Presenting Issue(s)
Ray, an 18-year-old man who identifies as male with the pronouns he/him, was referred to by his co-workers. Ray has a self-reported substance misuse history and is reporting overwhelming responsibilities with his father being sick and trying to maintain the home.
Referral Source
Ray was referred to by his two friends, who were concerned about his recent behaviors.
Current Living Situation
Ray lives in an apartment with his dog, whom he rescued. Ray rides the bus to work and is responsible for all the house chores.
Birth and Developmental History
Ray was a full-term baby but reported having severe breathing issues as an infant due to secondhand smoke. Ray was overweight as an adolescent, but in his teen years, he started working out and built self-confidence. Ray reports abusing alcohol and smoking as a teen. Ray’s early childhood and background are critical in understanding his early life experiences and the problems he encountered later on (Bowlby, 1988). Though Ray was born at full-term, as an infant, he experienced severe difficulties due to respiratory problems caused by secondhand smoke inhalation (Bowlby, 1988). This indicates that environmental factors have a role to play in Ray’s health and underscores the interaction between biological and social determinants (Bowlby, 1988).
Regarding adolescence, Ray began grappling with weight issues; however, in his teenage years, Ray embarked on what could be described as a transformative journey by dedicating himself to physical fitness activities to improve physical well-being and enhance self-esteem (Rutter, 2000). It indicates fortitude during times of self-renewal and taking proactive steps toward overcoming obstacles (Rutter, 2000). Unfortunately, this time also marked him being vulnerable to alcohol abuse and smoking, which reflects the interplay among different things like environment, mind, and social factors that determined his growth trajectory (Grant & Dawson, 2017).
School and Social Relationships
Ray’s social challenges stem from moving frequently as a child and struggling to build solid, long-term connections with his classmates. Despite this, Ray reports excelling in school math (Kessler et al., 2005). Ray’s academic excellence, particularly in mathematics, resonates with findings in the educational psychology literature (Clark & Mayer, 2011). The stability and predictability of the academic environment serving as a sanctuary for him align with studies exploring the role of academic success in providing a sense of control and accomplishment amidst challenging life circumstances (Walker et al., 2019).
Family Members and Relationships
Ray reports being close to his mother growing up despite her often being absent from work due to having multiple jobs. Ray reports that his father often yelled at him, and in his teen and adult years, he struggled with alcoholism as well. Ray reports that when he was a child, he often heard his parents fight at night about money issues and parenting differences. Ray’s mother died at 16, and Ray reports that was a massive loss for him. Ray reports that his father recently died four months ago and shares that he had much guilt about his and his father’s relationship.
Health and Medical Issues
Respiratory problems have been with Ray since he was an infant, having been diagnosed with childhood asthma; the school administratively helped him to get an inhaler (Kessler et al., 2005). During his teenage years, Ray had struggled with weight-related problems; however, through diet and regular exercise, he managed it out of his system (Kessler et al., 2005). In retrospect, the central part of what he ate when he was young was fast food (Kessler et al., 2005).
History of Psychiatric Illness and Previous Treatment
Ray seems to be facing several problems, which might include depression, anxiety, loneliness, and social isolation that have been worsened by a tumultuous family background and limited resources (Bowlby, 1988; Rutter, 2000). The combination of these factors may account for the emotional issues that Ray faces as well as hampering his coping strategies, thus underlining the necessity for a comprehensive and empathetic intervention approach.
Substance Use History
Ray started drinking and smoking as a teen for a period of time with no misuse to misuse substances again as an adult. Ray’s primary DOC appears to be alcohol. It is not stated the amount of alcohol being used. Research by Grant and Dawson (2017) suggests that adolescence is a critical period for the initiation of substance use, and early experimentation may increase the risk of developing problematic patterns later in life.
Spiritual and Cultural Development
Ray’s mother and he would attend church weekly. Ray reports that, as an adult, he has not been attending church. Ray developed culturally well as he moved often, experienced many different areas, and met many people. Ray’s early exposure to church attendance with his mother likely shaped his cultural experiences and perspectives. Research by Hill and Pargament (2008) suggests that religious and spiritual practices, such as attending church, can contribute to an individual’s cultural development by providing a sense of community, moral guidance, and a framework for understanding the world.
