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Advanced Generalist Practice: Assessment and Intervention Paper

The intersectionality of the client and the social worker differs depending on social location, identity, structural oppression, and political, economic and ecological power structures. The social worker did not consider the privileges the female Hispanic client would get from the US healthcare system, as the intersectionality focused on the disadvantages that she experienced. On the other hand, this health professional enjoyed privileges due to his race (White) and social class. The average salary of White social workers was higher than that of the female Hispanic client. The CBT will enable the social worker to address cultural diversity through case formulation. It will allow him to prioritize the client’s cultural identities and stressors that impact her mental health outcomes. This intervention will address cultural differences by focusing on areas where he may hold biases. The CBT will address intersectionality, cultural diversity and difference as it identifies coping skills linked to various intersecting identities (race, social class, and gender), prioritizing areas in which the social worker may hold biases and case formulation.

The client experiences grief and depression after losing her partner eight months ago. During the session, the patient remembered how she and her partner loved to celebrate their anniversary annually. They celebrated by selecting a special place to have a picnic. As she describes her memories, the social worker notes how difficult it can be to cope when someone loses a loved one. The client and her sister have different perspectives about how people should handle grief. The latter stated that sadness and crying were never tolerated in their family. As a result, she feels embarrassed and ashamed for being sad. The thoughts of the future are also overwhelming since the patient did not receive support from her family. However, she has been taking Percocet, an addictive opioid, to get enough sleep and relief from the grief of losing her partner. The social worker encouraged the patient to work with him to identify alternatives to improve her sleep rather than taking Percocet. The client agreed to explore these alternatives because she no longer wanted to feel sad and pain.

Intersectionality Assessment of the Client

Intersectionality accounts for aspects of a client’s identity. It enables therapists to understand how various forms of inequality create hurdles that often remain unrecognized among conventional ways of thinking. In this case, the client’s social location influenced her power and privilege based on her relative position in society. The patient is working class because she and her husband used to travel to various destinations depending on their money. Researchers observed that society gives people depending on aspects of their identity (Veenstra, 2011). This finding indicates that the client experienced class and race differently due to her social location in class and race structures. Although the patient and her partner were from the same race, they experienced it differently due to their social location in the class structure, as the working class.

The client, a Hispanic woman, also experiences an intersectionality of race, sexual orientation, and gender. Women of color face discrimination in Western society, whereas most White women do not due to the privilege Whites are offered. The idea proves that Black women who identify as lesbians may have less social power than those who are heterosexual (PettyJohn et al., 2020). In this case, the client had recently applied for a new job at a company in a different state because she wanted to relocate and open a new chapter in her life. The company rejected her application for unknown reasons despite meeting the qualification requirements. However, after examining employee reviews, she found that this corporation mainly employed White men. The point demonstrates that the enterprise may have ignored her application due to race or gender, as they are identity markers. From an intersectionality perspective, the client has more factors to consider that place her at a disadvantage in getting the work position than White women.

The intersectionality of political power structures involves intersectional stereotyping in elections and campaigns. Researchers observed that stereotypes linked with subtypes of women depend on their race and ethnicity. These stereotypes determine how women are perceived as leaders (Cassese, 2019). They noted that women of color experience more leadership hurdles than White women. For example, Hispanic female leaders who make mistakes on a job receive a harsher punishment than White female leaders. In this regard, the client may face race-gender intersections in political power structures, which places her at a disadvantage, as legislators are unlikely to create policies that increase access to affordable, quality mental health services. The idea demonstrates that she may face an intersectional disadvantage in politics due to her race and gender.

The intersectionality of economic power structures reveals various identities that expose the client to discrimination. For example, racism and class oppression are systems of discrimination that create inequalities that mainly affect women of color. These systems contribute to the variations in earnings of women aged 20 to 29. Since the client is Hispanic, her annual is $24,000, $4,000 less than White non-Hispanic women in the same age group (Social Security Administration, 2023). As a consequence of the patient’s multiple identities, she faces discrimination while others benefit from privileged positions.

