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Running head: Bio-Psycho-Social assessment

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Bio-Psycho-Social Assessment
Katie Brogan
Wayne State University, SW 3020

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Betty Lou is a 31 year old engaged female that currently resides with her parents in
Warren Michigan. She has become dependent on her family as her Muscular Dystrophy has
progressed to the point she is unable to complete daily living tasks independently. She is unable
to work, and is homebound do to her debilitating disease. She has dated the same man since high
school and has been engaged to him for ten years. Betty was referred for a social work
assessment due to an increasing dependency of her family responsibility and feeling
overwhelmed as a result.
Family of Origin History
Betty Lou was born to Margaret Lou and Norbert Lou in 1982, at the time of her birth her
mother was thirty one and her father was thirty five. Betty was the fourth child of Margaret and
Norbert. Margaret and Norbert have been married for forty years, navigating through the good
and bad times together. All of Margaret’s pregnancies were planned, after the pregnancy of Betty
Margaret had a sterilization procedure performed to prevent any unwanted pregnancy. Both of
Betty’s parents have high school diplomas. After high school Margaret seen no reason for
further education as she wanted to be a stay at home mother and Norbert went off to serve in the
Vietnam War. Once Norbert came back from Vietnam Margaret and Norbert were married,
Margaret was eighteen and Norbert was twenty two. Margaret became pregnant with their first
child when she was twenty, she gave birth to a son Brady Lou. Brady is currently estranged from
his parents and sisters. Brady has an associate’s degree, has been married three times along with
multiply relationships that did not work out. He currently is forty years old lives with his wife
and her two children and also has joint custody of two of his children. Brady’s first child is now
twenty years old, no attachment was ever formed. Brady works as a hearing booth installer for
the last seven years. Jamie Lou was born two years later, Jamie throughout childhood excelled at

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sports. She went to college with scholarships that paid for her entire education for her running
ability. Jamie holds a masters’ degree in early education and is nationally certified to teach
kindergarten through eighth grade anywhere in the United States. Jamie is currently thirty seven
years old, married with two children, and recently laid off. Prior to being laid off she worked for
Detroit Public Schools for several years until she was offered a brief opportunity to work for the
Lamphere school district, unfortunately due to budget cuts she was laid off while on maternity
leave with her second son. The next child Margaret and Norbert had was born four years later, a
daughter named Peggy Lou. Peggy currently holds two Associate degrees and is working on her
Bachelor’s degree. Peggy is divorced with five children, Peggy and the five children live with
Betty and their parents. Peggy along with going to school full time holds two part time jobs, she
is a bookkeeper and an applied behavioral analysis aide. While growing up Betty had the closest
relationship with Peggy, which still remains strong. The other siblings have never been there to
help Betty in her time of needs. All immediate family members are alive and no one close had
died during childhood. The family only celebrated Christmas, Easter, Thanksgiving, Halloween,
and birthdays. Every year for Halloween Margaret stayed home passing out candy, while
Norbert went with the kids trick or treating. Thanksgiving was always celebrated at Margaret
and Norbert’s home. The only people that came to share in the Thanksgiving meal were
Margaret’s parents. Up until Betty started high school Christmas was celebrated by waking up at
home, opening the presents that Santa Clause had brought followed by going to Margaret’s
parent’s house. At Margaret’s parent’s house presents were opened followed by brunch than off
to Norbert’s parent’s house to open presents and eat dinner. This tradition ended once Margaret’s
mother passed away, Margaret’s mother passed away when Betty was in the 9th grade. At the
same time Betty’s muscular dystrophy had progressed to no longer having a steady gait making

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walking up and down stairs nearly impossible. At Norbert’s parent’s house Christmas was
celebrated in the basement, and it was not acceptable to Norbert’s parents to make adjustments so
Betty could participate. The only other celebrations that were celebrated were birthdays, a
birthday party in the backyard was given for each of the children in the family. Birthday parties
included swimming, cake, ice cream and presents. Betty has never experienced physical or
sexual abuse. Her father was an alcoholic growing up, but has very little memory of his
alcoholism.
Developmental History
Margaret was pregnant with Betty for forty weeks, with no complications. Betty was
delivery was done vaginally. Betty was born weighing seven pounds three ounces; she was a
very happy and healthy baby. Betty latched right on to her mother at birth and was exclusively
breast fed, never drinking out of a bottle. Betty reached all of her development milestones at the
appropriate age. She started saying her first words at six months, was walking by twelve
months, and potty training by two and ½ years old.
Health History
Betty started off her life very healthy, only having a few minor infections that were
treated with antibiotics during her first five years of life. When Betty was six years old she
contracted the chicken pox, her sister Peggy also had the chicken pox at the same time. The next
few years of life went by with little concern until she started showing signs that something was
not correct. When Betty was in the fourth grade it was determined that she had a genetic
disorder, Muscular Dystrophy (MD). Since the time of the diagnosis she has lost the ability to
stand or walk along with her fine motor skills deteriorating. The MD has also led to her
developing scoliosis.

