Vulnerable Population in Biopsychosocial Assessment

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Table of Contents

Background
Patient
Theory
Plan for Care
Goals
References

Background

It is paramount for a social worker to take account of the needs of vulnerable populations. Particularly, the factors that are likely to pose a threat to the identified populations’ well-being must be identified and managed appropriately so that the target populations could develop efficient behaviors and coping mechanisms for handling threatening scenarios. Particularly, the needs of African American communities require close attention because of the socioeconomic concerns faced by its members and the emotional distress that they experience. The application of a biopsychological assessment may serve as the tool for identifying the current needs of the patient and providing her with the therapy and opportunities for developing coping mechanisms that will assist her in the future and help avoid developing psychological issues such as depression.

Patient

The focus on the cultural specifics of the patient particularly, on the issues faced by the representatives of the African American community, has shown that the patient is in dire need of reconsidering her current approach toward building relationships with her relatives, as well as changing her current work and sleeping at least 8 hours a day. The changes listed above may not be sufficient for the patient to fully recover, yet they will become the foundation for a gradual improvement in the patient’s life and health status. The importance of the identified change concerns primarily enabling the patient to become more independent in the management of their health issues, including their early identification, avoidance of the threats that may lead to the aggravation of their health condition, etc.

The patient is a 30-year-old African American female who has been working in the Navy and experiencing significant stress due to the pressure from her employee and family members. Furthermore, the patient has not been getting enough sleep over a significant amount of time, which has led to a steep rise in her distress levels. The strain under which she has been due to the unreasonably high expectations of her family that considers her a “golden child” should be viewed as the primary stress factor, whereas the emotional challenges that she has been having at her workplace can be deemed as the second most important factor. The fact that some of her family members are in prison and are going to live with her after their release should also be considered an important piece of information contributing to the increase in the patient’s stress levels and the overall emotional exhaustion.

Theory

When considering the current situation in which the patient has found herself, one must mention the Structural Family Theory (SFT). By definition, the identified theoretical framework implies determining one’s growth as an adult yet remaining a member of the family. Therefore, it allows measuring the ability of an individual to identify the factors and symptoms that may signal about health issues, as well as locate the available sources of assistance and information (Sewpaul, 2014).

Evaluating the patient’s situation, from the SFT perspective, one must clarify that the former has a very vague idea of self-care and is, therefore, suffering from a severe self-care deficit. Indeed, the patient’s inability to speak to others, listen to herself, and, therefore, isolate the factors that contribute to the enhancement of her stress levels and develop the strategies that will help eradicate the identified stress as factors show that the patient is in desperate need of help and counseling. The rationale for choosing the theory in question is quite obvious. Seeing that the patient is unable to take care of her own needs, it is crucial to teach her to get her priorities in line, reconsider the idea that her contribution to the family should not be reciprocal, and be able to identify health problems before they develop into serious ones. Furthermore, the application of the SFT approach is bound to help the patient manage the family-related issues since the framework focuses on the active engagement of family members into the therapy process. As a result, there is a high probability that the patient will change her current attitude toward the demands of her family members and focuses on supporting them without allowing them to rule her life.

As stressed above, the fact that the patient belongs to the African American culture must be taken into consideration when shaping the nursing approach. Indeed, a closer look at the patient’s cultural background will reveal that a significant emphasis on family values and support among relatives is placed in African American communities (Coontz, 2016). Therefore, it is imperative to make sure that the patient should not feel compelled to assist her family members without the slightest support from their side. Instead, one must promote the idea of unity and mutual support as the basis for improving the relationships between the patient and her family. SFT, in turn, is likely to serve as the foundation for introducing the concept of cooperation among the members of the patient’s family since the specified idea makes one of its core postulates (Boyd-Franklin, 2013). To address the unique characteristics of the patient’s culture in further interventions and the process of improving her relationships with the family members, one will have to consider several key factors. The first and most obvious, the fact that African American culture focuses heavily on respect for elders must be taken into account. Furthermore, possible disparities between the health and diet standards recommended by nurses and the ones that are viewed as appropriate in the African American culture should be listed among the key areas of concern. Finally, the suspicion of older African Americans toward innovative nursing and healthcare practices needs to be included in the list of issues that will have to be managed accordingly so that the needs of the patient could be met successfully.

