SW 2720 Fall 2026 Group 1 Presentation — Transcript

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1. 0:06Go.
2. 0:07>> Hello you guys. This is the virtual
3. 0:10treatment team discussion board
4. 0:11presentation and life skills. This is
5. 0:14module 2 assessment phase and the group
6. 0:17is with Kathy, me and Sterling.
7. 0:22Next slide. Next slide. Thank you.
8. 0:27Um, [clears throat] LOCUS, also known as
9. 0:30the level of care utilization system, is
10. 0:32a standardized tool designed to assess
11. 0:34the level of care required for an
12. 0:36individual's with mental health needs.
13. 0:39It provides a structured approach to
14. 0:41evaluating various factors that
15. 0:43influence a person's treatment
16. 0:46requirements and helps in making
17. 0:48informed decisions regarding their care.
18. 0:50There are two main key components of the
19. 0:53locust and the first one has six
20. 0:54subsections to it. The first one is uh
21. 0:58dimensions assessed. The first dimension
22. 1:00assessed is the risk. This one evaluates
23. 1:03the individual's risk of harm or to self
24. 1:06or others. The second one is functional
25. 1:09status which assesses the daily
26. 1:11functioning in various life domains such
27. 1:13as social relationships and job
28. 1:15performance. Comorbility is uh considers
29. 1:20the presence of other medical or
30. 1:22psychiatric conditions. Um recovery
31. 1:25environment looks at the individual's
32. 1:27living situation and support systems.
33. 1:30Treatment history reviews prior
34. 1:32treatment experiences and outcomes. And
35. 1:34the last one is motivation which gauges
36. 1:37the individual's willingness to engage
37. 1:39in treatment. The second key component
38. 1:42of it is the scoring system. Locus uses
39. 1:45a scoring system that classifies an
40. 1:47individual into levels of care ranging
41. 1:49from least intensive outpatient services
42. 1:52to the most intensive inpatient
43. 1:55hospitalization.
44. 1:57[clears throat]
45. 1:58Why is this important in mental health
46. 2:01and case management? It helps for
47. 2:03personalized care uh resource
48. 2:06allocation,
49. 2:07continuity of care, outcome measurement,
50. 2:11standardization as well. Using the locus
51. 2:14in mental health and case management
52. 2:16fosters a comprehensive understanding of
53. 2:19each individual's needs, ultimately
54. 2:21leading to better treatment outcomes and
55. 2:23more efficient use of sources resources.
56. 2:27Moving on to the NASW standard
57. 2:31assessment. Uh this is standard number
58. 2:34five. It goes over the assessment and
59. 2:37there are also six main points with this
60. 2:40one. Uh the first point is comprehensive
61. 2:44understanding. This is where social
62. 2:45workers must collect a wide range of
63. 2:48information about the client, including
64. 2:50their background, current circumstances,
65. 2:52and any relative social, economic, or
66. 2:55environmental factors that it may have.
67. 2:57This should also include an assessment
68. 3:00of strengths and resources as well as
69. 3:02challenges and barriers. Number two is
70. 3:05the c cultural competency. The
71. 3:08assessment should take into account the
72. 3:10cultural contact context of the client.
73. 3:13Understanding the cultural backgrounds
74. 3:15and perspectives is vital to at to
75. 3:18providing effective source effective
76. 3:22services.
77. 3:23Social workers should be aware of their
78. 3:26own biases and how these may affect the
79. 3:28assessment process. Number three is
80. 3:31about collaboration. Involve the clients
81. 3:34in the assessment process. their
82. 3:35insights and pers perspectives are
83. 3:38crucial for completing an for a complete
84. 3:41understanding of their situation.
