Jocelyn Chadwick

Case Assessment Assignment

Social Work with Individuals: Theory and Practice

Summer 2019

Academic Integrity Pledge: “I have abided by the Academic Integrity Policy on this assignment.”

Signature ___ Jocelyn Chadwick____ Date__6/17/19_

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Demonstrating Ethical and Professional Behavior

There are ethical issues in attempting to apply the principles of developmental and

personality theories to this case. Some of the ethical issues revolve around cultural and social

values that were not considered in the development of these theories. The problems that Sergio

and Richard are facing, like immigration status, gay rights laws, and religious undertones deal

with many systemic and political beliefs that they have little control over. Ethically, social

workers should have this fact at the forefront of their perspectives while working with this

couple.

A social worker’s political and/or religious values could influence the theoretical

perspectives that they use. It could also affect the resources and quality of service they give. An

example would be a social worker believing that a person who identifies within the LGBTQIA +

community has been sexually abused. This implicit bias or belief might direct them towards

using Freud’s theory of the unconscious mind to explain the couple’s sexuality. The social

worker would be digging into the clients past to try to prove their bias rather than to understand

and begin problem-solving with the client. In this situation, the social worker’s personal values

impacted the way they perceived and attempted to improve the client’s life.

One of the main ways to avoid value imposition is to remember that the client is the

expert of their lives. As a social worker, our job is not to push our values of the clients but to

improve our client’s lives. Our theoretical approaches should respect our client’s self-

determination and their various intersecting identities. The values that should guide social

workers are Service, Social Justice, and The Dignity and Worth of the Person. We can practice
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these values by having our primary goal be to help people in need, address social problems, and

challenge injustices. (NASW )

Engaging Diversity and Difference in Practice

Using cultural knowledge to understand this case

As I evaluate Sergio and Richard’s case, I find that it is vital to research more

information about Brazil in relation to Catholicism and gay rights to understand this couple

better. My research showed that Brazil is very accepting of members of the LGBTQIA+

community since homosexuality was decimalized in 1830, a first for a nation in the Western

Hemisphere, shortly after the country gained its independence from Portugal. Brazil, according

to the Guinness Book of World Records, held the largest gay pride parade in the world in 2009

when it brought an attendance of three million people to celebrate. Brazil is also believed to hold

Latin America’s largest gay community.

Although this is true, Omar G. Encarnación believes that this reality is a paradox. He

states that” For starters, there is a virulent strand of homophobia in the culture of Brazil that

belies the country’s reputation as a paragon of sexual liberalism. The Brazilian religious

landscape also features a larger than average percentage of Evangelicals (for Latin America),

which surveys find harbor more negative attitudes toward homosexuals than Catholics. These

two factors serve to discourage the public from supporting or demanding gay rights while

making gay rights a relatively high-risk proposition for Brazilians. ( Encarnación, 2016) He

believes this is why religious and conservative legislation does not reflect the perceived

accepting culture of the LGBTQIA+ community in Brazil.

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This knowledge of the diversity and difference of Brazil’s culture helps me as a clinician

to better understand Sergio and his family’s values. This also influences the perspectives I use by

reminding me that there are different barriers that this client will have to face. I can acknowledge

that some issues with being open with his family might come from his family’s religious beliefs.

Even if Brazil is welcoming and accepting of his sexuality on the outside, the legislation and

historically religious undertones might make Sergio feel that he will not be accepted by his

family.

Social and cultural impacts on development and personality

This information allows me to understand better how Sergio’s development and

personality could have been impacted by the mix messages he received about his sexuality from

his environment in his country versus from his family. These influences impact every aspect of

Sergio’s current life situations. His religious upbringing most likely socialized and influenced his

internalized beliefs that he must hide his identity as a gay man. It impacts the relationship with

his family of origin because he can not be his authentic self. It also impacts the quality of his

relationship with Richard and his kids because he keeps that part of his life hidden. Sergio’s

socialized religious beliefs seem to be weighing on Richard, causing him to question why Sergio

has not come out to his family after 15+ years.

