Index: L2 / Service for Offenders and Ex-offenders / Offenders and Drug Abusers / Elaborated proposal / 17499533

Keywords: Cognitive behavioral therapy / structural family therapy / probation order supervision / stealing behavior / family relationships

Elaborated proposal

Abstract: For her selected assignment, the student has chosen her work with an adolescent client who has been charged with theft. The client has been referred to the placement agency for counseling services while under probation supervision. The case proposal has been prepared after the placement student has carried out the initial intake and assessment interviews that included an office interview and a home visit. A brief introduction of how the case has come about to be under the placement student's charge is given at the start of this proposal. This is followed by the background information of the case that is organized into the client's social history, family composition, peer relationships and past offences. The placement student then presented her assessment of the case into a few key areas, namely the client's motivation to change her stealing behavior, the client's family relationships, the client's academic performance and the client's peer network. From the case assessment and in consideration of the brief placement period, the placement student prioritizes to work on the client's stealing behavior and on her relationship with her family especially with her mother. In the proposal, the placement student has identified the cognitive behavioral therapy and the structural family therapy as the two main approaches that will be used in her intervention. She then proposes a total of six interview sessions and gives a summary of the objectives for each of these sessions. In the case proposal, the placement student has further included a section on how she will evaluate the social work intervention. The four channels proposed were data collected from the client, homework and exercises given to the client, worker's observation and client's self-report. The placement student has also given thoughts to the different roles (directive role, facilitator role, enabler role and middleperson role) that she will undertake when working with the client and her family. In the final two sections, the placement student has stated the expected outcome of the case after her intervention and the difficulties she may encounter while handling the case.

Comment: This is a generally well-organized case proposal. The placement student is able to systematically present her case information, assessment and intervention plan. Her effort to relate the different components of the case proposal into a coherent document is also forthcoming.

Proposal for CWL

I.Identify data

Client: CWL

Date of intake: 4^th October 1999

II. Introduction

CWL is my first case. My supervisor had transferred the case to me on 4^th October 1999. That was the date CWL was sentenced. In August 1999, she stole a C.D. from the HMV store. She was charged with theft and went to the Eastern Court on 30^th August 1999. She confessed to the charge. The judge requested the Probation Order and the Community Service Order reports for her sentence. On 13^th September, she went to the court again for sentencing. However, after reading her P.O and CSO reports, the judge remanded her for two weeks to get the training center's report and the case was adjourned to 4.10.98 for sentencing. In this period of time, my supervisor had already tried to provide legal advice to CWL's family members. On 4^th October, I contacted CWL's parents first to provide psychological support for them and also tried to have a better understanding of the case. Finally, CWL was sentenced to 18 months Probation Order supervision. I continued to work on the case of CWL.

III. Number of Interviews

Till date, I have had 2 interviews with CWL and CWL's family members in order to make an assessment of the case.

(Comment: Section II and III offer the reader an understanding of how the placement student comes about working on the case and the contacts that she has had with other professionals, the client and the client's family prior to coming up with this case proposal. It is useful to include them in a case proposal as it helps to give a context to the case being discussed.)

Intake interview

Date: 14.10.99 (Thursday)

Venue: Fast food shop in Chai Wan Estate

Social worker: R

Objectives:     

• To assist her to overcome the negative effect of the prosecution
• To build up a relationship with CWL
• To collect information about CWL and assess her difficulties

Homevisit

Date: 21.10.99 (Thursday)

Time: 7:30 to 9:45p.m.

Social worker: R

Objectives:

• To assess CWL's relationships and communication patterns with other family members

IV. Background information

• Social History

  CWL was born in Hong Kong in 1982 and had completed her Form five education. She is doing design studies in T.I. and has obtained good results in every academic year. In the HKCEE, she got 12 marks. She said that even if she could be promoted to form six, she would still do design studies because it was her interest. The grade that she got for her conduct in the secondary school was very good. She is good at drawing and playing basketball.

• Family composition

  Client's family comprises her parents, one elder and four younger sisters (refer to Appendix B: The family genogram). The family lives in one of the public housing estates in Chai Wan. There are three rooms in her unit. One room is for her parents, the second room is for her elder sister, the fifth sister and her and the third room is for her second, third and sixth sister. (refer to Appendix A: CWL's Housing Map).

• Peer network

  The client has four girl classmates as her best friends in the secondary school. She has good relationships with them. Besides, she gets along well with the new classmates and has made many new friends after starting the T.I course for two weeks.

