al., (2021), there are also many facets of play that can easily be adapted and change strategies, including games, drawings, or even role-playing that can be made to assist the younger clients that they are dealing with. Thus, considering the fact that the world is full of children of different ages, structurally the application benefits from the lack of rigidity and embraces children of different age and developmental stages.
However, CBT limitations and difficulties with children are that this approach is based on the child’s ability to think and speak. Cognitive behavioral therapy may be less effective for younger children or for children with developmental delays because some components of the intervention that are meant to be completed independently may be difficult for them to perform. In addition, the use of CBT appears to be contingent on a certain measure of self- reflection and self-motivation, which some children may not have developed. There is usually a need for parental involvement and support, and this mostly cannot do well when there are conflicts in the family.
References
Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2023, May 23). Cognitive Behavior Therapy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470241/
Koukourikos, K., Tsaloglidou, A., Tzeha, L., Iliadis, C., Frantzana, A., Katsimbeli, A., & Kourkouta, L. (2021). An overview of play therapy. Materia Socio Medica, 33(4), 293. https://doi.org/10.5455/msm.2021.33.293-297
Adolescent Intervention
The choice of Cognitive Behavioral Therapy (CBT) was informed by its wide evidence base showing that therapy interventions are effective in treating adolescents who are most likely to be affected by anxiety and depression, among other disorders. CBT for adolescent clients is effective because it mobilizes them to understand and change patterns of negative thinking and behaving, which builds resilience during adolescent development. Programs that involve participation and skill enhancement, which the traditional CBT approach did not include, generally make adolescents more approachable.
We can also use CBT depending on the teens’ development. It helps individuals reflect on who they are, what they do and feel, and how these elements collectively form a system. This is particularly beneficial when an individual is actively addressing and resolving various issues, such as peer pressure, identity exploration, and managing anger. The structured format that CBT offers, which includes both teaching and self-practice, will make it easier for you to adhere to the sessions and complete the homework. This is especially beneficial for teenagers who desire autonomy but still need some guidance.
There are some drawbacks to treating this population with CBT. Young people often have abstract thinking impairment, making cognitive restructuring difficult for them and others. Furthermore, therapeutic relationships may play a role in the improvement of CBT, as adolescents often hesitate to share information with therapists due to fears of prejudice or nonrecognition. Cultural issues and receptors can influence an individual’s disposition to embrace CBT practices. Moreover, limited access to the trained expert and related material in some regions can complicate the entire process (Tanzilli et al., 2020).
Taken together, while CBT provides specific techniques that may help treat adolescent mental health, the practitioner is aware that the targeted group has some distinctive needs and requirements to receive appropriate treatment.
In conclusion, even though cognitive behavioral therapy is an essential tool for managing adolescent mental health, practitioners must stay aware of the unique needs and challenges this adolescent youth faces to achieve effective treatment outcomes.
Reference
Tanzilli, A., Gualco, I., Baiocco, R., & Lingiardi, V. (2020). Clinician reactions when working with adolescent patients: The therapist response questionnaire for adolescents. Journal of Personality Assessment, 102(5), 616–627. https://doi.org/10.1080/00223891.2019.1674318
Adult Intervention
Why did you select the intervention?
To improve the mental health, manhood, and social support of young teenage Black men, I selected the YBMen Project, an online behavioral health intervention. This intervention focuses on diversity-related topics like race, black masculinity, and stigmas associated with mental health issues. It was selected due to its importance in promoting culturally relevant services for a group of people who might face several obstacles in accessing traditional mental health care services (Watkins et al., 2020).
Why might it be beneficial for use with adults?
Adults can benefit from the YBMen Project since it makes use of social network-related contextual content and peer discourse. In addition to increasing comfort and resemblance, this strategy contributes to mental health awareness initiatives aimed at the targeted demographic. The intervention’s focus on mental health and masculinity, as well as the pressures of Black men’s dual ethnicity, makes it the perfect choice for Black males (Watkins et al., 2020). Due to time constraints, digital format also improves accessibility because most adults can participate in the learning process whenever they want.
Challenges or limitations of the intervention
One major issue with the YBMen Project has been that it relies heavily on technology, which may not be appropriate for people who are unable to use devices or the internet most of the time. Additionally, its distinctiveness might make it impossible to apply the intervention generally to other Black community groups or other populations that might also benefit from mental health promotion initiatives (Watkins et al., 2020).
Reference
Watkins, D. C., Goodwill, J. R., Johnson, N. C., Casanova, A., Wei, T., Allen, J. O., Williams, E. G., Anyiwo, N., Jackson, Z. A., Talley, L. M., & Abelson, J. M. (2020). An online behavioural health intervention promoting mental health, manhood, and social support for young black men: The YBMen Project. American Journal of Men’s Health, 14(4), 1–17. https://doi.org/10.1177/1557988320937215
Elderly/Aging Adult Intervention
Using your Week 10 Discussion as a foundation, analyze the elderly/aging adult intervention you chose in the same manner as you analyzed the interventions for other age groups. Specifically, answer the following questions:
· Why did you select the intervention?
· Why might it be especially helpful for use with elderly/aging adults?
· What challenges or limitations might there be for this intervention?
Summary
Write a 1-page summary describing your ideal population to work with, based on your research and work throughout the term. Is this the same population you identified in Week 1, or has your perspective changed? Identify the ethical, moral, and value challenges you might see in working with this population.
References
(Note that the following references are intended as examples only.)
American Counseling Association. (n.d.). About us. https://www.counseling.org/about-us/about-aca
Anderson, M. (2018). Getting consistent with consequences. Educational Leadership, 76(1), 26–33.
Bach, D., & Blake, D. J. (2016). Frame or get framed: The critical role of issue framing in nonmarket management. California Management Review, 58(3), 66–87. https://doi.org/10.1525/cmr.2016.58.3.66
Burgess, R. (2019). Rethinking global health: Frameworks of Power. Routledge.
Herbst-Damm, K. L., & Kulik, J. A. (2005). Volunteer support, marital status, and the survival times of terminally ill patients. Health Psychology, 24(2), 225–229. https://doi.org/10.1037/0278-6133.24.2.225
Johnson, P. (2003). Art: A new history. HarperCollins. https://doi.org/10.1037.0000136-000
Lindley, L. C., & Slayter, E. M. (2018). Prior trauma exposure and serious illness at end of life: A national study of children in the U.S. foster care system from 2005 to 2015. Journal of Pain and Symptom Management, 56(3), 309–317. https://doi.org/10.1016/j.jpainsymman.2018.06.001
Osman, M. A. (2016, December 15). 5 do’s and don’ts for staying motivated. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/5-dos-and-donts-for-staying-motivated/art-20270835
Sue, D. W., & Sue, D. (2016). Counseling the culturally diverse: Theory and practice (7th ed.). Wiley.
Walden University Library. (n.d.). Anatomy of a research article [Video]. https://academicguides.waldenu.edu/library/instructionalmedia/tutorials#s-lg-box-7955524
Walden University Writing Center. (n.d.). Writing literature reviews in your graduate coursework [Webinar]. https://academicguides.waldenu.edu/writingcenter/webinars/graduate#s-lg-box-18447417
World Health Organization. (2018, March). Questions and answers on immunization and vaccine safety. https://www.who.int/mongolia/health-topics/vaccines/faq
Last Completed Projects
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