336 Sample of Final Paper Assignment # 5 Assessment and Intervention Page 1 of 23

Running Head: ASSESSMENT AND INTERVENTION PLAN

Assessment and Intervention Plan: Dianne’s Story

XXXNYZZOKKCXXXZZ

Theory and Practice of Generalist Social Work 1

47-336-01

Dr. Wilfred Gallant

University of Windsor

December 17, 2007

Introduction
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It seems as though, like day evolves into night, people change and evolve as

well. Dianne and I have been working together throughout the course of three sessions.

We have built a strong helping relationship and it seems as though Dianne has placed

trust in our bond. During our previous sessions, Dianne has disclosed that she is 33

years old and was previously a social work student before she had to pause her

schooling. She is a single parent, however her child is in care due her crack cocaine

relapse. Dianne suffers from cervical cancer and has also been diagnosed with Bipolar

and Multiple Personality syndrome. She explained that she experienced personalities

that exhibited anger, addiction, depression and a combination of all three of these.

Dianne is also homeless with no source of income. Dianne has also explained that she

is originally from Ottawa, where she used to reside with her parents, but has come to

Windsor to seek out treatment for her substance abuse problem. At this point in our

relationship, Dianne and I will be working towards assessing her current situation,

creating a contract, as well as intervention and treatment plans. This will further be

analyzed throughout this paper.

Assessment

The assessment phase of the generalist social work interview allows the social

worker to aid the client through empowerment, making rational judgments, as well as

decision making (Timberlake, et. al., 2008). The assessment phase thus, allows the

social worker and client to create a strength-base problem-solving action plan through

the analysis of the data collected (Timberlake, et. al., 2008). Both the client and the

social worker work “…towards identifying client system strengths, capabilities, and

environmental resources…” (Timberlake, et al., 2008, p. 243). I reviewed the issues of

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concern that were disclosed in prior sessions in order to confirm that these issues still

need to be addressed and if there are any new issues that have come up between

sessions. Dianne has explained that her main issues of concern are her addiction to

crack cocaine, her lack of income and shelter, her son being in her parents care instead

of hers, her mental health conditions and her cervical cancer.

Problem Prioritization

In order for a social worker and their client system to be able to implement the

contract planning, intervention and treatment plan phases they must properly prioritize

the problems and needs first (Timberlake, et al., 2008). This will allow the social worker

and the client system to determine which need or problem should be addressed earliest.

Often times, client systems have more then one problem or need pending (Timberlake,

et al., 2008).

The social worker will attain the best results if they are able to re-assess the

problems-person-environment that was discussed in previous sessions. Keeping these

key factors in mind, the social worker must also be conscious of his or her relationship

with the client (Timberlake, et al., 2008). In order to keep the trusting relationship strong

throughout their time together, it is important that the social worker and the client system

be able to improve the problem or satisfy the needs as soon as possible (Timberlake, et

al., 2008).

In order to properly assess which problem or need should be addressed first the

social worker and the client system can use the Problem Prioritization Scale

(Timberlake, et al., 2008). This scale allows the social worker and the client system the
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ability to measure a problem’s potential for change by using a point system (Timberlake,

et al., 2008).

Dianne’s prioritization scale can be reviewed in Appendix A. According to the

scale, Dianne’s problem with crack cocaine use has the highest potential for change.

This problem scored 27/30 in regards to potential for change. This score was due to the

fact that Dianne was capable to stay clean for five years until her recent relapse. She is

highly motivated to change because she wants her son back and she has many great

treatment centers in this area that are available to her. Dianne also insisted, during this

interview, that she feels that this is the problem she would like to address first. The

scale, thus, corroborates with Dianne’s feelings.

Assessment Statement

Each problem that is identified by the social worker and the client must have an

assessment statement. In other words, each problem or need should have a

comprehensible statement of the nature of the issue of concern (Timberlake, et. al.,

2008). Dianne’s crack cocaine addiction will be the focus of this assessment statement.

The social worker and the client should come to a clear understanding of how the

problem interlocks with the client’s needs. When Dianne and I explored this question we

came to the understanding, with the data collected from prior sessions, that Dianne’s

crack cocaine use has caused her biological, psychological, social, cultural and spiritual

distress. According to Dr. Gallant, a professor at the University of Windsor, one must

take a holistic approach to the assessment. Therefore it is crucial to consider all five of

these components (personal communication, December 4, 2007).

