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Evidenced Based Practice
Jackie Gifford
Aurora University
Clinical Social Work
Kelli Barnes
07/15/23
Agency
Lucaz Agency is a private practice in the city center committed to giving its customers the best social work services possible. Our organization primarily serves people dealing with a variety of life issues. We provide comprehensive services catered to each client’s needs, such as case management, individual counseling, and group therapy sessions. Our team of skilled and caring social workers aims to foster a secure and supportive atmosphere for clients to examine their emotions, build coping mechanisms, and work toward personal empowerment.
Client
The client is a Chinese woman who is 45 years old. She is an immigrant of the first generation and was raised in the Chinese culture. She is married to a caring spouse and the mother of two adolescents. She seeks support in dealing with her dual cultural identity’s intricacies and controlling her anxiety.
History of the client
The patient’s past displays a complex tapestry of events that have molded her into the tenacious person she is today. She was born and reared in a tiny hamlet in China, where a close-knit society and traditional Chinese traditions surrounded him. She moved from China to Beijing due to a scholarship, and she met her lover; they married and had two children. She then migrated to Western countries. Acclimating to the new surroundings offered both thrilling prospects and unexpected difficulties. As she battled to meet the expectations of blending into a foreign society while upholding her Chinese heritage, she experienced emotions of cultural alienation and solitude. She has been feeling anxious for the past two years which affects her ability to concreate and to carry out normal activities.
Reasons for seeking help
Her ongoing anxiousness for over two years is the main reason she seeks help from the Lucaz agency. She has excessive anxiety, restlessness, and uneasiness, frequently accompanied by bodily symptoms, including a racing heart, breathing problems, and trouble falling asleep. She explains her anxiousness as being brought on by the difficulties of adjusting to a new culture, juggling the demands of her Chinese background, and the demands of parenting teens in a world that is becoming more diverse and fast-paced. These symptoms have impacted her everyday functioning, influencing her focus, enjoyment of activities, and capacity to uphold good relationships. She expects therapy will provide her with coping mechanisms and deeper inner peace, enabling her to face the challenges of life’s complexities with courage and resiliency.
Cultural
Her Chinese culture significantly shapes her growth and self-identity. Her treatment must be approached with cultural humility and competency while also appreciating and honoring her cultural values, traditions, and beliefs (Zghal et al., 2020). Understanding the effect of collectivism, Confucian ideals, and filial piety within the Chinese culture can guide interventions that advance family peace and respect her familial responsibilities. Knowing cultural quirks enables a more comprehensive approach, building a therapeutic partnership that honors her cultural heritage and advances her general well-being (Zghal et al., 2020).
Two human behaviors and the social environment
The Cognitive-Behavioral and Ecological Systems theories are two human behavior and social environment theories that may be used to effectively interact with her, who is struggling with anxiety. With an emphasis on the connection between ideas, feelings, and actions, Cognitive-Behavioral Theory enables clients to recognize and alter the unhelpful thinking patterns that fuel anxiety. She can understand her worried thoughts, build coping mechanisms, and gradually face anxiety-inducing events using Cognitive-Behavioral Theory approaches (Curtiss et al., 2021). The Ecological Systems Theory, which Bronfenbrenner established, recognizes the impact of numerous social systems on a person’s development. The social worker can investigate her relationships within her microsystem, the immediate home; mesosystem, the cultural community; and macrosystem, the societal influences using this theory to help understand the contextual factors impacting her anxiety and tailor interventions that address her unique social environment (Crawford, 2020).
Assessments
Diagnosis- Generalized anxiety disorder: DSM-5 300.02 (F41.1)
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in Generalized Anxiety Disorder diagnostic criteria the client must demonstrate several symptoms. These symptoms include excessive anxiety, worry about a variety of events or activities which must be present more days than not for at least six months. The symptoms can be accompanied by symptoms like restlessness, difficulty concentrating, muscle tension, and sleep disturbances that have a significant negative impact on her daily functioning (American Psychiatric Association, 2022).
Based on the DSM-5 criteria, the patient can be diagnosed with generalized anxiety disorder. First of all, she struggles to manage her excessive anxiety and concern. Her anxiety transcends particular circumstances and includes various events or activities, a crucial feature of generalized anxiety disorder. Her persistent anxiety, which has been present more days than not for at least six months, suggests that the illness is chronic.