Oppression is absolutely a factor in this case. Richard and Sergio are being oppressed

within their identity of being gay. Although they are in a committed relationship and have

children, only Richard is listed as a legal parent due to the immigration status of Sergio. Sergio

faces oppression in having fewer resources available to him since he is undocumented. They are

also both minorities in the United States, which shapes the lens in which they interpret and

navigate the world. Having oppressions intersect in multiple different areas of their lives add
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pressure to their partnership and to the development of their kids. As a person who identifies

with intersecting minority identities, I can relate to their oppression; I can use my cultural

identity to be more empathetic and understanding of the hurdles that this couple is facing.

Engaging the Clients

When Sergio and Richard walk into my office, the first thing I would do is introduce

myself with a smile and warmth in my heart. The second thing I would invite them to sit down

and get comfortable. Before the session got started, I would tell them about the confidentiality

policy and the role I play as a therapist to assist in accomplishing the collective goals that they

want to meet. I would introduce some of my perspectives so that they know exactly where I am

coming from and can determine if I am a good fit as a therapist for them. I would emphasize that

they are the experts within their relationships and their lives and encourage them to guide the

session in a way that would benefit them the most. After this, I would inquire more about who

they are, their presenting problems, and some goals that we can work on together. My intention

is for them to feel comfortable enough to connect with me.

These same skills can be used with larger groups and communities. The approach was to

be genuine and honest from the very beginning. It is essential to state your intentions and your

desire to see improvement in whatever area or community that you are working with. Even

within family settings or with large groups, the engagement process should be welcoming and

should set off the client-therapist relationship off to a strong start.

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Assessing the Clients

The first personality and developmental theory I would use to assess Sergio would be

Carl Jung’s theory of the persona. Jung describes the persona as being “ the ideal picture of a

man as he should be” (Jung,2013) The persona is the different masks that you put on when

interacting with certain groups or people. This mask does not represent our whole self, and if we

depend on it too much, we begin to lose sight of who we truly are. Sergio appears to wear a

mask around his family, presenting himself to be a straight male to please them, while hiding his

true identity and Richard/ the family in the process.

The second theory I would use to understand Sergio regarding his personas would be

Karen Horney’s theory of the complaint personality. The complaint personality can be described

as “ the need for affection and approval to fulfill one’s expectations of life” ( Kelland,2010) This

theory could help to explain a possible reason that Sergio is hiding his partner and his true

identity from his family that he cares for dearly. I think it is vital to understand this because

Sergio’s actions are causing strife within their union and also could be a sign at some deeper

socialized and internalized values that he has about himself and the world.

Exploring these theories and attempting to understand the reasons behind some of their

presenting issues could help to assess the actual needs of the clients. I would want to know how

Sergio balances the expectation of his family and religion in comparison to the expectations of

his partner. These competing social and cultural factors could cause a lot of inner battling within

Sergio. I believe that a lot of the strain in the relationship could be caused from the unacceptance

of Sergio’s identity in all aspects of his life.

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I would use the biopsychosocial (spiritual approach) within this assessment by

understanding that the clients are all affected on a biological, psychological, and social level of

their lives. In the sessions, it would be necessary to acknowledge how all of these different

aspects intersect and affect the personality and development of Sergio, Richard, and their kids.

We can see this emerge with the daughter who could be affected by autism spectrum disorder

and how they might want to approach these issues (spiritually, financially, medically, etc.)

depending on their different beliefs and access to care. Sergio being undocumented will affect

his ability to be present for a lot of medical and educational meetings. Richard will be affected

by how they unite religiously because he is an atheist, and their believes drastically differ from

Catholics. Sergio may want to pray for his daughter and consider that spiritual forces affect

medical disorders, while Richard might think that is nonsense. Navigating this might cause

issues with their kids because kids are affected by the emotional and environmental forces of

their caretakers.

