Biophysical Assessment: Demographics, Health, etc.

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Demographics

Client is single, does not have a girlfriend or a history of past relationships since “he has never had a serious girlfriend.” Client has no children. The Client has a strained relationship with his mother, he was removed from her under PINS at the age of 14 and lived in a care facility until the age of 16. He does not talk to his biological father and states that he has not seen him after the age of 3. Client mentioned having a good relationship with his grandmother until she and his mom had an argument and stopped talking when he was still a teenager. Currently, Client is unsure where his mother, father, or grandmother resides. He is uncertain if his grandmother is still alive. Client does not communicate with his parents or grandparents.

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Client has a younger half-sister Jeny XXXXX, he maintains contact with her. He has lived with Jeny and her boyfriend for several months until the latter discovered drugs in Client’s room and asked him to leave. Client has a good relationship with his sister and maintains communication with her.

Current Family/Relationship Information

Client was born when his mother was a teenager, more specifically (17), and his father was (23). His father helped raise Client until the age of 3 and a half, after that, the Client does not recall communicating with him. The Client’s parents never married, but his mother had several other relationships, and when the Client was (1), she gave birth to his younger sister. His mother, Ms. XXXX, raised him alone, occasionally getting help from her mother until they got into an argument and stopped talking. Ms. XXXX had several other relationships, including one where she had Client’s younger sister, Jeny XXXX, and several others. Growing up in a household with separated parents and experiencing several other separations could have an immense adverse impact on a child’s development and their views on relationships. Moreover, Saini et al. (2017) suggest that mothers play an essential role in supporting the relationship between a child and their father after a separation. In the Client’s case, it appears that no efforts were dedicated to ensuring that he is in contact with his father, either due to disagreements between parents or because of the father’s reluctance to see his child.

Client and his mother lived in the same neighborhood until he was 14, when he was removed from his family under PINS. They moved between several apartments, and after the last move, the Client lost connection with his grandmother, as he no longer knows where she lives.

At the age of (8), the Client’s mother moved in with her boyfriend of five months. Client does not report experiencing violence or abuse during childhood, but police records show that they had to come to the Client’s apartment after domestic abuse complaints, although no legal action was taken upon these visits. Client does not communicate with her mother’s boyfriends.

The first recorded drug use that the Client engaged in was when he turned 14 and his school administration asked him to do a drug test after noticing his unusual behavior. He refused, but upon filing a PINS claim, the officials took action to search the Client’s house since he claimed to find the drugs there. No drugs were found, but the Client was placed into an outpatient facility for treatment, which he did not complete because his mother refused to drive him to the facility. Child neglect, according to Widom (2017), affects the person’s perception of themselves and others and can lead to substance abuse problems, and “children who have experienced physical abuse become perpetrators of violence in adolescence or adulthood” (p. 186).

Educational/Vocational History

The Client has studied in one school district through his childhood. Client has had average grades throughout his education, within the range of C/B. At the age of (7), he had a verbal dispute with his teacher, and at (14), he came to school under the influence of marijuana. His mother was asked to come to school to communicate about the Client’s behavior several times. In all cases, she postponed the meetings and never talked to the school’s administration. Client reports not completing his GED, and he was enrolled in a local HVAC program but failed to complete it.

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Economic/Employment History

Client does not report having a permanent job after he was released from a juvenile facility at the age of 20. He worked several jobs, mainly in the construction industry. He reports living with his mother at the age of 20 and later on living with his sister, who helped him support himself. At the age of (20), the Client was homeless, and then he moved into his sister’s house.

Medical History

Client has been diagnosed with Bipolar Disorder, but he does not provide any details of his treatment. Client admits to using an unprescribed medication, such as Xanax. Prior to Client’s arrest, he was in a physical altercation with her mother’s boyfriend, but he was not hospitalized. In prison, he does not take any medication, however, he might begin treatment for Bipolar.

