Chapter 1

Chapter 1

Outcome-Informed Practice in Practice Two Case Examples

Case 1: A Foster Child’s Provocative Behavior • Sandra is a 16 year old that had been sexually abused for 7 years. • Grants are concerned with her provocative behavior towards her foster father. – She was removed from her previous foster home for the same reason

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Session 1 • Grants explain to the social worker what they mean by provocative behavior. • Grant’s admit that Sandra has no problems in areas. • Grants have talked to Sandra about her inappropriate behavior. – Sandra doesn’t see the problem


Session 1 • Social worker suggests a rating scale to describe discomfort. – Sandra is surprised that she has caused her foster parents discomfort – She is confused about what is wrong with her behavior


Session 2 • Social worker suggests – Cognitive behavior therapy (CBT) • To help Sandra develop better understanding of what her behavior means

– Behavioral skills training with the family • To teach Sandra how to behave more appropriately


Session 3 and 4 • Improvements – Greg’s daily number of uncomfortable interactions with Sandra has decreased. – Sandra says she feels more loved. • Her foster parents are not backing off from her

– She is doing better at being friendly at school without being so flirtatious


Session 5 • In this last week of observation the family has achieved their goals • They terminate services at this point. – The social worker will still check in on them monthly to see how things are going


Case 2: A Depressed University Student- Session 1 • Dahlia is a 20 year old Muslim junior from Saudi Arabia. • Has come to the center complaining of: – Sadness, weepiness, insomnia, and trouble concentrating

• Her grades have fallen from A’s to C’s this semester


Session 1 • Is administered the Quick Inventory of Depressive Symptomatology. – The results confirm clinical depression

• Social worker suggests CBT, and antidepressant medication. – Dahlia is open to both interventions – Is given a referral to a psychiatrist


Session 2 • Dahlia has shown no change since her last session. • The social worker thinks her depression is caused by: – Talks with her sister and life changes

• Dahlia starts CBT, continues graphing, and adds recording negative thoughts.


Session 3 • Dahlia shows some improvements in sleep and studying. • She now feels she has hope. • Has trouble charting her negative thoughts because they are so frequent. – She now realizes most of these thought relate to her sister


Session 4 • Although Dahlia was making progress, her symptoms are worse this week. • Dahlia has not spoken to her sister and school out on break. – The social worker now modifies her intervention to address her isolation • He suggests volunteering


Session 5 • Dahlia comes to her session reporting major improvements in her symptoms. • She is enjoying volunteering and spending time with her friends • Social worker suggest support group. – She is unsure but will think about it


Session 6 • Dahlia arrives for her session without her hijab and smiling broadly. • Her graphs show that she is doing well. – She is still volunteering – Is studying hard to pull her grades back up to A’s – Has decided to join the support group


Session 7 • By session 7 she is ready to discontinue therapy – She is going to continue taking her medicine – May continue to monitor her sleep and study hours for a few months – Has joined the support group