When using the DSM-5 to understand and help Sergio and Richard, I found that they both

meet criteria of different diagnosis’. Sergio met some criteria of depression. He stated that he

feels unappreciated, profoundly sad, and hopeless in regards to the legal responsibilities with

their kids. These criteria align with some symptoms of depression. I would use Beck’s

Depression Inventory (BDI) to assess the severity of Sergio’s sadness.

Sergio stated that he believes that Richard drinking has increased to the point that

Richard I using alcohol to escape from his reality. It seems that Richard meets criteria for

Alcohol Use Disorder. I would use the Alcohol Use Disorders Identification Test (AUDIT) to

identify the severity of alcohol use with Richard and see if it's possible that he might have some

dependency issues.
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Intervention with the Clients

For the diagnoses of depression and Alcohol Use Disorders, I would use Cognitive

Behavioral Therapy. I believe that CBT would be helpful for Alcohol Use Disorder as well as

depression because some of the deeper issues behind substance abuse is related to depression,

anxiety and feelings of hopelessness. According to research, Cognitive Behavioral Therapy

(CBT) is an empirically-validated psychotherapy that is recommended as a first-line treatment

for depression in Clinical Practice Guideline for Management of Depressive Disorder. CBT is a

structured, short-term, present-oriented approach to psychotherapy that helps patients modify

unhelpful patterns of thinking and behavior to resolve current problems. This intervention model

includes :A brief mood check, A bridge from the previous session, The setting of an agenda, A

review of the previous session’s homework assignment, A discussion of agenda items, A

homework assignment and A final summary. I believe this model will help to establish common

goals and a reliable schedule. (USUCDP)

I would use the skills and the relationship built during the engagement and assessment

stages to help the clients within the session. The CBT intervention model can be used with large

groups and families by acknowledging negative thoughts and behaviors on a macro or

community level. It would deal with cooperation within the members of the community and the

therapist to begin brainstorming ways to problem solve.

Evaluating the Clients

To measure the progress and impact of the intervention, I would have Sergio and Richard

critically reflect each week. I would Evaluate the clients’ symptoms but checking in with them
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and asking about their mood looking for improvements. I would also look at if the steps we

discussed are being taken. The steps would be progressing towards a specific goal and should be

motivating for the client. I would be able to pull out many strengths of the clients for continuing

to show up, working towards their goals, and beginning to change their negative self-talk.

There are a lot of solutions I would look into in order to help Sergio and Richard. Gay

marriage is legal and would be a option I would suggest. Getting married would allow Sergio to

get a green card so that he could legally reside in the United States. This would solve many of

the family issues related to the legality of the kids the couple has adopted. This would also

possibly allow Sergio to find more stable work and be financially supporting the family.

As I work with Sergio, a goal that I would have is uncovering some of the stress and

anxiety he might feel towards coming out to his family. I would also want to discuss some tools

and strategies to manage their vastly different religious beliefs. Regardless of their problems they

have a lot of strengths and they have a strong family bond. They have survived and relied on

another for 15 years an that is a huge accomplishment. I believe their love and commitment to

each other has kept their relationship stable enough to work through the issues that they are

facing today.
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References

Encarnación, O. (2016). Out in the Periphery : Latin America's Gay Rights Revolution. New

York, NY: Oxford University Press. (2016). Retrieved June 17, 2019

Jung, C. (2013). The Essential Jung. Princeton: Princeton University Press. (2013). Retrieved

June 17, 2019

Kelland, M. D. (2010). Personality theory: A multicultural perspective. Place of publication not

identified.

NASW Code of Ethics. (n.d.). Retrieved from

https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

USUCDP Cognitive Behavioral Therapy for Depression (CBT-D). (n.d.). Retrieved from

https://deploymentpsych.org/content/cognitive-behavioral-therapy-depression-cbt-d-0