Trauma History

Client denies being a subject of physical or sexual as a child. However, he reports that the staff of a juvenile detention facility he was held until the age of (20) attempted to sexually assault him, which might have caused trauma. Since the Client was still a minor when this incident happened, it might have caused trauma. The relationships the Client had with his mother and the absence of a father might have caused trauma as well because his childhood needs were unmet (Aas et al., 2016).

Mental Health History

Client was diagnosed with Bipolar at (20) but did not undergo any treatments. However, he reported using unprescribed medication for his condition. Notably, some researchers link the development of bipolar with childhood trauma. For example, Aas et al. (2018) state that “childhood traumatic events are risk factors for developing bipolar disorders, in addition to a more severe clinical presentation over time” (p. 10). This Client had a strained relationship with his mother since childhood and had no connection with his father. Separation at an early age may be the cause of psychological problems in the future. Separation at a young age affects a person’s future ability to build relationships with people, for example, the ability to stay in a relationship with a partner (Paccione-Dyszlewski, 2018). Moreover, “when a child is abruptly separated from the parent, vital needs go unmet, the parent/child trust bond is broken, and the child is thrown into traumatic free fall” (Paccione-Dyszlewski, 2018, p. 8).

Substance History

Client has a history of drug use, beginning at the age of (14) when he was placed into an outpatient facility after smoking marijuana. Later, at the age of (28), prior to his current arrest, he was asked to leave his sister’s home because he had drugs. There are no other reported incidents of the Client’s substance abuse, however, he reports taking unprescribed medication, Xanax. Client never finished his outpatient treatment and did not engage in other substance abuse treatment programs.

Strengths/Social Support

Client has a close relationship with his younger sister, whom he lived with prior to being arrested. She routinely visited him at the juvenile facility and after his arrest and provided support by allowing him to live with her and her boyfriend. The Client does not maintain relationships with other relatives, he is not close to his mother, does not know where his father or grandmother reside at the moment.

Mental Health Status Exam

Cognitive (memory, intelligence): Adequate historian, Average intelligence
Attitude toward social worker: Amicable
Behavior: Calm
Thoughts Process/Speech: Fluid
Judgment/Insight: Average
Mood/Affect: Appropriate
Perceptual Disturbances: Has bipolar, does no disclose having hallucinations.

According to the Centers for Disease Control and Prevention (CDC) (n.d.), Adverse Childhood Experiences (ACEs) affect the future of children by predisposing them to violent behavior and perpetration. These experiences can occur between the ages of (0) to (17) years. Some examples include but are not limited to living in a neighborhood with high crime rates or being a witness to violent behavior. It is possible that the Client’s behavior is a result of ACEs, in which case, it is necessary to help him overcome the trauma he experienced. Wisdom (2017) argues that such exposure creates a “cycle of violence,” which is when a child exposed to abuse and violence engages in the same behavior (p. 186). With the Client, ACES is evident considering the neglect that he experiences, for example, when his mother refused to drive him to an outpatient care facility or when she visited him at the juvenile detention center only once. The author of this report collected information about Brian and based on information about ACEs from CDC, and one can conclude that unfavorable environmental conditions, relationships with parents, and neglect he experienced as a child, combined with an attempt to sexually assault the Client when he was in a juvenile detention center have caused harm to his mental health.

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AI

Alternative incarceration (AI) programs are aimed at individuals who committed crimes but are sentenced to punishment other than prison. For the Client, the goal is to enroll him in a long-term drug or mental health program that will help address his childhood trauma or addiction. Based on this information, the author of this report offers several programs in NY that are suitable for this Client. Among the programs, they have one that targets substance abuse as well, which can help the Client overcome his addiction. In this program, there are qualified psychiatrists who can help the Client with his diagnosis and create a suitable treatment plan for him. One example is the Bronx Mental Health Diversion Services, which is suitable considering that the Client has Bipolar (“Alternative to incarceration,” n.d.). The Client’s case matches the objectives of this AI program since they work with criminals who have mental health disorders co-occurring with addiction.