•         Criminal Record

  -         The client had 2 records of Superintendent's Discretionary in 1996 &1997.

  -         In this prosecution, she was sentenced to 18 months Probation Order Supervision.

V. Assessment

• Presenting Problem

  The client was charged with theft and went to the Eastern Court on 30.8.99. She confessed to the charge. On 4.10.1999, CWL was sentenced to 18 months Probation Order supervision. She is now under the supervision of a probation officer.

• Assessment on the motivation of correction

  CWL claimed that her parents did not give her much money, so she always had financial difficulties. She said that she liked to listen to CDs but did not have money to buy them. One day, when she walked in the HMV store, she stole a C.D. out of greed. Besides, she has an illogical thinking about the concept "attempted theft". She thinks that if she steals one thing, then she can save the money to buy other things that she likes. Then she will try to steal things again in order to save the money for another things. She said that she had stolen in the past and she mainly stole candies, stationary and so on.

  After the period of remand, she promised that she would never steal things again because she felt very painful in those three weeks. However, in actual fact, she may be temporarily threatened by the experience of the remand and thus promises not to steal again. When she forgets the feeling of the punishment, she may attempt to steal again because I find that she still does not have the sense that committing theft is a wrong behavior.

After the first interview and the home visit, I find that her environment may not be the main factor that causes her to steal. Her parents have given her a reasonable amount of pocket money. Besides, all of her siblings and peers do not have stealing behavior. Therefore, it may be related to her manner of thinking or belief about the issue (stealing). This needs to be further assessed.

• Family relationships

  After the home visit, I assess that in CWL's family, the relationship between the family members is only fair. In the culture of CWL's family, members suppress their feelings in front of each other even though they love each other. They will not show their enthusiasm toward other family members. All of them handle their own tasks independently. Therefore, during the home visit, CWL felt very embarrassed when we talked about CWL's letter to her family members while under remand. When I asked about CWL sisters' feeling towards CWL's remand, they were very shy and avoided talking about it. However, the relationship between the siblings seems quite good. The elder sister teaches her younger sister how to do her homework. Besides, CWL knows about her elder sister's plan to get a job. CWL has the best relationship with her 3^rd younger sister. (Comment: At this point in reporting, it will be good to be able to identify and differentiate the information as collected from different family members, worker's observation, impression, worker's interpretation and assessment. For instance, was the information about CWL's best relationship with the third sister offered by CWL, the sister or from worker's observation? In this sense, the case proposal will comprise objective facts as well as subjective information of the client and her family. The latter can be as a result of worker's (or the clients') interpretation or assessment based on her observation and interaction with the clients.)

  On the hand, CWL's relationship with her parents was relatively weak. I asked her about her father's job and she did not know because she was not interested in that. She has not asked her father neither did the father tell them. In this event, if she was not charged with theft, she did not know that her parents love her.

  CWL's father is the breadwinner of the family. He is a traditional Chinese man, who wants to have a son to carry the family's name. He has 6 daughters not because he wants to have so many children but he wants to have a son. Therefore, he is not particularly fond of any of his daughters. He seldom communicates with his daughters. However, in CWL's theft case, he spends a lot of time to help her daughter, such as writing a letter to the judge, visiting CWL in the prison, approaching the probation officer and the social worker. He does not want her daughter to be put in jail. In fact, he does not know how to communicate and express his love to her daughter though he cares about her.

    CWL's mother manages the whole family. She is the central figure in this family. All the family members are attached to her. She is a traditional Chinese woman. She holds highly the virtues of women and the respect of seniority in the family. She thinks that the elder sister should have the responsibility of looking after the younger sisters. She transfers the parental discipline that she learned from the past completely to her daughters. She will use her powerful status and authority to discipline her daughters. Besides, CWL's mother shows does not show a very good as she will use negative wordings (e.g. stupid , useless and so on) towards her daughter.

   It is found that the father is excluded from the mother and daughters coalition. He seldom communicates with his daughter and the daughters do not have any attachment to him. In comparison, the children may be more attach to their mother. However, the communication is mainly related to daily routines such as finances, informing the mother the time of leaving and returning home, etc. They seldom share with each other about their study, future plans or feelings. Thus CWL may have a stronger bond with her siblings.

• Academic result and Peer network

  She is an independent girl who can handle her tasks by herself. She got good results in her study. She is very organized and plans for her study. She studies in T.I., which is her own choice and she had not discussed it with her parents. She is very interested in Arts. She will study design even when she is enrolled in form six. It can reflect that she plans well and is independent in her thinking.