85. 3:43Encourage collaboration with other
86. 3:45professionals, family members, and
87. 3:47community resources to gather even more
88. 3:50comprehensive information. Number four
89. 3:52is using evidence-based tools, utilizing
90. 3:55standardized assessment tools and
91. 3:57instruments when appropriate to enhance
92. 3:59the reliability and vitality of the
93. 4:02assessment. This may include
94. 4:04psychological assessments, risk
95. 4:06assessments or functional assessments.
96. 4:08Number five is the ethical
97. 4:10considerations. Assessments should be
98. 4:12conducted with respect for the client's
99. 4:14confidentiality and autonomy. Autonomy
100. 4:18autonomy.
101. 4:19I'm saying that wrong. [laughter]
102. 4:22Um, social workers must ensure that the
103. 4:25assessments are fair, unbiased, and
104. 4:27respectful of the client's dignity.
105. 4:30Number six, which is the last key
106. 4:32component of the NASW code of
107. 4:35assessment. Assessment is not a one-time
108. 4:38event. It is an ongoing process. It
109. 4:41should be um an ongoing process that is
110. 4:45revisited as the client needs and
111. 4:47circumstances change. Regularly updating
112. 4:50the assessment to reflect the new
113. 4:52information and the effectiveness of the
114. 4:54interventions.
115. 4:56And I am going to hand it off to
116. 4:58Sterling.
117. 5:02All right. So, that brings us to our
118. 5:04case study. And we uh tried to make
119. 5:06this, obviously, as you know, we were
120. 5:08given a bit of a prompt. Um, but we
121. 5:10tried to make when we expanded this, try
122. 5:11to make this as realistic as possible
123. 5:14for what you might expect for someone in
124. 5:16Utah. So, here we've got Nicole Sanchez.
125. 5:20She is a 17-year-old Latin American
126. 5:22transgender girl who's been living on
127. 5:23the streets in South Salt Lake City for
128. 5:25the last six weeks. She said that she
129. 5:28was previously living with her parents
130. 5:30Carlos and Alejandra in Murray, Utah,
131. 5:33where she was born and raised. Um, she
132. 5:36has two siblings, an older brother
133. 5:37Marcus and a younger sister Jasmine.
134. 5:40Um, and she revealed that she was raised
135. 5:42in an interdenominational Christian
136. 5:44household with Carlos identifying as
137. 5:46Roman Catholic and Alejandra identifying
138. 5:48as a member of the Church of Jesus
139. 5:50Christ of Latter-day Saints. and her
140. 5:53family would alternate attendance
141. 5:54between each of her parents' worship
142. 5:56services throughout her life. And she
143. 5:58reports having never been employed and
144. 6:00having never been in a romantic
145. 6:01relationship, expressing current
146. 6:03confusion and uncertainty about her
147. 6:05sexual orientation.
148. 6:08Um, she reports being referred to to us.
149. 6:12We're a drop-in youth shelter and she
150. 6:15was referred to us by a missionary
151. 6:17serving at the welfare square
152. 6:18transitional services office after she
153. 6:20expressed to him during a meeting for
154. 6:22food and clothing vouchers that she
155. 6:24didn't feel safe sleeping on the streets
156. 6:26anymore and was not able always able to
157. 6:29get into the overflow shelter at the St.
158. 6:31Fitz and Depal dining hall where she
159. 6:33would often try to sleep. Um, she cites
160. 6:36inadequate food, clothing, shelter, and
161. 6:38safety, as well as worsening mental
162. 6:40health conditions as her reasons for
163. 6:42seeking refuge here at the drop in youth
164. 6:44shelter at this time.
165. 6:49And then moving on to the fivep
166. 6:52assessment,
167. 6:54um, her presenting problem. She is
168. 6:57unhoused as a result of being kicked out
169. 6:59of her parents' home after opening up to
170. 7:01them that she was transgender. She
171. 7:04revealed that she'd been previously
172. 7:06meeting with a school therapist and had
173. 7:08a received a diagnosis of general
174. 7:10anxiety disorder and persistent
175. 7:12depressive disorder.