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Another question that needs to be explored is if the issue of concern is the only

problem or are there other connecting problems as well (Timberlake, et. al., 2008). In

regards to Dianne’s crack cocaine addiction, there are many other issues associated

with it. Dianne has bipolar and has a personality disorder. With that said, Dianne has

trouble regulating her moods and emotions, yet with the added mood changes that

come from crack cocaine use (Laugeault, personal communication, November 20,

2007), her moods seem to change more severely. Dianne dropping out of university and

being homeless is also associated with her drug use. Also, her son is out of her care

due to the addiction.

The social worker and the client must also ask who are the people involved that

may be imposing the problem onto the client (Timberlake, et. al., 2008). With the aid of

the data collection phase from a prior session, Dianne and I were able to determine that

crack users are influencing Dianne to use. It is also important to find out why the client

finds themselves to be in the problem situation presently. In regards to Dianne, she

explained that she started using again because her partner was using as well. Since

Dianne was sober for five years prior to her recent relapse, it is clear that she has

attempted to make positive changes. She has had success with riding herself from her

crack addiction but she relapsed due to environmental factors. This has influenced her

score in regards to the problem prioritization scale.

A social worker and the client needs to determine the major cause for all of the

problems and needs in the client’s life (Timberlake, et. al., 2008). Since we have

gathered information in regards to all of the implications of Dianne’s problems in prior

sessions, it is clear that her crack cocaine use has caused the majority of the sub-
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problems she is facing. Therefore, the assessment statement is as follows, Dianne’s

major problem that needs to have a contract, intervention and treatment plan is her

crack cocaine addiction. Once her crack cocaine addiction is in control, her other sub-

problems should naturally improve, yet may need further assistance. It is important for

the social worker to understand the potential of the client’s ability to change

(Timberlake, et. al., 2008). Therefore, the change potential for Dianne, in regards to her

problem of crack cocaine addiction, is assessed as very high because she has a history

of success and is highly motivated (refer to Appendix A) (Timberlake, et. al., 2008).

Ecological-Systems Perspective

In order to assess the client system in a holistic manner, one must take on an

ecological-systems perspective (Gallant, personal communication, December 4, 2007).

This perspective allows the social worker and the client to assess the issue at a micro,

mezzo and macro level in order to have a complete understanding. Social workers and

client systems must understand that all three of these levels interact and interlock with

one another, which means that one issue can very well affect a client system on all

three of these levels at any given time (Timberlake, et al., 2008). One must examine the

biological, psychological, social, cultural as well as spiritual components of the client

system in order to understand how the issue of concern may or may not affect the client

at a micro, mezzo and macro level.

Biological assessment.

Dianne’s crack cocaine use has highly affected her physical health. During this

meeting Dianne explained that she has many physical ailments due to her crack use.

She expressed that she has sores on her skin because she was picking at it thinking
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that she had insects crawling under her skin. This type of self abuse and paranoia is

common among crack users (Laugeault, personal communication, November 20, 2007).

Dianne has also explained that her teeth are falling out, rotting and hurt a great deal.

This type of tooth decay is also common among crack users (Laugeault, personal

communication, November 20 2007). She also disclosed during this session that she

has many blisters on her lips from smoking crack cocaine and is also experienced

trouble breathing. For instance, crack cocaine can cause “… a wide variety of

pulmonary complications including interstitial pneumonitis, fibrosis, pulmonary

hypertension, alveolar hemorrhage, asthma exacerbation, barotrauma, thermal airway

injury, hilar lymphadenopathies, and bullous emphysema” (Restrepo, Carrillo, Martínez,

Ojeda, Rivera & Hatta, 2007).

Psychological assessment.

During this session together, I asked Dianne is her crack cocaine addiction had

any effects on her mental health. Dianne explained that when she is coming down from

a high she experiences a large deal of depression. Wingood and DiClemente (1998)

explainthat often times when women use crack cocaine they experience feelings of

depression. She also explained that she experiences paranoia when she is coming

down from the highs. Dianne revealed that she experiences a great deal of stress when

she is going through withdrawals because she wants to get high but is trying to fight the

urge to use. Weiss, Ciccocioppo, Parsons, Katner, Liu, Zorrilla, Valdez, Ben-Shahar,

Angelletti and Richter (2001) explain that during withdrawals, crack users experience a

dangerous amount of stress.