To establish a strong bond between the client and a nurse, one will have to apply an adequate communication channel. In the case in point, it will be sensible to adopt the strategies based on meetings and group discussions. The concept mentioned above is bound to attract the attention of the at-risk population, thus, helping them learn more about the subject matter. Moreover, the adoption of a discussion-based system as the basis for encouraging active communication between a nurse, the patient, and her family can become the tool for encouraging the active patient education process. The incorporation of the approach based on discussion into the nursing strategy, in turn, will encourage every family member to participate and engage in the communication process. Thus, the premises for the successful management of the problem can be created.

Plan for Care

Problem diagnosis	Intervention	Outcome	Date
Sleep disorder	Developing a coping mechanism toward stress-related factors (i.e., the job and the pressure from the family)	The patient will be able to sleep for at least 8 hours per day.	October 10, 2017
Stress because of workload and pressure from the boss	Massage therapy; counseling for stress management	The patient will be able to resist the family pressure and manage her relationships with the family and the company	October 11, 2017
Stress because of taking problems home	Counseling and development of coping mechanisms; focus on viewing the home as the safe space where the patient must not experience any kind of pressure	The patient will experience a gradual drop in the stress levels; furthermore, the patient will stop taking her work-related problems home.	October 15, 2017
Stress because of the absence of any personal expectations	Counseling and development of personal expectations	The patient will have a distinct image of herself and the person that she wants to be.	October 31, 2017

One must admit that, despite numerous issues and complications faced by the patient, she has shown impressive resilience toward the stress factors. She has a range of strengths of which she must be aware so that the process of treatment could occur at a faster pace. Furthermore, the identification of personal strengths will help her develop coping mechanisms that will not inhibit her personal and professional growth. For instance, the ability to focus on a particular goal and do everything possible to attain it can be viewed as an important asset. Indeed, the patient has been going against all the odds to have a good education and get a well-paid job. Even now that she has been experiencing sleep difficulties and family issues, she continues delivering good results. The fact that the patient is driven should be used to encourage her to focus on developing a resilient coping strategy and reconsidering relationships with her family. The appreciation of her family should also be viewed as an important asset. The understanding of family values can be used in therapy to improve the communication process between the patient and her family members.

Goals

At present, the following goals can be identified:

Introducing the patient to the idea of self-care and enhancing the significance of developing an appropriate self-management strategy (particularly, the development of a coping mechanism for addressing stress);
Encouraging the patient to learn more about her problem and be able to identify the symptoms of a possible recidivism issue, locate the available resources, and contact a nursing service.

The goals listed above align with the primary tenets of SFT. By placing a powerful emphasis on the importance of the patient’s independence, one will encourage her to focus on building a coping mechanism that will guide her toward better relationships with family members, management of stress at work, and, most importantly, learning to value herself. As a result, rapid improvement is expected.

The suggestions provided above can be supported by two recent studies published recently. For instance, a study by Demby, Riggs, and Kaminski (2015) indicates that the significance of the spiritual connection between the members of the African American community is crucial and can be supported with the help of SFT. Particularly, the study specifies that the enhancement of the connection between the community members serves as the means of preventing and managing depression, which is essential for the case in point. Similarly, research conducted by Friedman (2013) points to the significance of implementing the SFT framework to promote spirituality in the family and encourage a tighter bond between its members.

References

Boyd-Franklin, N. (2013). Black families in therapy: Understanding the African American experience (2nd ed.). New York, NY: Guilford Publications.

Coontz, S. (2016). The way we never were: American Families and the nostalgia trap. New York, NY: Hachette.

Demby, K. P., Riggs, S. A., & Kaminski, P. L. (2015). Attachment and family processes in children’s psychological adjustment in middle childhood. Family Process, 10(10), 1-16.

Friedman, R. S. (2013). Commentary on family-directed structural therapy: Ten years of building on family strengths. Journal of Family Strengths, 13(1), 1-5.

Sewpaul, W. (2014). A structural social justice approach to family policy: A critique of the draft South African family policy. Social Work, 41(4), 310-323.

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