176. 7:14And she expressed that her anxiety and
177. 7:16depression had been worsening since
178. 7:18she's been on the streets, describing
179. 7:19significant ongoing confusion and
180. 7:21distress about the religious
181. 7:23implications about being transgender, as
182. 7:25well as deep hurt from the rejection
183. 7:27from her family. And she also reported
184. 7:30recently recent recently experiencing a
185. 7:33frightening incident in which she was
186. 7:35harassed, physically assaulted, and then
187. 7:37robbed by a homeless couple just three
188. 7:40weeks ago. [snorts]
189. 7:42Since the incident, um, she's been
190. 7:44experiencing recurrent nightmares and
191. 7:46increased hypervigilance
192. 7:48and a lot of anxiety when approached by
193. 7:50strangers, which happens pretty
194. 7:51frequently. Um, often in the form of
195. 7:55them offering housing in exchange for
196. 7:57companionship. and she always declines,
197. 7:59of course. Um, but that doesn't change
198. 8:02the fact that it's very intimidating for
199. 8:04her.
200. 8:05And she asserted that she's currently
201. 8:08managing her immediate survival needs.
202. 8:11[clears throat]
203. 8:12Quote, I alternate between Catholic
204. 8:14Community Services, Welfare Square, and
205. 8:16Crossroads Urban Center for food and
206. 8:19clothing. And Catholic Community
207. 8:21Services sometimes has a room in the
208. 8:22overflow shelter for sleep, but not
209. 8:24always. So, I'll sleep under bridges a
210. 8:26lot, too, which isn't great, of course,
211. 8:28but it's probably safer than whatever
212. 8:29any stranger is offering.
213. 8:32[snorts] She stated there was no legal
214. 8:34guardian to her guardian to her
215. 8:35knowledge who was currently willing to
216. 8:37be involved in her care. She said,
217. 8:39"Nobody in my family wants to deal with
218. 8:40me as long as I keep pretending I'm a
219. 8:42girl, as they put it." Uh, she expressed
220. 8:44additional worry that she won't be able
221. 8:46to graduate high school now that she's
222. 8:48been absent for almost two months.
223. 8:50As for the background that made her v
224. 8:53vulner vulnerable to the current
225. 8:54problem, she said she was born male but
226. 8:57has always felt off about it and felt a
227. 8:59stronger identification with being a
228. 9:00girl. She described her family as
229. 9:02strongly religious, especially her
230. 9:04mother, who adamantly upholds her
231. 9:06denomination's position on gender being
232. 9:08an essential characteristic of
233. 9:10individual identity and purpose.
234. 9:14Um, she as for what triggered the
235. 9:18current referral, well, the current
236. 9:20crisis and the referral, she related
237. 9:21that she'd been slowly embracing the
238. 9:23fact that she was a girl for years,
239. 9:24having been growing her hair out and
240. 9:27painting her fingernails and then, you
241. 9:29know, experimenting with women's
242. 9:30clothing in private. Uh, then she said,
243. 9:33"I finally mustered up the courage to
244. 9:34tell my family and they told me I needed
245. 9:36to leave unless I stopped trying to
246. 9:37pretend something I wasn't."
247. 9:39Uh she said that she wasn't willing to
248. 9:43suppress her experience any longer, even
249. 9:44if that meant leaving home.
250. 9:47Um so I've been living on the streets
251. 9:49ever since.
252. 9:51She expressed that she was tired of
253. 9:53sleeping under bridges and waiting in
254. 9:55line at the at the dining hall only to
255. 9:57find out they were full for the night
256. 9:59and stated that she wanted a safe and
257. 10:01consistent place to sleep and get back
258. 10:02on her feet.