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Social assessment.

Dianne has regrettably disclosed that her social life has diminished quite a bit

due to her addiction. She explained that she has lost important and strong friendships

and relationships with family members because they do not accept her substance

abuse problem. Further, due to her addiction she lost custody of her son. With that said,

she fears that her relationship with her son has been destroyed and she hopes to be

able to regain his trust and care for him again. Dianne also explained in this session that

she has made many negative relationships because of her addiction to crack cocaine.

She explained that she is doing her best to stay away from the other drug users that

peer pressure her but it is a difficult task when she needs to fulfill her need of crack.

Cultural assessment.

Dianne is a Black woman and seems to be well connected with her culture as

best as she can at the moment. Dianne explained that she is involved in cultural groups

and enjoys spending time with people who share the same beliefs and ideals as she

does. According to Lillie-Blanton, Anthony and Schuster (1993), crack cocaine users are

not necessarily more often Black. They explain further that crack use is not race specific

but more so depends on other environmental factors. With that said, Dianne’s crack use

may not be necessarily due to her culture (Lillie-Blanton, et al., 1993). On the other

hand, Boyd (1993) explains that female African American crack users are on the rise.

Spiritual assessment.

During this session Dianne explained that she is a Born Again Christian. She

enjoys spending time at Church, but has difficulty being in large crowds. Often times

she will go alone to collect her thoughts and spiritually reflect. It seems as though
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Dianne has a positive spiritual relationship with God which can be seen as a strength

and an asset that may help with her making positive changes.

Contract Planning

The next step of our meeting was to implement a contract plan (Timberlake, et

al., 2008). This contract plan allows the social worker and the client to prioritize tasks

and goals that they would like to see be accomplished, as well as a plan that dictates

how and when which tasks will be completed (Timberlake, et al., 2008). This type of

contract allows the client system to improve on their flexibility, growth, outside resources

and will also help minimize environmental barriers that the client may face otherwise

(Timberlake, et al., 2008).

It is very important that the client thoroughly understand the contract and what is

being asked of him, as well as the social worker (Timberlake, et al., 2008). With that

said, it is very important that there is a clear understanding of which problems are going

to be incorporated in the contract plan and why. Since Dianne has already explained

that she would like her crack cocaine addiction addressed first, and since this is

corroborated in the problem prioritization scale, we both have an understanding that we

will be tackling this issue first, with the others to follow. Dianne and I conversed about

how we may work at accomplishing her goal to become clean, and she expressed that

she would need the assistance of a treatment centre. I suggested two different

treatment centers to Dianne that are in the area and explained their differences.

According to Timberlake, et al. (2008), it is important to give the client system choices

and introduce possible environmental resources that may be available to them. Dianne

expressed that she was interested in House of Sophrosyne because it is a treatment

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centre for women only. Dianne explained that, with my encouragement, she is

comfortable with calling the treatment centre that same day to set up an appointment to

visit the centre and get the process started. I made sure to lend my support to Dianne

during this call which allowed her to feel more at ease and empowered. Timberlake, et

al. (2008) also explain that encouraging the client system to become an active part of

the contract planning process will allow the client to feel empowered and gives them the

opportunity to take control over the problem-solving process. I made sure to write the

contract plan with Dianne to give her that opportunity. Timberlake, et al.(2008), explain

that it may be difficult for some social workers to allow the client to be a part of this

process (Timberlake, et al., 2008). This type of client system involvement also impacts

the potential for the client to follow through with the tasks outlines in the contract plan

(Timberlake, et al., 2008). Due to its importance I made sure to resist the urges to take

over and respect Dianne’s ability to be self-determining. With that said the contract will

comprise of Dianne contacting and connecting with a treatment centre with my support.

Refer to Appendix B to review a detailed contract plan. Dates of the contract plan may

be altered due to realistic set backs and challenges the client system may face

(Timberlake, et al., 2008). All goals, tasks, responsibilities and dates have been agreed

by both Dianne and myself to ensure a collaborative working relationship.