Assessments tools
Several evaluations can help diagnose generalized anxiety disorder and guide the course of therapy, including the Beck Anxiety Inventory and GAD-7. Beck Anxiety Inventory is a self-report survey that gauges anxiety symptoms’ intensity (American Psychological Association, 2023). The patient’s anxiety levels are quantified by evaluating the frequency and severity of several anxiety symptoms. The Beck Anxiety Inventory may be used to determine the patient’s level of anxiety and monitor changes over time.
The GAD-7, a seven-item scale for generalized anxiety disorder, is another useful evaluation instrument. This self-report test especially looks for signs of generalized anxiety disorder. It evaluates the frequency of significant anxiety symptoms such as excessive concern, restlessness, and difficulty concentrating (Johnson et al., 2019). The GAD-7 can provide a standardized measure of the patient’s generalized anxiety disorder symptoms and assist in tracking her progress throughout the treatment process.
Frequency of reassessments
To track the patient’s development and make wise treatment choices, it is crucial to undertake routine reassessments throughout her course of care. Reassessment should occur at various times before, after, and throughout therapy. The patient’s symptoms, functioning, and objectives are baselined during the pre-intervention assessment, creating a point of comparison for evaluating change. The ability to measure the success of the therapies used and gauges the degree of symptom relief and functional improvement is made possible by post-intervention assessments. The patient’s development is monitored throughout therapy to spot any new issues and modify the treatment strategy as necessary. Her demands are always changing. Thus, regular reevaluation helps guide decisions on whether to continue, modify, or stop using particular treatment methods.
How human behavior and the social environment inform ongoing assessment
The continuous evaluation of the patient will be based on the Ecological Systems Theory and the Cognitive-Behavioral Theory. The social worker can quantify the intensity of her anxiety symptoms and monitor improvements over time by using Cognitive-Behavioral Theory and assessment instruments like the Beck Anxiety Inventory and the Generalized Anxiety Disorder 7-item scale. Cognitive-Behavioral theory informs the patient’s continual progress evaluation and directs therapies that target unhelpful thoughts and behaviors by pinpointing particular anxious thoughts, actions, and triggers (Curtiss et al., 2021). The Ecological Systems Theory aids in extending the scope of the evaluation beyond discrete variables. It offers a comprehensive picture of the patient’s experiences by examining the effects of family dynamics, cultural expectations, and societal pressures (Crawford, 2020). It also contributes to continuous evaluations and interventions addressing her social environment.
Prognosis
Examining the patient’s anxiousness indicates that she has a good prognosis. She can recover and relapse prevention with the right therapies and continuing support. She can create useful coping mechanisms, confront unfavorable thinking patterns, and acquire anxiety management techniques by using Cognitive-Behavioral Theory. Addressing contextual aspects, including family dynamics and cultural influences, would also help to create a more thorough treatment plan, according to the Ecological Systems Theory (Crawford, 2020). Regular reassessments and monitoring of her development will be crucial to assess the efficacy of the treatment and make any required modifications along the way.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR.
American Psychological Association. (2023). Beck Anxiety Inventory. APA PsycNet Direct. https://psycnet.apa.org/doiLanding?doi=10.1037t02025-000
Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. FOCUS, 19(2), 184-189. https://doi.org/10.1176/appi.focus.20200045
Crawford, M. (2020). Ecological systems theory: Exploring the development of the theoretical framework as conceived by Bronfenbrenner. Journal of Public Health Issues and Practices, 4(2). https://doi.org/10.33790/jphip1100170
Johnson, S. U., Ulvenes, P. G., Øktedalen, T., & Hoffart, A. (2019). Psychometric properties of the general anxiety disorder 7-Item (GAD-7) scale in a heterogeneous psychiatric sample. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.01713
Zghal, A., El-Masri, M., McMurphy, S., & Pfaff, K. (2020). Exploring the impact of health care provider cultural competence on new immigrant health-related quality of life: A cross-sectional study of Canadian newcomers. Journal of Transcultural Nursing, 32(5), 508-517. https://doi.org/10.1177/1043659620967441