259. 10:05As for what's keeping the problem going,
260. 10:06she expressed, "I mean, I don't really
261. 10:08have a choice. I didn't ask to be born
262. 10:10male, but feel like a female. I don't
263. 10:11really know how to change that, but I
264. 10:12feel better when I'm expressing who I
265. 10:14feel I really am. And if that means I
266. 10:16don't have a family anymore, and I have
267. 10:17to live on the streets for a while, then
268. 10:19so be it, I guess. Uh, she also noted a
269. 10:22lack of guardianship, as we mentioned
270. 10:24before, and a lack of employment and
271. 10:26stable shelter as other reasons for her
272. 10:28ongoing situation.
273. 10:31As [snorts] for strengths and supports,
274. 10:33um, well, in terms of strengths, she
275. 10:35said, "I'm pretty resourceful, I guess.
276. 10:37Like I said, I've been using the local
277. 10:40resources, CCS, Welfare Square,
278. 10:42Crossroads, to keep myself fed and
279. 10:44clothed and get bus passes and such. She
280. 10:46also noted, I'm authentic to myself,
281. 10:48more so than I used to be. Anyways, I'm
282. 10:50going to show up from as my true self,
283. 10:52even if that hurts when I'm rejected.
284. 10:53So, I guess I'm also pretty resilient,
285. 10:55too. And then in terms of support, she
286. 10:58cited her two friends from school, Tvita
287. 11:00and Stacy, as supports. Um, they've both
288. 11:03tried their best to support me over the
289. 11:05last few years, even if they don't
290. 11:06always understand it.
291. 11:08Um, especially to Vita, he isn't a super
292. 11:10masculine guy, and he says he's okay
293. 11:12with that without needing to change his
294. 11:14gender. So, he doesn't fully understand
295. 11:16why I fulfill that need myself, but he's
296. 11:18been very encouraging and has always
297. 11:20said that I shouldn't let society's
298. 11:21expectations stop me from being myself.
299. 11:25However, she also noticed she hasn't
300. 11:26seen e either of them in almost two
301. 11:28months because her school is in Murray
302. 11:30and all the resources are up here in
303. 11:31Salt Lake City. And when the that
304. 11:35homeless couple beat her up and robbed
305. 11:37her a few weeks ago, they also took her
306. 11:39phone which is limited communication
307. 11:40with her friends even further.
308. 11:43[snorts]
309. 11:44Uh as far as the uh applicability of the
310. 11:48assessment standard to to this case, uh
311. 11:51the whole purpose of assessment is to
312. 11:52gather information and identify goals
313. 11:54and priorities and strengths and
314. 11:56challenges and collaborate with a client
315. 11:58to make decisions with them. And
316. 12:00according to NASW, assessment is what
317. 12:02guides service planning and
318. 12:03implementation. It would be really
319. 12:05difficult for a case manager to help a
320. 12:07client navigate their problems if the
321. 12:09case manager didn't understand the
322. 12:11relationships between the client and
323. 12:12other people and the broader
324. 12:14environment. You can't really do the
325. 12:16equation unless you have all the
326. 12:17variables and without assessment case
327. 12:20management case management will be
328. 12:21pretty pretty chaotic and vague and I
329. 12:24would say even wasteful.
330. 12:26Um there'd be a lot of just wasting a
331. 12:29lot of time. [snorts] And with Nicole
332. 12:32just getting started, having appeared at
333. 12:33the drop-in shelter based on a referral
334. 12:35from another community resource,
335. 12:37conducting assessments is what's going
336. 12:38to help her and her case manager
337. 12:40identify the most salient needs and then
338. 12:42prioritize them and create the most
339. 12:44effective and efficient plan to address
340. 12:46those needs.
341. 12:49um
342. 12:51her screeners because she is a youth
343. 12:53because she's a minor, we we
344. 12:55administered youth screeners, including
345. 12:56the youth version of the ASUS screener,
346. 12:58which is the pearls, to screen for
347. 13:01um adverse experiences, as well as the
348. 13:03youth PHQ9 to determine depression
349. 13:05levels and the PSC 17 to gauge general
350. 13:08emotional and behavioral functioning. On
351. 13:10the Pearls, she scored a four in part
352. 13:13one and a four in part two, resulting in
353. 13:15a total score of eight, which is
354. 13:16indicative of multiple adverse
355. 13:18experiences.