Intervention and Treatment Plan

Intervention and treatment plan strategies are incorporated in the strengths-

based problem-solving process of the generalist social work practice at micro, mezzo

and macro levels (Timberlake, et al., 2008). Each of these levels of intervention and

treatment plans are designed to assist certain issues and concerns, contract plans and
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goals for different levels of client systems (Timberlake, et al., 2008). Since Dianne is

only one individual client system, we will be working with intervention and treatment

plans that focus on micro client systems.

The point of micro level interventions with individual client systems is to help

empower the client and help facilitate them in their problem-solving process

(Timberlake, et al., 2008). This will help the client gain control of themselves and their

environment (Timberlake, et al., 2008). Micro level intervention also allows the client

system to improve on the barriers and challenges that they have had to face in regards

to environmental resources, which will allow them to benefit from them and allow them

to reach their goals and aspirations (Timberlake, et al., 2008). Thus, the client will be

able to be empowered and be more confident in their abilities to make positive changes

in their life, the client system will be able to realistic about societal barriers that they may

face, the client system’s knowledge and skills wiill grow and strengthen, they will be

able to improve or implement important and positive support systems, and they will also

be able to take action and be responsible to make positive changes to their issues of

concern (Timberlake, et al., 2008). The components of intervention that apply to Dianne

are power-shared relationship, competency based assessment, normalization,

collectivity for mutual aid, and knowledge and skills for taking action.

Power-Shared Relationship

This component of the intervention and treatment plan explains that the social

work and the client system have to have an equal and realistic professional relationship

together (Timberlake, et al., 2008). This allows the client to feel confident that the social

worker is supporting them and, at the same time, allows the client to feel self-
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determining and empowered (Timberlake, et al., 2008). With that said, the client system

should be accepted as being able to determine their own problems and solutions to their

problems (Timberlake, et al., 2008). For instance, even though the problem prioritization

scale measure which problem has the most potential for change and which problem

should be tackled first, I still made sure to ask Dianne what she felt she wanted to work

on first. This allowed Dianne to feel empowered and in control of her situation.

Timberlake, et al. (2008) explain that this type of involvement heightens the potential of

the client being able to make positive changes to their issue. It is important to support

the client, but not take over the problem-solving process (Gallant, personal

communication, November 8, 2007).

Competency-Based Assessment

This component is the idea that the social worker and the client look at

contributing factors which may influence the client system’s powerlessness in regards to

their issue of concern (Timberlake, et al., 2008). With that said, the social worker will

look at both internal and external barriers which render the client system powerless

(Timberlake, et al., 2008). In regards to Dianne’s situation she is a Black women,

therefore she is a member of two minority populations. This is one factor which can

contribute to her powerlessness at a mezzo and macro level, which may block her from

benefiting from outside resources. Dianne is also and addict, which renders her

impaired and powerless at times. One the other hand, Dianne has great motivation to

change and acknowledges the importance to make positive changes.

Normalization
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A third component of the intervention and treatment plan process is

normalization. This is the idea that the social worker and the client look at the

environmental factors which has put them in the situation that they are in (Timberlake, et

al., 2008), and that perhaps they are a casualty of societal norms. For instance, black

women that a part of two minority groups and are often subject to discrimination and

oppression (Macionis & Gerber, 2005). Dianne is a part of both of these categories.

Collectivity for Mutual Aid

This component of the problem-solving process is the notion that it is beneficial

to offer the client system interaction with other individuals that have, or who are

currently, experienced the same issues they have (Timberlake, et al., 2008). With that

said, it would be beneficial for Dianne to undergo substance abuse treatment for one

reason that it will allow her to interact with others who share similar experiences that

she has. This will offer Dianne a sense of collectivity and assure her that she is not

alone in her struggles.

Knowledge and Skills for Finding Resources

It is especially important that the social worker and the client system gain

knowledge of the specific issue that they are tackling, as well as knowledge of skills that

may be beneficial to use for treatment and intervention (Timberlake, et al., 2008). With

that said, it is beneficial for Dianne to undergo treatment at a recognized treatment

center because they will offer her the skills and knowledge needed to successfully

graduate treatment. It is also important for social workers to be prepared to meet with

their client by completing research on issues that they do not fully understand
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(Timberlake, et al., 2008). Personally, I went to a workshop on crack cocaine which has

given me additional knowledge on the drug and its implications.