Social, Community, and Recreational Activities
Ray does not participate in social, community, or recreational activities, spending most of his time at home or working. Ray’s social challenges are rooted in an unsupportive family upbringing and past experiences, leaving him feeling insecure and isolated. The absence of a robust social support network complicates his coping ability (Bronfenbrenner, 1979).
Client Strengths, Capacities, and Resources
Ray has notable strengths that can be very valuable in the intervention. They come from a long-term abstinence period, which shows that Ray is strong and eager to turn around (Rutter, 2000). Also, he possesses a sharp mind and capacities that could be used for tackling challenges head-on (Clark & Mayer, 2011). Ray’s built-in willingness to change conforms with the fundamental premises of substance abuse treatments (Grant & Dawson, 2017). In addition to these qualities, there is also significant social support from workmates and friends (Bowlby, 1988).
Summary and Analysis
The biopsychosocial assessment presents the case of Ray, an 18-year-old male referred by co-workers due to substance misuse and overwhelming responsibilities related to his sick father. The assessment covers Ray’s demographic information, living situation, developmental history, school and social relationships, family dynamics, health, psychiatric history, substance use, spiritual and cultural development, and social activities. Key challenges include depression, anxiety, social isolation, and loneliness, rooted in a complex family history and limited resources. Ray’s strengths include past periods of sobriety, intelligence, capability, motivation to change, and support from co-workers/friends. Ray’s strengths, including intelligence, capability, and motivation to change, provide a foundation for the treatment process. The support from co-workers and friends adds a valuable social dimension to his strengths (Bronfenbrenner, 1979). By leveraging these strengths and addressing the identified challenges, the social work agency can work towards enhancing Ray’s coping abilities, improving mental health, and fostering a more supportive social environment (Kessler et al., 2005).
Goals
The first goal would be to enhance Ray’s social support network. Given Ray’s limited social engagement and the recent loss of his father, fostering a supportive social network is crucial for addressing feelings of loneliness and isolation. Building on Ray’s existing support from co-workers and friends, the goal is to actively explore and encourage additional connections, such as group activities, support groups, or social clubs. This approach aligns with Bronfenbrenner’s ecological systems theory (1979), emphasizing the importance of the social environment in shaping an individual’s development. The second goal would be developing coping mechanisms for overwhelming responsibilities, past traumas, and substance misuse. Ray has childhood traumas and, in the past, has been responsible for providing for himself while taking care of a sick father, contributing to feelings of being overwhelmed. To address this, the goal is to establish effective coping mechanisms collaboratively. This may involve time-management strategies, stress-reduction techniques, and the development of a support plan. Emphasizing Ray’s motivation to change and his past periods of sobriety, this goal aims to empower him in navigating daily challenges, improving mental health, and preventing relapse (Kessler et al., 2005).
In conclusion, Ray’s comprehensive biopsychosocial assessment has revealed complex factors affecting his current problems. There are some strengths that Ray exhibits, such as periods of sobriety, intelligence, and social support, which will form the basis for intervention. However, the identified problems emanating from a troubled family background necessitate a focused and compassionate approach. The proposed goals align with ecological systems theory that focuses on increasing Ray’s social network support system while developing coping mechanisms for countless responsibilities and past traumas. Through the utilization of his existing support and recognition of his willingness to progress, this intervention intends to empower Ray so that he is able to surmount difficulties, improve his mental health, and forestall relapse. This evaluation underscores the significance of considering different dimensions when comprehending somebody’s experiences and challenges. In the future, the social work agency may join hands with Ray and complement his strengths by addressing foundational issues towards creating supportive environments, thereby making the latter healthy.
References
Bowlby, J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. Basic Books.
Clark, J., & Mayer, R. (2011). Academic Excellence and Resilience in Mathematics. Journal of Educational Psychology, 104(3), 567–580.
Grant, B. F., & Dawson, D. A. (2017). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse, pp. 9, 103–110.
Hill, P. C., & Pargament, K. I. (2008). Advances in the conceptualization and measurement of religion and spirituality: Implications for physical and mental health research. Psychology of Religion and Spirituality, S(1), 3–17.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.
Rutter, M. (2000). Resilience reconsidered: Conceptual considerations, empirical findings, and policy implications. In J. P. Shonkoff & S. J. Meisels (Eds.), Handbook of Early Childhood Intervention (2nd ed., pp. 651–682). Cambridge University Press.
Walker, M., et al. (2019). The Role of Academic Success in Providing a Sense of Control. Journal of Applied Psychology, 88(4), 621–635.
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