THE UNCOMMON LIVING CONDITION

UNCOMMON LIVING CONDITION
COMMON ASSIGNMENT: FINAL PAPER
BY: RICKARD JEAN-NOEL
SWGS 6323: 901 Social Work Practice with Individuals

Part I

Often times in life, we believe that we are different because of our religion, ethnic background, race, color, and creed. However, when we take a step back and take a closer look, we realize that it is often times the clothing and worldly complexities that are diving us. When all of the jargon and politics are place to the side, we see that we all human. As humans, we go through times of pleasure and bliss, but we also go through times of hardships and uncertainties. During the times of hardships and uncertainties, many individuals usually look towards nonprofits, charities, and the government for assistance. At that moment, a Social Worker is then called to assess the issue at hand and to help resolve it. The Social Worker will then work with a vast network of other individuals and resources to help resolve the client’s crisis. During this paper, we will critically examine the client that was conducted with a client in regard to the relation to assessment and intervention planning. We will speak on the services provided and what plans of actions were constructed in order to resolve the client’ current crisis. We will take an in depth look at the work is conducted in the social service field and how it’s benefiting those that are in need.

The agency where we are currently conducting our internship is CAMBA. CAMBA is an abbreviation of Church Avenue Merchants Block Association. CAMBA dates back to 1977 and occurring to their website was “founded in Flatbush to meet neighborhood needs, including reducing crime, improving trash collection, and beautification projects”(https://www.camba.org/about/historyofinnovation). CAMBA’s mission statement according to their website is “CAMBA is a non-profit agency that provides services that connect people with opportunities to enhance their quality of life” (https://www.camba.org/about/missionandvalues). According to CAMBA’s website, CAMBA exist because “Many New Yorkers face daily hurdles such as housing instability, living with HIV/AIDS, language barriers, domestic violence, and insufficient job skills. Since 1977, CAMBA has helped New Yorkers transform their lives by providing holistic programs to individuals, families and communities”. They went on to state that “CAMBA takes a comprehensive approach to helping individuals, families and communities thrive, offering integrated programs in: Economic Development, Education & Youth Development, Family Support, Health, Housing, and Legal Services. Our programs build inclusive communities where New Yorkers have the support, they need to reach their full potential”.  Their website also goes into detail on whom they serve as well by stating that: “CAMBA reaches more than 60,000 individuals and families each year, including 10,000 youth. We serve a diverse cross section of New Yorkers from new mothers in Brownsville to job seekers in the Rockaways. More than half of our clients are immigrants and refugees from around the globe. Over 85% of our families are in living in poverty, reflecting the challenges faced by nearly 1.7 million New Yorkers today” (https://www.camba.org/about).

CAMBA has several offices and provides multiple services. One of the services that it provides is shelter to the homeless. We are currently stationed at CAMBA’s Atlantic House Men’s Shelter. Atlantic House is a 200 Men MICA Shelter, located in the Brownsville Section of Brooklyn, New York. The shelter houses men with psychiatric disabilities, men that are chemically addicted to drugs and alcohol. As well as men who have recently been paroled from jail and have one where else to go and no relatives that are willing to take them in. The main goal for the majority of the client’s are:

1. To be medication compliant.
2. To obtain some form of income and to have a certain level of savings.
3. To obtain sobriety
4. To obtain a housing subsidy to find a room or an apartment.

The majority of the clients are heavy drug users with long criminal history. Many of the client’s also suffer from serious mental illness such as bi-polar, schizophrenia, and personality disorders. It at times can be a dangerous environment and so there are private security on duty as well as DHS Peace Officers on site.

Our main duties during our internship at CAMBA’s Atlantic House Men’s Shelter is to:

1. Maintain medication monitoring.
2. Maintain the medication cabinet and the storage of medication.
3. Conduct life skills group with clients.
4. Conduct one on one interviews with client’s in regard to their goals for process recording.

During our time at Atlantic House, we come into contact with a client that we will use the initials RF for HIPAA client confidentiality. Under the HIPAA law, we can not provide any personal information or medical records unless we have the authorization to do so. According to the “NASW Code of Ethics: 1.07 Privacy and Confidentiality (a)Social workers should respect clients’ right to privacy. Social workers should not solicit private information from clients unless it is essential to providing services or conducting social work evaluation or research. Once private information is shared, standards of confidentiality apply. (b)Social workers may disclose confidential information when appropriate with valid consent from a client or a person legally

authorized to consent on behalf of a client. (c)Social workers should protect the confidentiality of all information obtained in the course of professional service, except for compelling professional reasons. The general expectation that social workers will keep information confidential does not apply when disclosure is necessary to prevent serious, foreseeable, and imminent harm to a client or other identifiable person or when laws or regulations require disclosure without a client’s consent. In all instances, social workers should disclose the least amount of confidential” (https://www.uaf.edu/socwork/student-information/checklist/(D)-NASW-Code-of-Ethics.pdf).

• Informed Consent

Before the start of our session with Mr. MF, weexplained to him the procedure in regard to client confidentiality. We would also explain to him the reasoning behind the interview and inform him that we had his been interest at heart. We also explained to him that this assessment report would include personal information. He was also encouraged to ask as many questions as he wanted in regard to his assessment and the release of his information. Mr. MF also signed HIPAA consent forms for the release of this information.  This allow Mr. RF to be more relax and open to expressing himself.

