Biopsychosocial Assessment

Vanessa Jones is a 57-year-old African American woman from Atlanta, GA. She came to

the Cancer Treatment Centers of America (CTCA) on September 2nd,2021 for treatment for her

stage 3 breast cancer. At her appointment her oncologist Dr. Johnson noticed something was off

with Ms. Jones. Dr. Johnson reached out to the behavioral health team for an assessment on the

patient. During the assessment Ms. Jones admitted to being a user of Crack-cocaine for over 25

years. Due to the fact that Ms. Jones uses narcotics her doctor has decided to stop treatment until

Ms. Jones is clean.

Growing up Vanessa was the youngest of 4 children. She grew up in Bowen Homes

Project and she attended Frederick Douglass High School in Atlanta. Ms. Jones had her First

child at the age of 15 years old. After high school Ms. Jones took a job working at a local

factory. Ms. Jones has 6 children with 4 different men. Ms. Jones States the first time she ever

used Crack-cocaine was when she was when she was 32 years old. She states that she was in an

abusive relationship with her boyfriend, and she started using to as she states to numb the pain

she was experiencing. Due to her drug use she ended losing custody of 5 of her 6 kids. The

oldest was 18 at the time so he didn’t have to go into care. She never married and is currently

single. She has a relationship with 4 of her kids. she currently lives in Riverdale, GA with one of

her sons. She is currently not employed and is receiving Social Security Disability Insurance

(SSDI). Since her diagnosis her son is her primary caretaker making sure she has a ride to her

appointments at CTCA.

Ms. Jones states that she attempted to get clean serval times in the last 10 years. She has

attended many different detox programs and will stay clean for a few weeks. The longest she has

been clean was 3 months. When asked what she thinks causes her to relapse she stated that she

goes back whenever she starts feeling stressed. When asked do she think she can stay clean long

enough so she could start back receiving treatment she stated that she could try but the Labor

Day weekend was coming up and that she also was getting her SSDI check. She said one of her

triggers was when she gets her checks and that she will spend majority of the check on drugs.

When asked if she think giving her check to a trusted person to hold on to the check for her. She

stated that she would rather not do that. It was suggested that she enters a detox program to get

clean to resume treatment.

Ms. Jones is open to get treatment for her addiction so she can begin her journey of

healing from cancer again. She states that she needs to clean for her children and grandchildren.

Her goal is sobriety and beating cancer.

Social workers are aided by social work theories when creating competent interventions

for their clients. Social workers who understand theories and interventions have the tools that are

required in the provision of evidence-based treatment to help their clients overcome their drug

addiction (Walsh, 2013).

Crisis Theory and Intervention

This theory is mainly used for clients experiencing crisis and trauma such as

violence and for clients who need intervention to prevent physical harm or suicide caused by

drug addiction. This theory is a short-term technique that minimizes potential permanent damage

in people affected by a crisis. This theory helps in preventing any psychological trauma and

restoring the mental health state following a crisis.

An individual who needs crisis intervention has usually exhausted the ability to

handle a situation. Crisis intervention is outlined to help drug addicts in realizing that the

position they might be going through is not permanent, and soon enough, they will return to their

normal state. This theory is designed to give drug addicts the tools that they need in coping with

their addiction and handling situations that might cause the crisis.

The elements of this theory include assessing the current situation of the drug-

addicted client. Here, the client is questioned about his or her problem by the counselor with the

aim of determining what the client needs to cope with the drug addiction (Neil, 2017). Next is

allowing the client to understand his or her situation and explaining that what the client is going

through is normal. The counselor will then develop an action plan for the client to deal with the

addiction. This involves coming up with a set of skills such as positive thinking that can be used

by the client currently and in the future. The counselor should offer support to the patient and

should not be judgmental. This is the most crucial part of this intervention. The client needs to

know that he or she is accepted regardless of the current situation. The intervention for Ms. Jones

case will be to have her meet with a therapist to develop a plan for working on positive skill

building and life skills. She would need to meet with the therapist once a week to work on those

skills and to take progress.

