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As a social worker, when you address the needs

 As a social worker, when you address the needs of an individual client, you must also take into account the systems with which the client interacts. Obtaining information about these systems helps you better assess your client's situation. These systems may provide support to the client, or they may contribute to the client's presenting problem. Consider the example of a workplace; a client may get great satisfaction and sense of purpose from a career but the interpersonal relationships at the workplace itself are toxic. This system could be contributing both positively and negatively to the client’s well-being.

For this Discussion, you examine the systems perspective and its relevance and application to practice, in light of all you have learned about human behavior and the social environment.

To prepare:

 Access the Social Work Case Studies media and navigate to Lester. 

As you explore Lester’s case, consider the systems with which Lester interacts. Think about ways you might apply a systems perspective to his case. Also consider the significance of the systems perspective for social work in general.

 Post an explanation of how multiple systems within the social environment interact to impact individuals across the life span. Use Lester’s case as an example. Then explain how you as a social worker might apply a systems perspective to your work with Lester. Finally, explain how you might apply a systems perspective to social work practice in general. 

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.

Lester

Lester is a 59-year-old divorced African American male with two adult children. Four

months ago, he was a driver in a multiple vehicle crash while visiting his daughter in

another city and was injured in the accident, although he was not at fault. Prior to the

accident he was an electrician and lived on his own in a single-family home. He was an

active member in his church and a worship leader. He has a supportive brother and

sister-in-law who also live nearby. Both of his children have left the family home, and his

son is married and lives in a nearby large metropolitan area.

When he was admitted to the hospital, Lester’s CT showed some intracerebral

hemorrhaging, and the follow-up scans showed a decrease in bleeding but some

midline shift. He seemed to have only limited cognition of his hospitalization. When his

children came to visit, he smiled and verbalized in short words but could not

communicate in sentences; he winced and moaned to indicate when he was in pain. He

had problems with balance and could not stand independently nor walk without

assistance. Past medical history includes type 2 diabetes; elevated blood pressure; a

long history of smoking, with some emphysema; and a 30-day in-house treatment for

alcoholism 6 years ago.

One month ago, he was discharged from the hospital to a rehabilitation facility, and at

his last medical review it was estimated he will need an additional 2 months’ minimum

treatment and follow-up therapies in the facility.

As the social worker at the rehab center, I conducted a biopsychosocial assessment

after his admission to rehabilitation.

Biopsychosocial Assessment

At the time of the assessment, Lester was impulsive and was screened for self-harm,

which was deemed low risk. He did not have insight into the extent of his injury or

changes resulting from the accident but was frustrated and cried when he could not

manipulate his hands. Lester’s children jointly hold power of attorney (POA),but had not

expressed any interest to date in his status or care. His brother is his shared decision

making (SDM) proxy, but his sister-in-law seemed to be the most actively involved in

planning for his follow-up care. His son and daughter called but had not visited, but his

sister-in-law had visited him almost daily; praying with him at the bedside; and

managing his household financials, mail, and house security during this period. His

brother kept asking when Lester would be back to “normal” and able to manage on his

own and was eager to take him out of the rehabilitation center.

Lester seemed depressed, showed some flat affect, did not exhibit competency or show

interest in decision making, and needed ongoing help from his POA and SDM. His

medical prognosis for full recovery remains limited, with his Glasgow Coma Scale at

less than 9, which means his injury is categorized as catastrophic.

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© 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social

work case studies: Foundation year. Laureate International Universities Publishing.

Lester currently has limited mobility and is continent, but he is not yet able to self-feed

and cannot self-care for cleanliness; he currently needs assistance washing, shaving,

cleaning his teeth, and dressing. He continues with daily occupational therapy (OT) and

physical therapy (PT) sessions.

He will also need legal assistance to apply for his professional association pension and

benefits and possible long-term disability. He will also need help identifying services for

OT and PT after discharge.

He will need assistance from family members as the determination is made whether he

can return to his residence with support or seek housing in a long-term care facility. He

will need long-term community care on discharge to help with basic chores of dressing

and feeding and self-care if he is not in a residential care setting.

A family conference is indicated to review Lester’s current status and short-term goals

and to make plans for discharge.

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