An Introduction to Human Services 9th Edition
Discussion 1 Case Management
Case management, as defined by Woodside and McClam (2019), involves “the activities of planning and coordinating, and, in some cases, delivering treatment strategies” (p. 279) and is an important service delivery strategy. After reading the required chapters from the Woodside and McClam text, the articles Case Management at the Intersection of Social Work and Health Care (Links to an external site.)Links to an external site. and Strengths-Based Case Management: Individuals’ Perspectives on Strengths and the Case Manager Relationship, and watching the video Case Management in Health Care, discuss the basic features associated with case management and explain the case manager’s role. Then, reflecting on the case management section from Chapter 1 of the course text, discuss the three factors that created the need for case management.
Discussion 2 The Human Service Model
As we recall from Chapter 6 of the Woodside and McClam (2019) text, human services are provided in many ways. In this discussion:
- Explain the service delivery human service model and the worker’s role in solving problems.
- Distinguish among the three models discussed in the text. How are the medical and public health models different from the human service model?
- Lastly, read the Susan and Ted case study in the Human Service Model section of Chapter 6 in the course text and explain how the human service model can address the circumstances presented. Consider the significance of problem identification, client strengths, context, and culture.
SUSAN AND TED
Susan and Ted met in college, where she was studying to be a teacher and he was studying to be an engineer. Ted was from an upper-middle-class family; Susan, from a religious, working-class family that was biracial. Her mother was Filipino, and her father was white. Even while they were dating, Ted was a heavy “social drinker,” but Susan ignored his drinking. She wanted to marry a man with a college education and have a large family. She came from a small, close-knit family and had only one sister. She remembered her family as having few luxuries while she was growing up but much love and nurturance. In fact, following an automobile accident when she was 18, a major source of support and strength was her family. Ted’s family was also small but not close. Ted had little contact with his family, even though they lived in the same town as the university.
Ted and Susan decided to marry during Ted’s senior and Susan’s sophomore year. They were living together and talked about a life together. When Susan became pregnant, they talked with both of their families about the pregnancy. Her family saw marriage as the “right thing to do” although they had some reservations about Ted whom they didn’t know very well. Ted’s family was opposed to the marriage from the very beginning, believing that Ted could better and marry someone who was more “their kind of people.”
Nevertheless, Susan’s family promised to help care for the baby. Ted’s family agreed to pay tuition and basic living expenses until Ted graduated. Ted continued in school; Susan dropped out to concentrate on building their home. Her religious tradition placed value on her responsibilities as a wife and mother.
Ted felt he was leaving behind a happy, carefree life without responsibility. He was now beholden to his parents for financial support. He was determined to graduate so he could take his place in the world and earn a decent salary. His dreams did not include children; he saw college and career as a way to enhance his social status and pay for an exciting lifestyle that included fast cars and an active social life. He also wasn’t sure how a biracial wife would fit into his plans.
Susan tried to be the “perfect wife” her mother had been. She was determined to work before the baby was born. After the baby was born, she would assume the role of wife and mother. Susan and Ted did not discuss their finances together. Susan felt that Ted should assume the role of the financial planner. She was happy to have an allowance for food and other expenses. She deposited her check from work into their account. Ted felt that Susan had no business in the financial affairs. That was a husband’s role. In addition, Ted’s parents were paying many of their expenses. Susan’s small financial contribution did not merit her involvement.
Ted began drinking heavily after they married. His grades were slipping. He did not spend much time at home. When Ted came home, he seemed angry. He did not resemble the man Susan married. He threatened to hit her several times. Susan was sure that she must be doing something wrong. He complained that the house was a mess, she was a poor cook, and she had let herself go. She thought her mother was a good wife and she followed her mother’s example, so she was lost about what else she could do. She was scared that she might lose Ted if she complained. Her tension and anxiety escalated. Ted turned to drugs, and the relationship deteriorated further. Susan was alone and depressed but did not confide in her family, because she did not want to upset them.
