Taking the lazy way out.

So I really don't have any major inspiration for which to write a blog...
So instead, I'll share my latest masterpiece, 2,000 words of a Case Study on a young man called 'John'.
Clearly John isn't his real name... but I couldn't really put mine into it (pretty sure there's rules against using oneself as the subject of a Case Vignette).

Anyways, here it is. My own little attempt at making sense of the inner workings of my mind.
I don't know if enjoy is the right word, but your thoughts and opinions would be most appreciated :)

1. Case Data:
John is a 21 year old student who lives at home with his mother and is currently studying full time in his 3rd year of a Bachelor degree at university.
He works long hours as on weekends aswell as during the week when he isn’t attending class in an attempt to pay off a loan from his Grandfather so he could purchase a car in order for him to travel the hour journey to uni each morning.
John has presented to the service requesting counselling as he is feeling immense stress due to his current situation and has also asked about strategies he can put in place to prevent this from happening again in the future.
John states that he is feeling depressed and overwhelmed by what he has taken on. Due to his academic commitments, he is often awake until the early hours of the morning trying to complete assignments which often means he is only getting 2-3 hours of sleep each night.
According to John, he feels extremely anxious when he sits down to study and has experienced heart palpitations on two occasions.
This coupled with the long and often stressful hours associated with being a Chef are making life extremely difficult for John.
Due to his work and academic commitments, John hasn’t seen any of his friends outside of classes in weeks and feels as though he has no one he can talk to about what he is going through at the moment.
John has also stated that his family is currently arguing over his Grandfather’s estate and the amount of money each member of the family will get, this is placing further strain on John as his loan is constantly being brought up by his Auntie as leverage for her own arguments. As a result of this, John’s Mum is placing pressure on him to pay back his loan faster than what was originally agreed upon in order to appease the rest of the family.

2. Assessment:
From what John has said, it is clear that he is in crisis and is currently at breaking point.
It is concerning that he is becoming anxious whenever he attempts to study and that he has begun suffering heart palpitations as a result, this is more than likely an indication of some underlying mental health issue, given his sleep deprivation and lack of social contact I wouldn’t be surprised if he was suffering from some level of depression.
Also of some concern is the lack of sleep he is getting and the distances he is currently travelling in order to get to university each day. Aside from the obvious possibility of him falling asleep while driving, it is well documented that sleep deprivation can have a pronounced effect on a person’s mental well being and can often be the cause of a person’s depressive symptoms (Baglioini, et al., 2011).
John also seems to have very poor self care strategies in place, from what he has said in his initial interview it sounds as though all he is doing of late is either related to work or university. While these two places clearly hold some importance to John, the fact that he hasn’t seen his friends on a social level in some weeks suggests that he isn’t taking any time out for himself to have some ‘me time’ and to get away from the daily grind of his academic and professional life.
To top it all off, he also seems to be stuck between a rock and a hard place in regards to his family situation. The loan from his Grandfather initially seemed to be an excellent idea, it allowed John to purchase a car which he needed for university and to allow him some ammount of freedom and independence in his life. It is unfortunate for him that this has now been turned against him because of a family dispute which has left him with no other option but to pay back his loan as quickly as possible.
While his work is also a contributing factor to the issues John is currently facing, it seems to be more a means to an end rather than posing any major problem for him. Given the way that John spoke about his work place during the initial interview, it seems as though he has begun using it as an ‘out’ for the stresses he faces at home and academically. While he may not conciously realise it himself, he seems to have begun to use work as a social outlet for himself. While it is good that John still has some social interaction, doing so while at work is far from ideal.