Structural intersectionality outlines ways in which racism and sexism oppress women of color while molding their experiences in various ways. People may face numerous disadvantages or privileges in respect to their gender, sexuality, or race (Roth, 2021). In this case, the client may face structural racism and sexism when accessing quality mental healthcare services. This finding indicates that structural oppression occurs when the US healthcare system ignores the mental health of minorities, such as this female Hispanic client. As a result, people from minority groups are likely to poorer psychological and physiological outcomes than the US general population.

Intersectionality influences environmental issues based on class and race. The intersection of class and ecological issues becomes salient when the client considers the location of power plants and the dumping of toxic chemicals that pose significant health risks to poor neighborhoods. Minority groups, such as Hispanics and Black, mainly occupy these neighborhoods due to their low incomes. Environmental pollution also correlates with reproductive health risks, including birth defects, declining sperm count, and infertility. This client mentioned that she and her partner did not have children because she was infertile. Therefore, there is an intersection between environmental power structures and classism and racism.

The social worker will consider how intersectionality reveals the complexity and specificity of women’s rights. In this regard, he may address various intersections in future sessions, such as how environmental issues intersect with race and class and the intersectionality of identity with gender and race. If the client was from the social worker’s state, the key areas of power and oppression that he may consider include racism and sexism oppress against women of color (structural oppression) and class oppression which affects the economic status of women of color (economic power structure). The health professional will not consider privileges that the client would get from the US healthcare system since the intersectionality prioritized the disadvantages that she experienced.

Intersectionality of the Social Worker

The intersectional approach enables social workers to address the unique needs of their clients. In this regard, the social worker’s social location correlates with race and social class stereotypes. Researchers observed that women of color are considered unintelligent, hostile, and poor, whereas Whites are believed to be intelligent, wealthy, and productive (Moore‐Berg & Karpinski, 2019). For social class stereotypes, most individuals consider those living in poverty as untrustworthy, lazy, and dishonest. They also perspective people in the upper class as competent and heartless. Since the social worker is White, the intersections of social class and race stereotypes may affect how he perceives the female Hispanic client.

The social worker, a White male, may experience intersectionality of identity based on gender and work location. Although most people consider social work as a female-dominated profession, men disproportionately occupy senior positions. This finding indicates that social work is a female-majority, male-dominated profession since there are more women than men in the field, but they are not dominant. Therefore, the social worker experiences privileges that female social workers do not due to gender and work location.

The intersectionality of political power structures depends on the constitution of power relations within social interactions, such as political representation. In this regard, social workers need to consider ways in which political representation creates privileges and disadvantages (Severs et al., 2016). Since the social worker is White, he can advocate for policy reform that would enable minority groups to access affordable, quality mental healthcare services. The idea proves that the health practitioner’s race gives him the privilege of getting the attention of legislators to make the policy reform.

The intersectionality of economic power structures relates to gender, socio-economic status, and race. The social worker’s socio-economic status gives him privileges that the client does not. For instance, the average salary of White social workers is $64,360, whereas the client’s annual salary is $24,000 (Bouchrika, 2023). This finding demonstrates that the health professional can afford quality mental health services compared to the female Hispanic client due to their differences in gender, race, and socio-economic status. However, he can promote economic justice by prioritizing women’s rights to mental care regardless of socio-economic status and race.

Structural oppression within social work happens due to gender. Researchers observed that gender is a fundamental dimension of human experience and differs between men and women. They also noted that social processes produce generate, not biological. As a result, gender becomes individualized, as people view it as a personal characteristic, whereas gender oppression serves as a form of personal behavior (Hicks, 2015). The finding explains why the second-wave feminism separated the concept of sex from gender to show that gender is a set of social expectations that society may challenge. In this case, the social worker experiences structural oppression due to his gender, as society prioritizes feminism over masculinity. He cannot express grief as a man because the community expects him to be strong and emotionless.

The intersectionality of environmental power structures involves gender and class. A recent study found that gender identities influence people’s participation in environmental justice movement (Roth, 2021). Women engage in campaigns that protect their families from dangers associated with mountaintop removal coal mining. The society requires them to care about the environment. On the other hand, men’s coal-mining identity is interrelated to gender ideology, as they are the breadwinners in their families. The point proves that environmental movements and the framing of ecological issues depends on gender and class. In this regard, the society requires the social worker to prioritize his family’s wellbeing before caring about the environment since he is the breadwinner.