356. 13:19On the PHQ9, she scored a 22, which sits
357. 13:22in the severe range from 20 to 27. It's
358. 13:25about as that's as bad as you can get.
359. 13:27[snorts] Um on the PSC 17 she had an
360. 13:30internalizing score of 10 and an
361. 13:32attention score of nine which are both
362. 13:34clinically significant and then an
363. 13:36externalizing score of three which isn't
364. 13:38clinically significant in itself but
365. 13:40together with the other two subcores
366. 13:42that gives her a total score of 22
367. 13:45which is clinically significant and it
368. 13:47indicates that her although her behavior
369. 13:49isn't too much of an issue right now she
370. 13:51is experiencing a lot of internal
371. 13:54emotional struggles and also problems
372. 13:56with attention.
373. 13:58And that brings us to the next steps.
374. 14:03>> Yes. Okay. So for the next steps,
375. 14:06considering our our patient is 17 years
376. 14:09old, um the next step would be to
377. 14:11determine the level of care that the
378. 14:13client is at by using the CA CSI
379. 14:17assessment, which is the child and
380. 14:20adolescent service intensity instrument.
381. 14:23that is a standardized assessment tool
382. 14:25used to um determine the appropriate
383. 14:28level of mental health service intensity
384. 14:30needed for children and adolescence from
385. 14:34ages 6 to 18 years old.
386. 14:38So in this case, I would um start
387. 14:40focusing on what seems to be the most
388. 14:42urgent based. Uh yeah, so based on her
389. 14:45housing situation, we would refer her to
390. 14:48an emergency youth shelter and contact
391. 14:51child welfare and CPS for abandonment
392. 14:54and neglect from her parents. Um, since
393. 14:57our patient is part of the LGBTQ plus
394. 15:00community, we would also recommend
395. 15:02trauma-informed and LGBTQ plus
396. 15:05outpatient mental health treatment so
397. 15:08that they can meet with a counselor
398. 15:10counselor and get some guidance on how
399. 15:13to better manage her care and emotional
400. 15:16well-being.
401. 15:18Another recommendation would be to look
402. 15:20into some housing resources she can use.
403. 15:23So there is a 360 youth services who
404. 15:27offers trauma-informed care and help to
405. 15:30get that housing.
406. 15:35So for psychoeducational intervention
407. 15:37there are uh three coping strategies
408. 15:40that includes the emotional coping,
409. 15:42problem solving coping and avoidance
410. 15:45coping.
411. 15:47Our client seems she has been trying to
412. 15:50cope in the way she knows how. So, as
413. 15:52professionals, it's up to us. It's up to
414. 15:56us to help teach her healthy coping
415. 15:58skills and hopefully help with her
416. 16:01mental um and emotional load. So, like I
417. 16:04mentioned, there are those three main
418. 16:06types of coping strategies.
419. 16:08Um,
420. 16:10yeah. And before approaching the client
421. 16:13about these types of strategies, I think
422. 16:15it's important to find out what coping
423. 16:19skills they're already using and whether
424. 16:22those strategies are working and helping
425. 16:24them.
426. 16:26And if not, we that's why we are here to
427. 16:29help find a solution. So once we know
428. 16:32that we can introduce different coping
429. 16:35strategies and
430. 16:38hopefully potentially use. So these
431. 16:42coping strategies are tools to help um
432. 16:45our client manage their stress,
433. 16:47emotional pain and challenges that they
434. 16:50face.
435. 16:51Going on to problem focused coping that
436. 16:54is about addressing the problem and the
437. 16:58source of stress. So an example of that
438. 17:00would be if they are stressed um about
439. 17:02school or housing like our client is and
440. 17:05so we can help them identify that
441. 17:08problem and come up with possible
442. 17:10solutions.