Susan knew that Ted was intent on completing school. He was often away for days. As Susan’s pregnancy progressed, Ted would come home after class frustrated and angry. He began to hit her. Once, he beat her so badly that he cracked two of her ribs and broke her nose. He also attempted to strangle her. She told no one and lied to her doctor, coworker, and friends about the injuries. Ted “came to his senses” and tried to make amends, but he began drinking heavily once again and in a fit of rage kicked her in the stomach, bringing on labor. Susan delivered a son in the sixth month of her pregnancy. Justin weighed 3 pounds, 2 ounces and had difficulty breathing. He was placed in an intensive-care nursery for six weeks before his parents could take him home. During this time, Susan worked and Justin continued to be sickly, suffering from chronic ear infections and colic. Ted had trouble adjusting to his new son and refused to help, so Susan quit her job and took care of Justin alone. The pain in her back and neck became unbearable, so she made an appointment with Dr. Jones, her mother’s doctor. After an exam and subsequent tests, she prescribed a combination of hydrocodone and Tylenol.
Susan worried about the medical bills related to Justin’s premature birth and subsequent medical treatments. Anytime she brought up questions about finances, Ted yelled at her, saying she did not trust him to manage that part of their lives. He forbade her to open the mail. In addition to her problems with her neck and back, Justin was so sick that she could not go back to work. After Ted graduated, Susan hoped that their relationship would improve. Ted took a job at a local company; Susan believed that the job would be less stressful than school and Ted would have fewer pressures.
Justin continued to have many health problems and was constantly under the care of physicians. He was often hospitalized with pneumonia and severe dehydration. When Justin was 14 months old, Ted deserted them. Susan had no money, no job, and no car. She turned to her parents for a small loan and took a job in a department store making minimum wage.
At this point, the pain she was experiencing became debilitating. Justin’s doctor noticed her stress and anxiety and the pain she felt when she picked Justin up. He prescribed a mild dose of an antianxiety medication as well as muscle relaxer. The combination of the four drugs she was now taking seemed to help with her pain. She was desperately unhappy but determined to make the best of things.
Several months later, Ted returned. He had a new job, making good money, and was ready to “work things out.” He continued to drink and he still beat her, but she now wanted him at any cost. He soon learned this fact.
The tension in the household exacerbated Susan’s pain, so she established herself as a new patient with Dr. Gupta. She saw no reason to share with him the two prescriptions from Justin’s doctor, but she did tell him about the prescriptions from Dr. Jones that she said were no longer helping. He, too, prescribed a regimen of Tylenol and hydrocodone but increased the dosage.
One year later, Susan had another son, Matthew. At this point, Ted and Susan bought a house and proceeded to raise their family. For Ted, this consisted of nightly bouts with the bottle in front of a television set, long sessions on the computer, and forcing himself sexually on Susan. Whenever Susan thought about leaving, she concluded that her life included two very important aspects: she was financially secure and she was not raising her children alone. And Dr. Gupta prescribed oxycodone for her unrelenting pain.
As Susan developed a tolerance for the drugs she was taking, she became desperate to find another doctor who would prescribe more meds. In the meantime, she continued to lie to both Dr. Gupta and Justin’s physician about what and how much she was taking. In addition, throughout the day, she began making herself drinks from Ted’s liquor shelf. She found that drinking with the meds provided the relief she needed so desperately.
Susan’s stability ended the day that Ted announced he had lost his job. He was to pack up his office by the end of the week. He received one month’s severance pay. Susan had feared this would be the result of the recent downsizing in many of the local industries. The entire community was feeling the effects of the changing economy. Susan was afraid that Ted would not be able to handle the layoff. She tried to talk with him about next steps in looking for alternate employment and applying for unemployment benefits. Ted’s answer was escalating violence and drink. He left a week later.
Susan knows that she needs help. In fact, she is overwhelmed by all the problems. She tries to make a list of what issues she faces but quits 10 minutes into the activity. In desperation, she fortifies herself with pills and a drink, puts the boys in the car, and grabs a bottle of bourbon to take with her. Only three blocks from her home, she is stopped by the police for running a stop sign. She is charged with driving under the influence, possession of narcotics, child endangerment, and having an open liquor bottle in the car. She is sentenced to 180 days in jail where she will receive no treatment for substance abuse. Her children are with her parents. Ted is nowhere to be found.
Last Updated on June 6, 2019 by EssayPro