In preparation for future sessions, the social worker can demonstrate self-awareness by considering structural oppressions that form the basis of his behavior. For instance, the society does not expect him to show grief due to his masculinity. The intersection that he may need to address in the session may include how the framing of environmental problems relies on gender and class. This health professional may also consider key areas of power, privilege, and oppression, such as how economic power structures intersect with gender, socio-economic status, and race, structural oppressions related to gender, and the privilege of race on social location.

The social worker can demonstrate cultural humility by appreciating their cultural identities and those of others. They need to be aware of their privilege and power and recognize how these concepts impact their work. The idea demonstrates that cultural humility enables this health practitioner to understand how personal biases impact his work with this client. For instance, unconscious bias may affect the social worker’s judgment, decision-making, and relationship with the client. The NASW (National Association of Social Workers) requires social workers to be culturally competent to address personal biases that may impede their practice.

Presenting Client Concerns

Suicidal Ideation

Social workers can address suicidal ideation through safety planning. Once they have recognized clients’ suicidal ideation, these health professionals can design a safety plan with them (Bray, 2019). This plan can outline individualized warning signs that may lead to suicidal thoughts and identify protective factors and coping techniques that would prevent clients from harming themselves. For example, social workers may teach clients breathing techniques that would minimize their suicidal thoughts. This approach empowers these patients, as they can control their emotions. Counselors should also check up on the former frequently to ensure that their safety plans are applicable and working. Therefore, the safety plan needs to consider protective factors and coping techniques that would address suicidal ideation.

Psychiatric hospitalization can also address suicidal ideation, especially for clients with suicidal behavior and immediate high risk of suicide. While awaiting hospitalization, social workers should ensure the room does not contain objects that patients may use to harm themselves (Kennebeck & Bonin, 2023). Family members can be present depending on whether patients want them there, and the social worker should provide constant observation.

Substance Use Disorder

Social workers will address substance abuse disorders through behavioral therapies. For instance, DBT (Dialectical behavior therapy) utilizes concepts of acceptance and mindfulness to ensure that clients are aware of their current situation and emotional state (Edwards et al., 2022). It will teach patients with SUDs to control intense emotions, decrease self-destructive behaviors, and improve how they relate with others. Alternatively, therapeutic communities (TC) will help the former develop healthier values and behaviors. This therapy creates drug-free environments in which individuals with SUDs collaborate to achieve desired mental health outcomes (Vanderplasschen et al., 2013). These behavioral therapies are suitable for patients with SUDs, as they often experience mental health disorders, such as anxiety disorders and depression.

CBT Assessment and Intervention

Cognitive behavioral therapy (CBT) can address issues related to intersectionality, cultural diversity, and difference. It is a talk therapy that helps clients with SUDs to learn how to cope with difficult circumstances by challenging their irrational thoughts and changing behaviors (National Institute of Mental Health, 2023). The intervention addresses intersectionality by providing education, empowerment, and coping skills that help clients manage experiences of discrimination and stigma. A recent study found that CBT identifies coping skills that relate to various intersecting identities, including sexual minority and socioeconomic status (Flentje et al., 2022). It also addresses cultural diversity through case formulation. This therapy model ensures that social workers prioritize the clients’ cultural identities and stressors and the relevance of their religion and spirituality on mental health outcomes (Maura & Kopelovich, 2020). This finding indicates that CBT incorporates positive aspects of clients’ culture, religion, and spirituality to change their behavior. Alternatively, the intervention addresses cultural differences by prioritizing areas in which social workers may hold biases. Since humans can create categories as a way of organizing and making sense of their experience, this process of categorizing and generalizing facilitates their relationships. When people’s categories become rigid and the generalization is broad, biases may arise (Hays & Iwamasa, 2019). Therefore, CBT enables social workers to be aware of their biases to address cultural differences and embrace the impact of culture on a client’s beliefs, identities, and behaviors.