  CWL has many good friends. This reflects she has the appropriate communication skills. (Comment: Social and inter-personal relationship skills is likely to be more encompassing then just communication skills.) However, CWL revealed that she would not disclose many of her personal matters to her friends.

VI. Objective of working on CWL's case

• To prevent her from committing crimes again
• To dispute about her irrational belief which leads to committing theft
• To build up a good relationship with her family members (Comment: To achieve what purpose?)

VII. Theoretical Rationale

Cognitive Behavioral Approach

Cognitive Behavioral Interventions "emphasize the complex interaction among cognitive events, processes, products and structures, affect, overt behavior, and environmental context and experiences as contributing to various facets of dysfunctional behavior" (Braswell & Kendall, 1988, p.167). Ellis (1979) asserts that psychopathology is originally caused by the inculcation of irrational or maladaptive beliefs from significant others during the past experience as well as by one's creative inventing of irrational dogmas and superstitions. Although emotional disturbance is rooted in childhood, people keep repeating to themselves irrational or maladaptive beliefs from significant others during the past experience. Moreover, people will creatively invent irrational dogmas and superstitions and repeat to themselves irrational and illogical sentences. The irrational quality comes from demanding that the universe should, ought to and must be different. (P.4)

In fact, the experience of working with offenders showed that most of them have their own belief systems to handle their problems. However, most of their beliefs are unreasonable and irrational. The cognitive behavioral approach will not only help the clients' to control their behaviors (not to commit crime again) but also change their cognitions. The irrational beliefs will be disputed by the social worker during the counseling session. The rational beliefs will replace under the ABC counseling model of the Rational Emotional Therapy that is the developmental part of the cognitive behavioral approach. (Comment: What does this mean?)

Structural Family therapy

According to Snider (1992), the structural organization of a family refers to the relational patterns that evolve from the composite of influences from its traditions, culture, and socioeconomic status as they are adapted to meet the functional requirements necessary for family functioning. Each family develops a repertoire of structures to carry out these functions. Families develop codes for regulating behavior. The structural dimensions of transactions in families include definition of boundaries, description of coalitions, and ways family members influence the outcome of an activity. Every interaction contains varying degrees of these dimensions. (P.14)

Working with family is a very complex job, especially family with many members. In fact, there are so many coalitions and systems in the family. Each of the systems will influence the others. In most of the times, family members may not want to solve their family problems together. They may think that their family does not have any problem to deal with as a result of several decades of socialization. Therefore, before handling the whole family, meetings with the sub-groups in the family may be need.

VIII. Plans of intervention

In the initial period, I will try to assist the client to overcome the negative effects of the prosecution. After the intake interview and home visit, CWL seemed to be more positive rather than negative about the period of remand. Her emotion is very stable. Due to the time limit of the placement, I will mainly deal with CWL's stealing behavior and her relationship with her mother. The cognitive behaviour approach will be the main therapy that is used to work with CWL's irrational belief concerning stealing. The structural family therapy will be applied to help CWL to improve her relationship with the mother.

Due to the time limit of my placement, I can only select some main tasks to deal with. In fact, I should also handle the coalition of the sisters, which repels the father. However, changing the family system is a very long-term task. Therefore, I can only start with the relationship between CWL and her mother. However, further actions are recommended after the relationship between her and her mother is dealt with. (Comment: Given that the placement period is rather short, often the placement student has to prioritize the intervention focus. In this case, the student has chosen two areas of focus, first, dealing with client's stealing behavior and second, dealing with client's relationship with her mother. The student has done a rather good job in presenting the case information so far. She has also offered her assessment as and when appropriate. In narrowing her focus to the two areas, she has also stated her rationale for doing so. This allows the reader to develop an understanding of how the student thinks through her practice and how practice decisions are made.)

I will plan to have 6 sessions with CWL. Four of the sessions will mainly handle CWL's cognition and behavior. Another 2 sessions will mainly rebuild CWL's relationship with her mother.

• Summary of the Schedule of Session Plan

(referring to Hong Kong Family Welfare Society(1995) Practice Manual for Cognitive behavioral group therapy , Hong Kong : Hong Kong family Welfare society . &  Lui. S.Y ( 1997) "Structural family therapy" edited by Grace P. C Ko and Chu. L.K Individual Work and Family Therapy. Hong Kong : The Chinese University Press.)

