Three Levels

Charro Moore
Three-Level Paper
Micro Mezzo Macro
SW 3010
Wayne State University
December 7, 2013

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Introduction

As a social worker, I will discuss how involving the multiple social systems which are micro,
mezzo, and macro can assist in the engagement, assessment, and treatment of my consumer. I
will identify a mezzo and macro system change that I will face which is different from my usual
micro practice. I will demonstrate the roles as a counselor during my micro practice, a case
manager while practicing the mezzo system, and advocating using macro skills. While assessing
my client I will share the overlap between the three levels, and the affects it has on African
American women suffering from alcohol abuse. These social systems will convey the ethical
dilemmas and ethical principles that are created and resolved in result of black women whom
experience substance abuse.

Mezzo/Macro Change
Although I primarily utilize a micro level practice I demonstrated mezzo/macro level change
within our session. Biological, psychological, and social assessing has help me determine the
excessive amount of alcohol consumed, which has had an effect on my consumers health
biologically. In result, this has influence the need of a medical specialist. During my mezzo
practice I used a social assessment which displayed the effects of the relationship between the
consumer and her friends, family, and granddaughter. This mezzo practice has lead me to
organize a family counseling therapy to educate Valerie and her family about her behavior, and
management techniques that will be useful to Valeries treatment and the recovery of their

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relationship. Psychologically assessing helped me discover Valerie needed not only a

psychiatrist, but also a certified addiction counselor. The counselor that I referred provided
intensive support individually and group therapy and this is an action of mezzo practice. I plan
on interacting and meeting with this advisor to discuss the consumers progress. I utilized my
Macro skills by joining a local and state alcohol abuse council, and raising issues about the
amount of liquor stores in Black communities in comparison to predominately White
neighborhoods.
Roles of Social Worker
I demonstrated different roles as a social worker to help benefit my consumer. As a counselor, I
provided guidance to Valerie by creating a treatment plan. Valerie and I identified her strengths
and weaknesses, we discussed improving her family relationships, and her goal is to alleviate
the depression, and to improve her quality of life. After confronting Valerie about her excessive
alcohol intake we agreed that she is suffering from alcohol abuse and we need to cope with this
issue immediately. I was also able to act as a case manager and provide mezzo level practice by
locating a support group for alcohol substance abuse users, group family therapy, and I made a
referral for the consumer to make an appointment to see a psychiatrist for a medical evaluation
for the depression she is experiencing. I also utilized my role as an advocate. I felt it was
important to speak out on behalf of Valerie and find assistance, support resources, and policies
that help grandmothers who are raising the children of their incarcerated children. In our first
session Valerie displayed how she felt overwhelmed in the care of her granddaughter. At
Valeries age, she never intended on raising a child all over again, so I empathize with this issue

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and feel she should receive the proper assistance from the government, and community to
cope with this matter.
Overlap of Three Levels
There is an overlap between the utilization of micro, mezzo, and macro in relation to the
treatment of African American women suffering from alcohol abuse. Valerie is a Black woman
therefore; she is a member of two minority populations. During my micro practice as I
counseled my client I discover the factor that early childhood abuse triggered the alcohol
dependency she is experiencing. Due to my client being an African American women, coping
with the stresses and sources of depression she has turned to alcohol as a coping mechanism,
and this is a common amongst single black women whom are raising children alone. This one
factor that can contribute to her powerlessness at a mezzo and macro level, which may make
this population, feel blocked from benefiting from outside resources. During my mezzo practice
I discovered there was a need for a group therapy, and if possible within the community. My
client being a Black woman and feeling inferior to other races helped me with structuring
therapy amongst other African American women which made my consumer feel more
comfortable. The neighborhood that my client resides in is a key factor in her alcohol abuse.
Those at risk develop alcohol addiction and have a difficult time coping, because they have easy
access to alcohol and are encouraged to drink by their social environment. The alcohol is at a
low cost, and generally alcohol is advertised throughout the community. This environment is
generally a low income, single family home, predominately African American women who are
suffering from hardship. Valerie displayed this concern in our first session, because she felt
there werent any opportunities, resources, or policies in place for black women who are