3. Intervention:
According to (Goldstein, 1983) it is important to start where the client is and not get too caught up in tackling all of the client’s issues all at once as this runs the risk of overloading both the client and the worker themselves.
With this in mind, I would probably begin using a task focussed approach. This will allow John to break down his seemingly insurmountable problem into smaller more managable pieces (O'Connor, Wilson, & Setterlund, 2003).
Using this approach will also allow John to work through his own problems, ideally, leaving him with a sense of self-empowerment for the future. This approach will also avoid running the risk of sounding as though you are lecturing him in how he should run his life (Goldstein, 1983).
The first step in this process would be to work with John to create a series of steps allowing John to identify what he wants for himself (O'Connor, Wilson, & Setterlund, 2003).
Overall, it was John’s acknowledgement of his problems and the decision that something needed to change that highlighted the use of a task centred approach to assist him (Chenoweth & McAuliffe, 2008).
In order for these interventions to have maximum effect,I would more than likely spend most of our first sessions exploring exactly what John wanted from his chosen objectives, refining them and discussing an appropriate time frame for John to achieve them in and eventually write them up as some kind of a contract for him to follow (Marsh & Doel, 2005).
I would also recommend that John come back to see me for a couple of sessions just to make sure he is coping with everything and that things are coming along the way he intended in the time frame that we had discussed. Doing so will also allow the two of us to problem solve any issues that may arise during this process.
For these goals to be most effective, it would also help to use the ecological-systems and strength based theories of practice. As a worker, this would allow me to look at how John functions within the various systems of his life and find out where his strengths and limitations are in relation to the objectives he has chosen to work towards.
Using an eco map would also give John a visual picture of where he fits into the big picture and may help him to realise that in the midst of his crisis that he may have overlooked some of the resources he currently has for himself (Gilgun, 2005).
Given that one of his main issues is to do with a breakdown in family relationships, a genogram may also help him to visualise what is really happening with his family and if he has anyone who may be able to speak with to help support him in the discussions around his loan repayments (McGoldrick, Gerson, & Shellenberger, 1999).
The strengths approach is particularly useful here as it takes what seems to be one big negative for John and allows it to be seen in a much more positive light (Chenoweth & McAuliffe, 2008).
Although not necessarily related to a Social Work intervention, I would also recommend that John see his GP in relation to his heart palpitations and anxiety as a precaution that these conditions are not symptoms of something more serious.

4. Reflection:
Given I’m a university student myself, I have some level of empathy towards John’s current predicament. I know all to well the stresses of trying to find a balance between work, study and friends. I would have to be careful that this didn’t impact on the advice I was giving John though, as it would be extremely easy to fall into the trap of a single solution that would fit across the board or the idea that something that worked well for me would work equally as well for John.
Overall, I think the task based approach would work extremely well for John, as it would leave him feeling self-empowered as opposed to completely overwhelmed as his is currently.
Given that John’s issues stem from university, the short time frame associated with a task focussed approach will also prove useful in that he should be able to see some results before the end of the year/semester which in turn should allow him to complete any academic requirements.

As far as my own beliefs are concerned, this has given me far more insight into this approach to practice. Previously my knowledge of a task based approach was based purely on the idea that it could only be used where a client was in an immediate crisis ie. Homeless or needing to make arrangements for a family member who was ill.
It has also shown me that many theories of practice tend to have some level of overlap in their methods of practice and as such, are complimentary to one another and can even have a synergistic effect on treatment outcomes.

It has also highlighted for me that I am somewhat hesitant when it comes to dealing with clients with mental health issues, looking back over my intervention strategies I seem to have taken a stance whereby I address a number of John’s issues that I feel may be contributing to his anxiety (and possible depression) and hoping that in turn this will alleviate any mental health problems he may be suffering from. This is probably highlighting a lack of confidence on my part rather than an underlying prejudice towards people with a mental illness, either way it has highlighted something that I need to be more aware of when consulting with clients and devising interventions with them. 
References:
Baglioini, C., Battagliese, G., Bernd, F., Spiegelhalder, K., Nissen, C., Voderholzer, U., et al. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders , 1-10.
Chenoweth, L., & McAuliffe, D. (2008). The Road to Social Work Human Service Practice 2nd Ed. Melbourne: Cengage Learning.
Gilgun, F. (2005). An ecosystemic approach to assessment. In B. Compton, B. Galaway, & B. Cournoyer, Social Work Processes (7th ed., pp. 349-360). Chicago: Dorsey.
Goldstein, H. (1983). Starting Where the Client Is. Social Casework: The Journal of Contemporary Social Work , 64 (5), 267-275.
Marsh, P., & Doel, M. (2005). The task-centred book. London: Routledge.
McGoldrick, M., Gerson, R., & Shellenberger, S. (1999). Genograms: Assessment and Intervention (2nd ed.). New York: W.W. Norton.
O'Connor, I., Wilson, J., & Setterlund, D. (2003). Social work and welfare practice (4th ed.). Frenchs Forest: Pearson Longman.