Counseling with Individuals

Often times counseling relationships between the social worker and the client

system vary a great deal in length (Timberlake, et al., 2008). This depends on the

willingness of the client to make positive changes, the issue of concern and

environmental factors (Timberlake, et al., 2008). Counseling will allow the client system

to improve the problem or need, determine individual and environmental strengths and

resources, allow the client system the skills to manage their problems and adapt to

societal changes, as well as improve the overall well-being of the client (Timberlake, et

al., 2008).

Throughout the helping process, and especially the intervention and treatment

planning phase, it is very important that the social worker and the client have

established good rapport between one another (Timberlake, et al., 2008). The social

worker will implement social work interviews skills, such as “skills of listening,

responding, guiding, paraphrasing, clarifying feelings, sensing, and, possibly

confronting” (Timberlake, et al., 2008, p. 295). Throughout this counseling process, the

social worker may also implement previous phases of engagement, data collection and

assessment when needed (Timberlake, et al., 2008). This will allow the client to

establish a better understanding of their true self (Gallant, personal communication,

December 4, 2007).

There are plenty of methods a social worker may feel are appropriate for the

client system and the counseling process. Some include genograms and eco-maps to
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have a better understanding of the person-in-environment (Timberlake, et al., 2008).

Please refer to Appendix C for Dianne’s genogram and Appendic D for Dianne’s eco-

map. These tools allow the social worker and client to have a better understanding of

the environmental factors which may effect the client system (Timberlake, et al., 2008).

Further, Dr. Gallant explains that there are many other modern techniques, such as

therapeutic breathing and music therapy, which help relax the client and enable them to

see their true self instead of their false self (personal communication, December 4,

2007). These techniques allow the client to better connect with themselves and

understand their situation.

Information and Referral

Often times the social worker and/or their agencies cannot facilitate the client’s

needs. With that said, it is the responsibility of the social worker assigned to give the

client as much information as they can and refer them to someone who is more

equipped to problem-solve with the client system (Timberlake, et al., 2008). This

process of directing the client to another social worker or agency is called referral

(Timberlake, et al., 2008). This is corroborated by the Canadian Association of Social

Workers (2005) code of ethics which insists that “social workers analyze the nature of

social needs and problems, and encourage innovative, effective strategies and

techniques to meet both new and existing needs and, where possible, contribute to the

knowledge base of the profession”. This allows the social worker to connect the client

system with specialized services which may make the client system more confident in

the helping process (Timberlake, et al., 2008).

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With that said, it is important for a social worker to understand when and how

they refer the client elsewhere (Timberlake, et al., 2008). In order to have a successful

referral, the social work must implement six steps, according to Timberlake, et al.

(2008). The social worker must be sure to elucidate the issue of concern, they must

research the proper outside resource that they feel is appropriate for the referral, they

must go over the options of referral with the client system, implement a contract to

release information to the referred resource and accompany the client to meeting the

resource. Also, it is important to follow-up with the referral to ensure a proper match

(Timberlake, et al., 2008). It is furthermore important to allow the client to refer

themselves, where applicable, in order to empower them to make their own choices and

take responsible action (Timberlake, et al., 2008).

In regards to Dianne, we established that she needs to under go treatment for

her addiction to crack cocaine. I researched possible treatment centers, gave her the

information and allowed her the option of which treatment centre she would like to be

referred to. I made a contract plan in regards to her referral to the treatment centre and

ensured that I would support the client throughout the entire referral process. I also

explained to Dianne that, once her treatment was successfully completed, we would

meet again and re-assess her situation.

Conclusion

Throughout the entire general social work interview it is important to take on a

holistic approach to each method and phase implemented. Whether it is the

assessment, contract planning, or intervention and treatment planning, one must look at

all aspect of the client systems environment. With that said, it was no doubt beneficial to
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consider the biological, psychological, social, cultural and spiritual aspects of the client

systems life throughout the assessment phase and beyond. I also felt as though the

contract planning phase was a very useful tool to help organize tasks and goals, as well

as give responsibilities to both the client system and the social worker. This, I feel,

allows the client system to understand that they are not alone in the helping process

and that the social worker will empower them and help them throughout the entire

process. Further, I felt that implementing specific methods and techniques to the

individual client system was very important because it was client specific. This allows

the social worker and client system to attain the highest potential for change because

the methods are catered to the client’s specific problems and needs.