443. 17:12The next one would be emotion focused
444. 17:14coping and that will focus on managing
445. 17:17your emotional response. Some of those
446. 17:20examples you could use are techniques
447. 17:23like
448. 17:25uh journaling, talking about emotions,
449. 17:28deep breathing, practicing mindfulness
450. 17:31and muscle rea relaxation.
451. 17:34It's important to be able to calm down
452. 17:37those nervous system um while being in
453. 17:40these stressful situations.
454. 17:43The last strategy would be avoidance
455. 17:45coping. And that is when the client
456. 17:47distances themselves from what they're
457. 17:51stressing about and
458. 17:53reducing that anxiety and those heavy
459. 17:56feelings.
460. 17:58These distractions um are like watching
461. 18:02movies, being with friends, and engaging
462. 18:04in hobbies.
463. 18:07drawing one's focus to something else
464. 18:09can help relieve that anxiety and panic
465. 18:11symptoms when dealing with these
466. 18:13stressful situations. So that's why
467. 18:15giving them those um examples and
468. 18:19resources like those would be is
469. 18:23important.
470. 18:25Um, and then as I briefly mentioned
471. 18:27earlier, when we start to teach these
472. 18:30different strategies, we need to assess
473. 18:33the client's needs and their current
474. 18:35stress stressors. So once you explain
475. 18:38the different strategies and demonstrate
476. 18:40how they work,
477. 18:42you will come up with those solutions to
478. 18:43the problem and it would be good to give
479. 18:47the client many plans instead of just
480. 18:49one so that they can choose what seems
481. 18:52to be what they need and for to be more
482. 18:55personalized to their needs.
483. 18:57I would also help them practice use
484. 18:59their new found skills in a role play
485. 19:02roleplay exercise
486. 19:05and throughout the sessions with the
487. 19:06client um
488. 19:09you'll monitor and adjust the skills as
489. 19:11needed. So for our client using these
490. 19:14skills will will not only um help with
491. 19:18the current stressors but also in learn
492. 19:21long-term challenges and crisis
493. 19:23situations that you know may come up in
494. 19:26the future.
495. 19:29These skills were created to help
496. 19:31clients manage stress and enhance
497. 19:33emotional resilience to be able to teach
498. 19:36them healthy and coping skills.
499. 19:46So, going into what the actual problem
500. 19:50solving is going to look like, um, you
501. 19:54will give this little cute little paper
502. 19:57for your client to look at which goes
503. 20:00over defining the problem. The way the
504. 20:02person defines a problem helps determine
505. 20:04the kind of result that you're going to
506. 20:06get. what's why is it considered a
507. 20:08problem? What is it what is considered a
508. 20:11problem by the person etc. Um you're
509. 20:15gonna on step two include the others.
510. 20:17Think about who else the problem
511. 20:19affects, who you can help or who has the
512. 20:22information about the problem. Um
513. 20:24describing the best possible outcome,
514. 20:27what would what would the client like to
515. 20:29happen? Um list options, different types
516. 20:32of strategies that the client might go
517. 20:34through, things that they can do, uh
518. 20:36things that they want to achieve. Um and
519. 20:38then outweigh the pros and cons of each
520. 20:41option as well and break them down into
521. 20:43why they why it's good, why it's bad. Um
522. 20:47and then decide which option to take
523. 20:49from there. Uh, breaking it down like
524. 20:51this helps the client um, see it in a
525. 20:54very good step-by-step basis, which
526. 20:57helps them process it a lot better. Um,
527. 21:00and I believe that was all that we had
528. 21:03to say on that. So, moving on to our
529. 21:06resources page or our reference page.
530. 21:09There you guys go. Thank you so much for
531. 21:12listening.
532. 21:15>> Thanks, guys.
533. 21:17>> Thank you.