Conclusion

The intersectionality of the client and the social worker assesses the impact of converging identities on opportunities and access to rights. It enables counselors to link the aspects of discriminations (race, gender, and social class) to the social, political, economic, and environmental power structures that contribute to inequalities. The social worker will consider the client’s intersectionality to understand the complexity and specificity of women’s rights. As a result, he should address various intersections in future sessions, including how the ecological issues intersect with race and class. The social worker may also consider his intersectionality to key areas of power, privilege, and oppression, such as structural oppressions related to gender and the privilege of race on social location. In future sessions, he may proceed by demonstrating self-awareness and cultural humility. This health professional can also address personal biases through cultural humility, which allows him to understand how these biases impact his work with the client.

References

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Bray, B. (2019, August 26). Making it safe to talk about suicidal ideation. Counseling Today. https://ct.counseling.org/2019/08/making-it-safe-to-talk-about-suicidal-ideation/

Cassese, E. C. (2019). Intersectional stereotyping in political decision making. Oxford Research Encyclopedia of Politics.

Edwards, E. R., Dichiara, A., Epshteyn, G., Snyder, S., Linzer, S., Riglietti, K., … & Goodman, M. (2022). Dialectical behavior therapy for justice-involved veterans (DBT-J): Feasibility and acceptability. Psychological Services.

Flentje, A., Sunder, G., Dilley, J. W., Neilands, T. B., Lisha, N. E., Katuzny, K. E., & Carrico, A. W. (2022). AWARENESS: A cognitive behavioral intervention to reduce intersectional minority stress among sexual minority men living with HIV who use substances. Drug and Alcohol Dependence Reports3. https://doi.org/10.1016/j.dadr.2022.100059

Hays, P. A., & Iwamasa, G. Y. (2019). Culturally responsive cognitive behavior therapy: Practice and supervision (2ed.). American Psychological Association.

Hicks, S. (2015). Social work and gender: An argument for practical accounts. Qualitative Social Work14(4), 471-487. https://doi.org/10.1177/1473325014558665

Kennebeck, S., & Bonin, L. (2023, February 10). Suicidal ideation and behavior in children and adolescents: Evaluation and management. UpTo-Date. https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-children-and-adolescents-evaluation-and-management#

Maura, J., & Kopelovich, S. (2020, January 6). Cultural considerations in applying cognitive behavioral therapy to racial/ethnic minority groups with serious mental illness. Mental Health Technology Transfer Center Network. https://mhttcnetwork.org/sites/mhttc/files/2020-07/Cultural%20Considerations%20for%20CBT_Practice%20Brief_reformat-07-10-20_0.pdf

Moore‐Berg, S. L., & Karpinski, A. (2019). An intersectional approach to understanding how race and social class affect intergroup processes. Social and Personality Psychology Compass13(1), e12426.

National Institute of Mental Health. (2023). Substance use and co-occurring mental disorders. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

PettyJohn, M. E., Tseng, C. F., & Blow, A. J. (2020). Therapeutic utility of discussing therapist/client intersectionality in treatment: When and how?. Family process59(2), 313-327.

Roth, S. (2021). Intersectionality and coalitions in social movement research—A survey and outlook. Sociology Compass15(7), e12885. https://doi.org/10.1111/soc4.12885

Severs, E., Celis, K., & Erzeel, S. (2016). Power, privilege and disadvantage: Intersectionality theory and political representation. Politics. https://doi.org/10.1177/0263395716630987

Social Security Administration. (2023). Earnings of women aged 20-59, by age group and race/ethnicity, 2020-2021. https://www.ssa.gov/policy/docs/factsheets/at-a-glance/earnings-women-age-race-ethnicity.html

Vanderplasschen, W., Colpaert, K., Autrique, M., Rapp, R. C., Pearce, S., Broekaert, E., & Vandevelde, S. (2013). Therapeutic Communities for Addictions: A Review of Their Effectiveness from a Recovery-Oriented Perspective. The Scientific World Journal2013. https://doi.org/10.1155/2013/427817

Veenstra, G. (2011). Race, gender, class, and sexual orientation: intersecting axes of inequality and self-rated health in Canada. International journal for equity in health10(1), 1-11.

 

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