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experiencing alcohol abuse and raising their grandchildren. During my macro practice I was lead
to advocate due to my consumer being a part of a diverse oppressed group. I structured a
treatment program that will help provide childcare for African American women substance
abuser within predominately black communities who need assistance. This can help with higher
retention rate, and a factor associated with greater treatment success.
Relevant Issues
As a social worker, in order for me to assess and identify the issues that were relevant to my
client I took on an ecological perspective. This allowed me to assess and treat the consumer
substance abuse problem involving micro, mezzo, macro levels which are all social systems that
allowed me to gather information and have a complete understanding of my consumers issues
and concerns. Biologically assessing Valerie I discovered the alcohol abuse was the most
relevant issue, which affected my consumers physical health. She has been diagnosed with
congestive heart failure and liver damage due to high alcohol consumption. I conveyed how I
was concerned about the excessive amounts of her alcohol use. It seems to be more of a
dependency than a social use. Alcohol is a substance that has to be controlled, balanced, can
affect your health and everyday life.
Psychologically assessing displayed relevant issues as far as my client being deprived of sleep,
experiencing lack of appetite, suffering from low energy, and feeling of hopelessness which are
all signs of depression and symptoms of alcohol abuse. I explained that alcohol dependency
caused her to become unstable, and the alcohol abuse is complacency for high stress level and
depression. Valerie explained how stressful her life is and the concurrent depression she has

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been experiences since the imprisonment of her daughter and her kinship with her
granddaughter.
During the social assessment disclosed another relevant issue, and how she regrets that her
social life has diminished due to her alcohol abuse and depression. She explained how
supportive her family was during her first attempt to quit drinking alcohol, and how they wont
interact with her until she works on getting help. Valerie lost important strong friendships and
relationships with her family members, because they dont accept her substance abuse
problem. She fears the relationship with her granddaughter is suffering due to her addiction,
and she wants to regain her trust to develop a healthier relationship. Valerie generally
consumes alcohol alone, but when she uses to socialize for entertainment purposes, she had a
group of friends that would encourage her to drink displaying peer pressure. Valerie expresses
she is doing her best with staying away from other alcohol abuser that could possibly influence
her.
Ethical Dilemmas
This issue brings me to the value and ethical dilemmas that prevailed due to her addiction. I
was concerned if she came forward about her substance abuse she would lose custody of her
grandchild. I was put in a situation where due to my clients alcohol addiction, and because she
is raising her granddaughter alone there is a chance that her grandchild could be in a harmful
environment. The possibility of drinking and driving with her granddaughter being in the car is
very likely. If my client is drinking and neglecting her granddaughter this would also be an issue.
Ethically it is my responsibility to make sure the wellbeing of my client and her grandchilds are

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safe and stable. I have to be competent in my decision making. Part of her anxiety and
depression stemmed from her dilemma of wanting to get professional help for her substance
abuse, but being afraid of losing her custody kinship of her granddaughter delayed her decision
for assistance. I was concerned that she wouldnt complete her treatment plan, if she lost
custody of her grandchild, but the safety of their lives was my main concern.
Ethical Principals
There are ethical principles that can help resolve the problem that Valerie is experiencing.
During her treatment, I advised for the granddaughter to stay with my clients sister. It was
important that the grandchild stayed with a close family member, and wouldnt be a part of
foster care. We will be setting up a meeting with the relative and make arrangements for the
granddaughter to be comfortable. The grandchild will also continue at the same high school,
because that was a concern of the grandmother. We were able to develop a healthy client
social worker relationship. We were able to display respect, dignity, and the importance of
human relationship toward each other. Valerie explained with my encouragement, she is
comfortable with attending group therapy, and she feels it important to meet people with the
same issues. I realized she feels more at ease and empowered, because she is beginning to
make right decisions in her life. This process will allow the client to feel empowered and
strengthened. These are code of ethics that I utilized during the treatment and it has created
positive changes in Valeries life.

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Conclusion
Throughout my paper I was important for me to display the approach, method, and how I
implemented the three level systems in my counsel. Micro being more of an individual counsel
(smaller systems), mezzo being more of a group therapy (medium system), and macro relate to
advocating, law and policy changes (large system) are used as a guide that shape the effective
strategies in social work. Biological, psychological, and social assessing were all utilized in the
treatment plan and intervention. Micro mezzo, and macro levels are definitely helpful to all
social worker, and these are systems that intertwine and complement each other. Regardless of
which level a social worker pursues, being knowledgeable of all three practices will broaden
your career possibilities, allowing you to direct your client to the right resources and services. I
learned utilizing these levels of practice adequately will help social workers become more
competent in helping their client and sufficient in their decision making.