In regards to the entire social work process, I feel as though all theories and

practices that have been implemented throughout the entire interview process will be

useful in real life situations. I feel as though I will, if I already have not, implement these

skills when I am conducting interviews and assessing clients during my placement at a

homeless shelter. Social work is much like their client systems; it is forever evolving like

day into night.

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References

Boyd, Carol J. (1993)."The antecedents of women's crack cocaine abuse: Family

substance abuse, sexual abuse, depression and illicit drug use." Journal of

Substance Abuse Treatment 10(5): 433-438.

Canadian Association of Social Workers (2005). Code of ethics. Retrieved December 4,

2007 from:

http://cronus.uwindsor.ca/units/socialwork/socwk.nsf/9d019077a3c4f6768525698

a00593654/5925a4c891639b89852571e60065a2fc/$FILE/06F%20CASW

%20Code%20of%20Ethics.pdf

Lillie-Blanton, M., Anthony, J. C., & Schuster, C. R. (1993). Probing the meaning of

racial/ethnic group comparisons in crack cocaine smoking. The Journal of the

American Medical Association, 269, 993-997.

Macionis, J. J., & Gerber, L. M., (2005). Sociology (5th ed.). Toronto: Pearson Prentice

Hall.

Restrepo, C. S., Carrillo, J. A., Martínez, S., Ojeda, P., Rivera, A. L., & Hatta, A.

(2007). Pulmonary complications from cocaine and cocaine-based substances:

imaging manifestations. Radiographics, 4, 941-56.

Timberlake, E.M., Zajicek-Farber, M.L. & Sabatino, C.A. (2008). Generealist social work

practice. A strengths-based problem-solving approach (5th ed.). Boston: Pearson

Education, Inc.
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Weiss, F., Ciccocioppo, R., Parsons, L. H., Katner, S., Liu, X., Zorrilla, E. P., Valdez, G.

R., Ben-Shahar, O., Angelletti, S., & Richter, R. R. (2001). Compulsive drug-

seeking behaviour and relapse. Annals of the New York Academy of Sciences,

937,1-26.

Wingood, G. M., & DiClemente, R. J. (1998). The influence of psychosocial factors,

alcohol, drug use on African-American women's high-risk sexual behavior.

American Journal of Preventive Medicine, 15, 54-59.

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Appendix A

Dianne’s Problem Prioritization Scale: Change-Potential Scores (0-10)

Problem Problem: Personal Environmental Total Problem Severity:

List: Strengths: Resources: Change Prioritization:
Potential:
Crack 8 9 10 27 1 *
Cocaine
Use
Son in 8 3 8 19 3
parent’s
care
Bipolar 2 2 9 13 4
Disorder
Personality 2 2 9 13 4
Disorder
No source 8 8 10 26 2 *
of income
Scale: 0= no potential
1= very low potential
2= low potential
3= somewhat low potential
4= somewhat high potential
8= high potential
9= very high potential
10= maximum potential for change
336 Sample of Final Paper Assignment # 5 Assessment and Intervention Page 21 of 23

Appendix B

Dianne’s Contracted Plan:

Date Problem/Need Goal Task Contract Date Date

Identified Anticipated Accomplished
December Crack cocaine 1) Stay 1) Choose a 1) Dianne 1) 1) December
8th, 2007 addiction clean from treatment December 8th, 2007
crack Centre 8th, 2007
without (Brentwood
relapse or House of
2) Return Sophrosyne
her son into 2) Call 2) Dianne 2)December 2) December
her care treatment and social 8th, 2007 8th, 2007
3) Improve centre with worker
mental and my support
physical 3) Schedule 3) Dianne 3) To be 3) To be
health appointment determined determined
4) Return for
back to consultation
school 4) Undergo 4) Dianne 4) 21 days 4) 21 days
5) 21 day after first after first
Reestablish residential treatment treatment day
positive treatment day (to be (to be
relationships determined) determined)
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Appendix C

Genogram:
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Appendix D

Eco-Map: