Biopsychosocial Paper

Biopsychosocial Paper Wayne State University SW 3020 004015470 February 21, 2012

Biopsychosocial Paper

Presenting problem: Molly Mingle (pseudonym) is a 23 year old, Caucasian female who lives with her parents in the house she grew up in. Ms. Mingle works as an EMS worker at Beaumont Medical Transportation and has been there for about three years. She is coming to see a social worker because she has recently broken up with her boyfriend and met a new man online. Ms. Mingle fears she will get excited too quickly and possibly move too fast in her new relationship. She is also hesitant because she did meet him online and you can never be too sure. This has all taken place within the last month and a half and she is feeling very anxious. Family of Origin History: The client states that her parents were married and her mother was 36 years old and her father was 25 years old when she was born. The client explains that she has two siblings: John is a 35 year old, married safecracker for the navy and Angela is a 31 year old, married digital artist who owns her own business and is the mother of one 5 year old son. John does not have any college under his belt; however, he earned his high school degree and a lot of training and education from the United States Navy. The client states that her sister has her bachelors in photography from CCS. Both of Ms. Mingles siblings were planned pregnancies; however, she was an accidental pregnancy. The clients mother, Dottie is now 59 years old and her father, Joe is 49 years old. The client says that her mother has some college education and an EMS license from Macomb Community College and her father has his bachelors degree from Baker College in emergency services and is currently going for his masters in health administration. The client describes the atmosphere in her home while she was growing up as chaotic but comfortable. She says that things were never bitter or angry for very long and that she feels it was a great

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house to grow up in. Ms. Mingle also mentioned that her brother left home when she was just 5 years old, so most of her childhood was spent with her parents and her sister. Holidays in Ms. Mingles house as a child were centered on family and tradition. Christmas Eve was spent with her fathers family; enjoying a Christmas dinner and gifts. She describes the experience as a fantastic time. Christmas morning was spent with just her immediate family, opening gifts from Santa and each other. That night, the clients paternal grandparents came over for dinner. Thanksgiving was explained by the client as being a lazy day at her Uncle Steves house with a lot of food and just hanging out with each other. The client states that she would go trick-or-treating with her mother every year as well as carve pumpkins with her sister. The fourth of July was spent with neighbors, according to the client, watching the fireworks from their street and doing sparklers. The client states that on Mothers day she and her sister would make breakfast for their mother, they would go out to brunch with the ladies in the family, and then dinner and gifts in the evening. Fathers day was similar, according to the client, in that the men would go out to lunch and dinner and gifts were in the evening. Easter is clearly a special holiday for Ms. Mingle. She would attend church with her grandmother in the morning and then help her to decorate her house and color eggs with her sister. There would be an Easter egg/basket hung with her sister at home and then another, much larger egg hunt at her Uncle Mikes. According to the client, the most special part of this holiday was the Hungarian Egg-Cracking Game that her grandmother would set up every year. Everyone would hold a hard-boiled egg and try to crack the other eggs: whoever survived the longest without cracking would win. The client states that on Valentines Day she would receive candy and cards from her mother. New Years Eve was spent at home with her parents until the client was older. The client states that at midnight they would have sparkling cider and noise makers.

Biopsychosocial Paper

The client states that her mother is overall pretty healthy; however she is anemic. The clients father has many more health related problems though: type II diabetes (hes on the pump and its pretty advanced), early stages of coronary artery disease, severely asthmatic, and high cholesterol. The client states that her sisters health problems include a buildup of yeast in the stomach and a buildup of fluid around the heart. She also mentions that as far as she knows, her brother is as healthy as an ox. The client did not experience death until she was older. The reactions, according to the client, varied between her parents. Her father would go into work mode, ignoring what was going on. Her mother would follow the stages of grief pretty closely and handle the situation normally. Ms. Mingle states that she was 13 years old when the man she babysat for took his own life. This incident remained sheltered and was not brought up after it happened. She states that she did not lose anyone in her family until she was 20 years old. Ms. Mingle states that there was no form of abuse in her family as she grew up. She explains that her siblings and she were not even spanked. When asked if there was anything else about her family she felt was important, the client explained that her mother had gotten pregnant when she was 18 and has given the baby up for adoption. The client knows nothing about her half-sister except that she is in her 40s now and doing very well for herself. The clients mother does not talk about it. Developmental History: Ms. Mingle does not discuss any issues related to her mothers pregnancy with her. According to the client, she was born by a vaginal delivery, 2 weeks late at 6 lbs. 9 oz. At birth, the client had several issues: her heart rate kept dropping, her organs were slightly

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underdeveloped, she was colicky, and she was jaundiced (reason for this is unknown to the client), causing her to be in the NICU. The client states that she was bottle fed, without any issues related to feeding. Her mother weaned her off the bottle when she was about a year old. The client says that she was running before she could walk (chasing a cat) and that was just before she turned a year old. She was also speaking before she turned one, although she states her mother always tells her she was born talking. Ms. Mingle was potty trained by the age of three and reading simple books by the age of 2-3. The clients parents were never told that she had any developmental delays or that she was advanced developmentally. Health History: The client describes the many health issues she has when she was born: being colicky, jaundiced, her heart rate kept dropping, and her organs were underdeveloped. Ms. Mingle states that as a child she has chicken pox (age 3), ear infections (quite often, she had tubes put in), and pretty bad asthma. The client states she has always had severe environmental allergies. She did not mention any chronic illnesses as a child. The client was involved in numerous accidents as a child. According to Ms. Mingle, these include: multiple broken fingers and toes, broken wrist (softball in gym class, age 12), broken nose (twice in the same month from hitting her exfiancs forehead), cracked tailbone (twice- both from slipping on ice in the winter), cracked kneecap (slipping on the ice, age 8), dislocated her right knee four times (14-19), three car accidents that gave her whiplash and a sore body. The client also had a scratched cornea when she was a kid. When the client was two years old she describes a time when she drank a lot of liquid paraphin and was hospitalized so the hospital could pump her stomach.

Biopsychosocial Paper

The Client states that since she has been an adult, several more illnesses have gotten to her. These illnesses include: chronic kidney infections, enlarged liver and two extra feet of large intestines, chronic strep throat and other infections in general, idiopathic sleep disorder (involving insomnia, hallucinations, light sleeper), sleep walker, sleep talker, chronic nightmares, idiopathic enlarged lymph nodes, high levels of proteins in kidneys, still has her environmental allergies, positive orthostatic, and she is tacacardic. According to the client, the surgeries she has had since becoming an adult are mostly quite simple and include a lap scope, colonoscopy, tonsillectomy, a biopsy of a lymph node, and a stigmoidoscopy. When the client was age 20, she describes having the worst headache shes ever had before that lasted four days. The doctors thought it was meningitis, but Ms. Mingle refused any testing for it. She was put on muscle relaxers for two weeks and there is still no known cause of the headache. When discussing her weight issues, the client mentions that she was a chubbers as a child and was anorexic from age 14 to 16. She said she did not have any real issues regarding her weight since then. The illnesses that have been in Ms. Mingles family are plenty. According to the client, diabetes runs in her dads side of the family, heart disease runs on both sides of the family, her mothers father has bladder cancer, both of her fathers parents had numerous strokes, leukemia, breast cancer, and several other cancers that shes not sure of also run on her mothers side of the family. (Ms. Mingle states that she doesnt know very much about her mothers side of the family). The client said that she began her menses at the age of 13. The only medications that the client is on are a rescue inhaler; however, shes supposed to be on Allegra but doesnt take it. She also mentioned that shes allergic to klonopin. Substance Use/Abuse History:

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Ms. Mingle tried her first drink of alcohol when she was just 15 years old, but didnt continue drinking until she was 17 years old. She admits to being a current user, drinking about 2-3 drinks a couple times a month, and not needing any treatment to handle it. The client states that she was 16 years old when she began smoking and is still a current user. She was able to quit cold turkey and remain a nonsmoker for 9 months when she was 20. The client states that she smokes about a half pack to a full pack of cigarettes per day and has not received any treatment for it. Another substance that the client mentions having used before was marijuana. She client states that she was 18 when she first smoked pot but stopped by the time she was 19 and in that year she only smoked a few times and no treatment was used. The client also mentions have a slight addiction to caffeine, but claims that is not a problem in any way. She states that she drinks coffee and pop to get her caffeine fix. Mental Health History: Ms. Mingle declared that she had a mental break when she was 16 years old because a lot of things were happening to her in a very short period of time. She began seeing a therapist at the pediatricians office and considers the treatment to be successful. When the client was 20 she began seeing another therapist, Phyllis because she lost her grandfather, she was struggling with relationship issues, and kept recalling her past relationships and the problems she had with them. Ms. Mingle is still currently seeing her therapist and loves her very much. She feels this treatment, at Eastwood Clinic (mental health clinic) is going very well and she gets along with her therapist very easily. At the age of 16, the client mentions that she was severely depressed. Relationship/Sexual History:

Biopsychosocial Paper

The client mentions several important friendships from her childhood: Amber (age 2, they are still close friends), Audrey (grew up with her, were close friends but now just good neighbors), Lindsey (elementary school and middle school), Same, Megan and Ashley have been friends since elementary school and still are, but not nearly as close as they once were. Jessie has been the clients best friend since they were 14 years old. The client then continues to discuss James (since 14), Jason and Justin (since 11), Katie (for the past 3 years), Emily (since they were 18), and Ashley V has been a good friend of hers since she was 18 years old. Beth and Sandy are Ms. Mingles most recent friends; however, they have gotten extremely close in the past several months. Ms. Mingle states that she began dating when she was 14 years old and claims she had her first sexual experience when she was 15 years old. The client identifies herself as heterosexual and although she describes sexual activity as enjoyable, she only has an occasional orgasm because she has not been able to find her G-spot. The client states that she is not currently having sex with anyone; however, she is in a committed, sexually intensified relationship. The client states that the method of birth control she relies on when having sex is condoms. She states that she has never had any sexually transmitted diseases or infections. Since becoming sexually active at the age of 15, Ms. Mingle has had 9 sexual partners and all but one of them was in a committed relationship with her before they began having sex with her. Family of Creation History: The client states that she has never been married, but has been in several committed relationships. When she was 14 years old she was dating Chad, a 15 year old boy in her high school who was working in a party store at the time. They were together for two years. She

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mentions that they had a good relationship and the only reason they broke up was because they were growing apart. She states there was no abuse throughout the relationship. At the age of 16, Ms. Mingle began dating Kyle and remained with him for a year and a half. Kyle was 16 at the time as well and they were in a good relationship, according to the client. She is unsure of why she and Kyle broke up in the first place. Kyle was in high school at the time, just like the client, and did not have a job at the time. The client states there was no abuse of any kind in this relationship. The summer after high school, the client recalls being with Brad for three months. She was 18 years old and Brad was 15 years of age. She describes the relationship as being a fun fling that was nothing serious. The reason for them breaking up was that she moved away to college. She states there was no abuse in this relationship. The client discusses her ex-fianc, Eric in a bad light. They were both 18 when they got together and stayed together for almost three years. They became engages after being together for a year and a half and she describes the relationship as being shitty. She states that he was controlling and abused her in every way possible (verbal, emotional, mental, and sexually). They broke up because neither one of them was happy anymore. Eric had some college experience and was working in fast food at the time. After Ms. Mingles engagement, she began seeing Ryan, who was 22 at the time. The client was 21 and describes the relationship as a rebound. They ended because they lived so far away from each other. Ryan had his high school degree and was working in pest control. The client states that there was no abuse in this relationship.

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When the client was 21 she began seeing a 25 year old that she worked with, Will. Will had some college experience and worked with her in EMS. The two remained a couple for about 3 months. The client describes the relationship as being very one-sided, with her doing everything. She believes the reason they broke up was because of his vile temper. She states that he was obsessive and controlling while also subjecting her to both mental and verbal abuse. The client states that she was 21 when she began her relationship with Kevin, who was 27 at the time. Their relationship lasted about 6 months; he was also in EMS and had some college experience. The client says that Kevin was obsessive, controlling, and sociopathic and that is the reason they stopped seeing each other. He did however start stalking her after they broke up. He caused her a lot of mental abuse. The clients most recent boyfriend was Dan. She began dating Dan when they were both 22 years old and they were together for just over a year. She describes the relationship as being dysfunctional. She states that he was possessive, jealous, obsessive, controlling, had different values than her, and had a terrible temper. She also mentions that when they were together and he wasnt being all of those things, they had a good thing going and she was happy with him. They had a lot of fun together. They broke up because she was not happy at all anymore and he began crossing some lines, like snooping through her cell phone. Dan had some college under his belt and worked as an EMS and firefighter. The client states that there was verbal, emotional and mental abuse in her relationship with Dan. Most recently, the client has begun dating Kristopher. They are both 23 years old and they met on an online dating site about a month ago. She states that the relationship is so far-so good! and that they are keeping things casual right now, but she really likes him. Kris is a

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current graduate student and works at Community services for the blind. The client states there is no kind of abuse right now in their relationship. Religious History: The client states that her family of origin is Catholic and that is the way in which she was raised. She also mentions that this is not very important to her at all, and not very important to her family either. Growing up, the client states that she used to attend church every week and that she was baptized when she was 12 years old. The client discusses her current religious views as none. She states that she has no religious affiliation, she does not agree with organized religion, but she does respect those with that faith. Educational history: Ms. Mingle attended Miami Elementary school as a child, Wyandotte Middle School, and then Chippewa Valley High School. She graduated in the year 2006 and states that she received average grades throughout high school. She began attending Saginaw Valley State University in 2006. She attended for 2 years, but did not receive any degrees at that point. The client then discusses her time at Macomb Community College from 2009-2011 where she got her associates in social work and was on the Deans list. Beginning last year, Ms. Mingle began attending Michigan State University while she goes for her BSW. In the year 2009, the client states that she became nationally licensed in EMT from Med star Ambulance Company. She is currently still licensed in the state of Michigan.

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The clients future educational goals include getting her masters degree in social work and then continuing on to get her PhD in anthropology. Ms. Mingle believes that her intelligence level is average, maybe slightly above average but nothing special. Employment History: The client states that she did chores at home when she was kid whenever her parents asked her to. She did not receive an allowance for these chores, but they included things like cleaning her room, vacuuming, and other random things around the house. When she was 14, Ms. Mingle began working as a waitress in an assisted living home. She worked there for about a year and then was fired due to a miscommunication. She states that she enjoyed interacting with the elderly, but that it was just a typical waitressing job with a limited menu. Cleaning was included in her job description also. The client couldnt really recall her exact wage, but she believes she was making minimum wage, which would have been consistent with the training. From the ages of 16-18, the client worked at Olgas Kitchen. She states this was another typical waitress job where she was making $2.65 plus tips. She states that is was just a job, she didnt love it but didnt hate it either. The client says she stopped working there because she moved away for school. After moving up to college, the client began working for Subway as a sandwich maker. She worked here while she was 19 and 20 years old, making $8 an hour. She states that the job was fun, but she didnt want to make it into a career. She stopped working there when she moved back home from school. The clients current job is at Beaumont Medical Transportation and she has been there for the past three years. Her job consists of driving the ambulance, patient care, and emergency care. She states that she saves lives! and loves that aspect of her job. She makes $10.46 an hour and

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feels that this is not consistent with the amount of training she has received. She believes that she should be making a lot more money right now. Ms. Mingle states that she loves her job and the people for the most part, but she hates the company she works for. Strengths While learning all this information about the client, she expressed several strengths about herself to me. She believes her strengths lie in her ability to stay calm in intense situations, her honesty and openness and also her strong will. She identified her support systems as being her friends, family, dogs (especially Thea) and her current therapist. While I was meeting with Ms. Mingle, I noticed a variety of strengths and talents that help her cope with everything she has gone through and is going through now. Ms. Mingle is an extremely strong-willed person who is not afraid to say what she feels or stand up for what she believes is right. Her ability to communicate effectively and openly has greatly helped me in getting to know her. She is also quite a humble person, never wanting to toot her own horn, even when she deserves it. I also noticed those same qualities that she mentioned as being her strength, especially her ability to stay calm when she is stressing out, feeling anxiety, or just going through a risky situation like she does at her job every day. Ms. Mingle has a great support system of her friends and family as well as several people she attends class with and works with who are willing to help her out when she needs. I can see how much she loves the people in her life and would do absolutely anything to protect them. Ms. Mingle is a very strong, supporting, and passionate person and I can see from talking to her that her love for her friends goes far deeper than anything else.