(Comment: The placement student needs to keep in mind the importance of being flexible in her intervention plan. A large part of casework practice is the worker's ability to jointly work with the client on the desired direction of how the case will move and the desired outcome of the case intervention. The proposed intervention plan should ideally have been a product of the worker and client's joint agreement. In some social work texts, this is referred to as the process of contracting with the clients. (One should also see this as an ongoing process.) In other words, the worker uses the intake and social assessment interviews to get to an understanding of how different people involved (client, family members, worker, other professionals working on the case) view or assess the client's situation. Base on the assessment, an intervention plan is drafted with the agreement of the clients. A common mistake a placement student may make is to engage in `armchair' planning. In other words, upon gathering the case information, the placement student takes it back to her office and started assessing and planning the case on her own. There is little involvement or joining with the client(s) on the assessment and planning of the case. The readers will find the following workbook a useful reference on the skills in assessing (chapter 8) and contracting (chapter 9) with the clients: Cournoyer, B. The Social Work Skills Workbook, Wadsworth Publishing Company, Belmont, California, 1991.)

IX. Plans for evaluation

• Data

  CWL will be invited to provide some data for evaluating her communication pattern with her family members.

• Homework and exercise

  The homework can reflect CWL 's attitudes, thinking and changes.

• Observation

  The social worker's observation during the interview can be used to evaluate the progress of the intervention

• Client's self-report

  CWL can share with the social worker about her changes.

X. The Role of the worker

In this intervention, the worker may play a directive role. However, the client's expectation will also be considered. The overall plan will be flexible and changeable to adjust to the preference of the client and unexpected issues.

The worker will be the facilitator to help the client to think about her issues in a more systematic and in-depth way.

The worker will play the role of the enabler to share the client's emotional problem and give psychological support to her.

The social worker will also play the role of the middleperson between the client and her family in order to improve the family relationship.

XI. Expected Outcomes

• To build up a good relationship with CWL
• To prevent CWL from committing crime
• To build up the ability to distinguish between right and wrong beliefs through the rational and irrational thought training process
• To improve her communication pattern and relationship with her mother

XII. Expected difficulties

It is not easy to change CWL's mother thinking within a short period of time. Thus I will focus on changing CWL's communication pattern with her family so as to help her to improve her relationship with her mother. In fact, after the sentence, her mother told me that CWL's attitude had improved and her mother appreciated her. If CWL shows a slight change, her mother will change too. It is the concept of the system theory. Therefore, I will focus more on working with CWL's communication pattern rather than changing her mother's thinking.

  In fact, it is not easy to change a person's cognition too. CWL's irrational beliefs concerning theft can be disputed during the intervention period. However, once the intervention period is finished, she may not have someone at the side to remind. Her greedy intention may be very easily aroused. She may attempt to steal again. Therefore, I wish to use the relationship between the social worker and the client to influence her not to steal again. Besides, her family members' concern is also very important. I will invite her parents to remind her regularly not to attempt theft. The parents are encouraged to use gentle and caring ways to remind the client so that she knows that her parents care about her very much. This show of care and concern may further help to prevent CWL from attempting theft again. In fact, her parents will also be helped to understand the objective of contact between CWL and her probation officer as a way of following up on CWL's attitude towards theft.

References

Annunziata. J & Jacobson-Kram.P (1994) Solving Your Problems Together, Hong Kong: American Psychological Association

Granvold.D.K. (1995) Cognitive and Behavioral Treatment: Methods and Applications, Brooks/ Code Publishing Company, U.S.A

Hong Kong Family Welfare Society (1995) Practice Manual for Cognitive behavioral group therapy , Hong Kong : Hong Kong family Welfare society

Jr. A. J Finch & W.M.N (1993) Cognitive-behavioral Procedures with Children and adolescents, Allyn and Bacon, U.S.A

Lui. S.Y (1997) "Structural family therapy" edited by Grace P. C KO and Chu. L.K Individual Work and Family Therapy. Hong Kong: The Chinese University Press.

Scott.J, Williams. J.M.G & Beck.E.A.T (1989) Cognitive Therapy in Clinical Practice, London and New York: Routledge

Snider.M (1992) Process Family Therapy, Allyn and Bacon, U.S.A

Appendix A: CWL's House Map

Appendix B: Family Genogram

Appendix C

CWL Family Relationship system

Written and revised by: 17499533 (Student)

Instructor: K S To

Copy Edited by: Phyllis Chee

Commented by: Phyllis Chee

Copyright © 2001 by the City University of Hong Kong.  All rights reserved.