An alternative to the Bronx Mental Health Diversion program is the Nathaniel Project. Center for Alternative Sentencing and Employment Services (CASES) created this project to help inmates who have mental health problems and struggle with substance abuse (Alternative to incarceration,” n.d.). Under this program, the convicts are under supervision for 24-months, and specialists help treat mental health illnesses and address substance abuse disorders. Moreover, they provide housing support upon the completion of the program, which is especially relevant, considering that the Client has been homeless for a while prior to incarceration and does not have a permanent living space.

The Nathaniel Project is perhaps the most suitable AI for this Client because it will help him not only address his current problems but also will support him after the program is completed. In this way, the Client will be able to reintegrate into the society since having a permanent place to stay in is linked with one’s ability to find a job, since “constraints in shelter bed supply may limit responses of homelessness to changes in economic conditions” (Hanratty, 2017, p. 640). This AI program can provide the Client with a chance to begin a new life after he serves his sentence since, as shown in this report, he has little social support, apart from his sister. The limited social support means that he might have difficulty finding a job and housing, which would increase the likelihood of committing a crime. Hence, the Nathaniel Project is a good AI choice for this Client, which will not only serve the purposes of justice but also will help him become a better citizen.

Other Considerations

Apart from the information above, the author of this report can gather other information about the Client’s life that will assist in choosing an appropriate ATI program.

For example, it would help to know how the Client was able to provide for himself between the ages of (18) and (28) since he reports no employment history. In addition, asking him about his interests would help him choose a program that would target not only his criminal behavior but would also help him learn new skills so that he could find a stable job afterward and live independently. In addition, more information about the Client’s experience with Bipolar is needed to assess his mental state better. The main issue here is that he does not take prescribed medication, despite the fact that bipolar is a serious mental health illness, and referring him to a psychiatrist may be necessary to ensure he receives treatment.

In addition, the information the Client disclosed during this assessment, mainly the fact that he admitted committing a crime that has not been resolved, is alarming. Typically, the state’s laws require a social worker to report information that may lead to child abuse or harm to a third party, even if the Client objects to such disclosure. However, in this case, the Client does not threaten to harm a child, elderly person, or a third party, he admits that he had committed a crime. In this case, it is an obligation of a social worker to maintain the Client’s confidentiality unless the judge orders otherwise.

Despite this, I would feel disturbed by this confession, and I would discuss my concerns with a supervisor without identifying the Client. Mainly, I feel that it is unfair that the Client admitted to committing a crime where he harmed another individual, but he will not be charged for it. Regardless, I would adhere to the ethical standards and not disclose any information connected to this confession.

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References

Aas, M., Henry, C., Andreassen, O.A., Bellivier, F., Melle, I. & Etain, B. (2016). The role of childhood trauma in bipolar disorders. International Journal of Bipolar Disorder 4(2), 10-20. Web.

Alternative to incarceration (ATI) programs. (n.d.). Web.

Centers for Disease Control and Prevention. (n.d.). Preventing adverse childhood experiences. Web.

Hanratty, M. (2017). Do local economic conditions affect homelessness? Impact of area housing market factors, unemployment, and poverty on community homeless rates. Housing Policy Debate, 27(4), 640-655. Web.

Paccione-Dyszlewski, M. R. (2018). Parent/child separation: Immediate trauma with lifelong consequences. The Brown University Child and Adolescent Behavior Letter, 34(9), 8–8. Web.

Saini, M. A., Drozd, L. M., & Olesen, N. W. (2017). Adaptive and maladaptive gatekeeping behaviors and attitudes: Implications for child outcomes after separation and divorce. Family Court Review, 55(2), 260–272. Web.

Widom, C. S. (2017). Long-term impact of childhood abuse and neglect on crime and violence. Clinical Psychology: Science and Practice, 24(2), 186–202. Web.

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