Solution-focused Theory and Intervention

This theory is a short-term practice model that involves a social worker and client

coming together and identifying an issue and developing a solution that is based on the strengths

of the client. This will give the client the opportunity to be present and have a role in the positive

changes. This theory is great for a drug-addicted client because it aims at changing the actions of

a client to achieve favorable outcomes rather than changing who the client is (Thomas, 2018). If

this theory is used properly, it can lead to significant improvements in the lives of addicts, such

as resuming a healthy and fulling life.

Solution-focused therapy is effective in the treatment of drug addiction because it

targets the underlying cause of addiction while attempting to get rid of substance abuse. When

handling a client, a counselor will first try and create a shift in the self-image of the client. This

can be achieved by learning new behaviors which will replace drug abuse. Next, the counselor

will develop a plan for change which will involve both the client and the counselor working

together. Included in the plan will be the needs of the client, such as developing new healthier

behaviors, which will include exercise and dieting as well as other personal activities.

By developing these healthier habits and behaviors, the client will face the issue of

drug addiction with more confidence as well as aiding the client in meeting his or her goal of

being sober. The client will also be motivated and encouraged to continue reducing his or her

drug addiction. A client will achieve being sober though a combination of motivation and

encouragement as well as rewards.

Due to the urgency of Ms. Jones case and that she needs to start her cancer treatment as

soon as possible it was recommended that she start a detox program. Once she completes her

detox program she may resume her cancer treatment.

Behavior Theory and Intervention

Behavior theory focuses on changing the behavior of a client concerning substance

abuse. This is done by teaching the clients life skills that will aid them in coping with situations

that are likely to lead to substance abuse also as well as relapse. Behavior theory has shown

significant effectiveness in treating substance abuse in addicts, but the therapy is better suited for

a particular drug (Handwerk & Manack, 2020).

This theory is efficient because it aids in engaging drug addicts in drug abuse

treatment, offering them with incentives if they remain abstinent, changing their behavior,

attitude, and habits in relation to drug abuse, as well as increasing their life skills to help them

handle environmental cues and stressful situations that may trigger the craving for drugs and lead

to another cycle of abuse.

The elements in this theory include the client learning how to identify as well as

rectify problematic behaviors. This is done by the application of different skills that can be used

in stopping drug addiction. A central element of this model is the enhancement of the self-control

of patients as well as the anticipation of problems that are bound to happen by helping the drug-

addicted clients to develop coping strategies that are effective and efficient. Some techniques

include looking into the negative and positive consequences of continued substance abuse, self-

monitoring which will allow a client to identify cravings early as well as what environment

triggers the cravings that put the client at risk of use and develop a plan for avoiding those

environments and cravings that put the client at risk of use. The skills that individuals battling

drug addiction learn through this model will remain with the client even after completion of the

intervention.

Ethical Dilemma

The ethical issues of Ms. Jones case are self-determination versus do no harm. When

working with a client as a social worker self-determination should always be used. Self-

determination can be defined as an ethical principle in social work that recognizes the right and

needs of the clients to be free to make their own decisions. At CTCA patients are allowed to

make their decisions when it come to their treatment plan. In Ms. Jones case its different because

her drug addiction it a major problem. Her cancer care team is concerned that the cocaine could

affect her chemotherapy medication, they are not sure how they would mix, and it could be fatal.

Even if Ms. Jones wanted to take the risk of continuing care while actively using, that could

cause serious problem for the hospital ethically. As social workers in our codes of ethics it states

that we should “do no harm”. Whenever working with a client, we should never suggest or

recommend anything that could cause harm to a person. In Ms. Jones case the hospital decided to

do no harm and decided to pause her treatment until she has detoxed.

Strengths-based Practice

Whenever a patient meets with a social worker at CTCA its always a strengths-based

conversation. When the was presented with Ms. Jones case solution focused theory was instantly

applied. We assessed her strengths and applied to her treatment. One of her strengths is that she

wanted to get clean for her family. She knew that if she wanted to be around for her family, she

needs to get clean so she can resume her treatment and beat the cancer. The team was able to find

a treatment facility and was able to get Ms. Jones to enrolled in the program. If Ms. Jones is able

to complete the program, she can start back her treatment immediately.