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Relationship/Sexual History
Betty no longer has the same friends that she had in elementary school, as her disease
progressed her friend became more and more distant, until they were gown. New true friendship
have been formed, these new friends have been made while participating in activities such as
wheelchair basketball and sled hockey. Wheelchair basketball is where she met her fiancé Bill
(pseudonym). Betty and Bill have been engaged for ten years and she has remained a virgin.
Betty is uncomfortable with any type of sexual conversation, while growing up this was a subject
that was never mentioned.
Family of Creation History
Betty has been engaged for the last ten years, to the only boyfriend she has ever had.
Betty has no children, except her three German Shepherds that she calls her babies. Both Betty
and her fiancé Bill received an Associate’s degree from Macomb Community College than went
on receive their Bachelor’s degrees in communications from Central Michigan University. Since
earning their degrees Bill started working in a sporting goods store and Betty stays home with
her mother. They are happy healthy relationship.
Substance Use/Abuse History
Betty grew up in a home with an alcoholic father. Betty’s father was in and out of rehab
for his addiction for the first ten years of her life. By the time Betty was a senior in high school,
Norbert received his final drinking under the influence citation, which ended with him losing his
driver license. Once Norbert received lost the privilege to drive this last time he never picked up
the bottle again. After ten years of not driving he has earned back the privilege to drive and has
remained sober.

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Financial History

Betty viewed the finances of her family while growing up to have not been an issue, even
though now she knows that her family struggled greatly. Margaret protected her children during
their childhood from the financial stress the family was enduring. Currently Betty makes enough
money to pay a few bills, but not enough to be able to live on her own. Betty’s only source of
income is Supplemental Security Income. She relies on her father’s health insurance and
Medicaid to be able to pay for her medical expenses. Her fiancé is also below the poverty level,
only working part time for a low paying wage.
Other History
Betty has no experience or history with mental health, military, legal or immigration
issues.

Step 1
Betty and I discussed her Bio-Psycho-Social Assessment, Betty agreed with everything
that was discussed. Betty’s main problems of lowered self-esteem, frustration, and a feeling of
worthlessness is all directly related to her thinking that she is a burden, that can’t do anything to
contribute to her family and or society. Betty wants to feel useful and needed, not a strain to
everyone she knows.
Step 2
The most significant problem that is affecting Betty is her feeling of being useless. This
feeling of being incapable of doing a task on her own is lowering her self-esteem, creating
frustration and a feeling of being worthless. The main focus will start with Betty Lou realizing
that yes she does rely on others for assistance but she also has a great deal to contribute to

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society. Betty agrees that she would like to start focusing on what she can do, instead of what
she can’t do.
Step 3
Betty Lou is a very intelligent individual with full mental capabilities; she has declining
gross and fine motor skills that limit what tasks she can physically complete. Identified problem
is Betty Lou is home bound she needs transportation other than her family members. Betty is
unemployed while her medical condition would interfere with employment she could find
volunteer work that is contingent.
Step 4
Betty Lou is a very intelligent, kind, caring, patient young woman. Betty Lou enjoys
working with children and has previously volunteered in a local elementary school helping
teachers with preparations and working with students. Betty Lou is still mentally capable of
volunteering at the elementary school for short periods of time. Betty Lou could volunteer at the
Elementary School, with the assistance of public transportation for individuals with disabilities
to get to work and the school’s safety squads helping Betty get to her destination once at school.
In volunteer work Betty can utilize her college education, giving back to the community. Betty
will also increase her dependency by using a bus to get to the school instead of her family.
Through volunteering Betty will increase her self-esteem, independence, and her feelings of
worth. This strategy will involve all three levels of micro, macro, and mezzo. Betty will be
given the tools to work independently through the help of the local elementary school, and the
transportation provided by the county. The pros with this strategy are the elementary school
always needs volunteers, Betty’s work is needed. Betty has completed this kind of volunteer
work in the past, and it brought to her great joy helping children.

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Plan of Change
1) Betty Lou will increase her feeling of independence
A. Betty will call the school and make arrangements to volunteer once a week
B. Betty will make arrangements to have busing from and to the school
2). Betty Lou will increase her feelings of worth
A. Betty will volunteer in the school once a week
B. Betty will complete one task for a family member a week.
3) Betty Lou will decrease her frustration
A. Betty will keep a journal, writing down her feeling and thoughts for the day four
times a week.
B. Betty will write down one thing that frustrates her and possible alternatives that could
alleviate the frustration.

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Contract for Intervention Plan
Client Name: Betty Lou

1. Description of the Problem: Betty Lou is suffering from low self-esteem, frustration, and a
feeling of being worthless due to increasing dependency of family members.

2. Primary Goals: The primary goals are in increase Betty Lou’s self-esteem, feeling of worth
and decrease frustrations.

3. We, the undersigned, agree to the objectives in the following plan;
A. Independently make arrangements to volunteer at the elementary school.
B. Independently make arrangements for transportation to and from school
C. Volunteer once a week at the school
D. Keep a journal of thoughts and feelings, writing in the journal 4 times a week
E. Will complete one task per week for a family member.
F. Will write down one thing that causes frustration, along with possible alternatives that could
alleviate the

____________________________
Signature of Client

____________________________
Date

___________________________
Signature of Worker

____________________________
Date

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Bibliography
Barsky, A. E. (2010). Ethics and Values in Social Work. Oxford University Press.
Brogan, K. (2014, July 9). (B. Lou, Interviewer)
Kirst-Ashman, K., & Hull, G. (2010). Understanding Generalist Practice Second Custom
Edition for Wayne State University. Manson: Cengage Learning.
Workers, N. A. (2014). Code of Ethics of the National Association of Social Workers. National
Association of Social Workers.