• Client Identification and Bio

Mr. RF is a slim built, darker skin, 38-year-old African American male. He is about 5’7, is well dressed and groomed. He is originally from the island of Jamaica, but immigrated to Brooklyn, New York at a young age. Mr. RF stated that he did graduate from a Brooklyn, New York High School and his High School diploma. He explained that he had it hard growing up because he was raised in poverty. Being poor and an immigrant made it very difficult to fit in at school, and he would often be picked on. We were able to sympathize with him because we too were immigrates and came from a small island in the Caribbean’s. Mr. RF stated that eventually he grew tired of being poor and picked on and joined a gang. He informed us that this eventually led to a life of drug dealing and violence. He stated that at one point,that family even made it on “America’s Most Wanted”. Mr. RF stated that his ambitious activities eventually landed him in the penitentiary for an undisclosed amount of time. After his release, Mr. RF moved to Florida and restarted his entrepreneurial work with his narcotic business. Unfortunately, while, he was in Florida, he was incarcerated again and which in jail, he began to lose his vision. While he was in jail, his girlfriend took his car without his permission and had it impounded. This led to him losing the car. He also ended up losing the home and was now homeless. With very little resources, and no where else to turn, upon his release from jail, he returned back to Brooklyn, New York. Mr. RF informed us that both of his parents are deceased as well as his brother. He also stated that he has only one other brother, but he was deported back to Jamaica. Mr. RF is currently in Brooklyn, New York alone and legally blind. Mr. RF is currently single and is not married. He has a 4-year-old son, that currently lives with he’s child’s mother. He has informed us that he is no longer with the child’s mother buttries to visit his son as often as possible. Mr. RF is currently now working, and his only source of income is his Social Security Disability and public assistance.  Mr. RF stated that he currently only smokes marijuana and cigarettes. Mr. RF reports not using or abusing any other drug. Mr. RF also states that he has no mental health diagnoses, besides depression and anxiety. His psychiatric evaluation confirms his claims. Mr. RF is currently not on parole or probation. Mr. RF is currently not on any forms of medication.

• Presenting Problem

Mr. RF does not associate with many people at the shelter. He feels that his blindness is a weakness and feels that others will pick on him because of this. Mr. RF has informed us that he at times fear for his safety because of his lack of vision and feels that he is being targeted by other shelter residents. Mr. RF has stated that several other clients have attempted to intimidate him in order to extort him for money. Mr. RF stated that he does not want to retaliate and resort back to his old ways of violence. Mr. RF stated that his only goal is to obtain housing and to try to live a normal life. Mr. RF makes a point to emphasize the fact that he does not feel comfortable in the shelter. Mr. RF stated that the longer he stays in the shelter, the worst his vision becomes, and he fears being completely blind in the shelter. Mr. RF does not have any friends or family members that he is able to move in with, and therefore has to rely on the government housing subsidies to obtain housing. Mr. RF stated that he qualifies to receive the assistance of a caretaker to assist him, however he cannot receive these services until he is out of the shelter. Mr. RF is currently being assisted on a day to day bases by one of the other clients at the shelter, that services as his handlers. However, that individual often times involves himself in conflict and therefore Mr. RF has been disassociating himself from him. Mr. RF is avoiding conflict at all cost because he is vision impaired.

• Research Summary

Mr. RF is currently in an unfortunate situation due to poor choose and a series of unfortunate events. Mr. RF does not make mention of his family’s mental health history but does state that his family upbringing was not the most ideal. Mr. RF does use cannabis, but states that he is not dependent upon it. Mr. RF has stated that he does not feel comfortable in the shelter and at times has issues sleeping. He has also stated that he has lost weight while in the shelter because he is unable to cook and does not enjoy the food that the shelter provides. Mr. RF does have a criminal history and it was during his incarceration that he began to loss his sight due to a chronic condition and lack of medical assistance. The lost of his vision has been one of his most traumatic events and is now affecting his everyday life. Mr. RF has little to no social support, due to has lack of family and friends. Mr. RF believes in God but is not part of any church. His main focus at the moment is to obtain housing and to obtain a care giver to assist him with his everyday struggles. Mr. RF is highly resilient and is determined to exist shelter.

Part II

According to CAMBA.org, their mission is: “CAMBA is non-profit agency that provides services that connect people with opportunities to enhance their quality of life” (https://www.camba.org/about/missionandvalues). If we are to apply the companies’ mission to Mr. RF presenting issue, we would reach the conclusion that Mr. RF issue is housing and he is currently at a CAMBA homeless shelter to seek assistance in that department. Mr. RF is very resilient in his housing search. He is meeting with his caseworker regularly, as well as myself. Mr. RF is very respectful and rarely use foul language when he meets with us. Mr. RF is always well groomed and well dressed. This shows that regardless of his current disabilities and current living arrangements, he is not allowing himself to be a victim or fall to his circumstances. Mr. RF is usually in a positive mood and is often optimistic about obtaining housing. He has expressed in detail that he will do everything necessary to obtain housing. Mr. RF has also done a great job and not associating himself with the other drug abusers at the shelter. He understands that if he were to associate himself, then he too would be abusing drugs, making it harder to obtain housing. Mr. RF is also careful with the way that he spends his money. He has never once complained about not having funds and states that he has a savings. Proof of this was presented to us and his caseworker. From our interactions with Mr. RF, we can state that he is very motivated to obtain housing and knows the importance of being independent.

The interactions that we have with the client are always professional. At times we meet in the office, and when he was interviewing for housing, we would meet him in the field. Mr. RF is intelligent and is conscience of the world around him. Mr. RF has many things in common with us. We are both men of color and are of West Indian/ Caribbean decent. Mr. RF also attended the same high school as us and is from the same neighborhood in Brooklyn. The similarities in background makes it much easier to communicate with Mr. RF and to find a common ground. This allows the assessment to follow very easily. There have never been any hostilities during any of our meeting and therefore we have a very healthy client/ social worker relationship. Our meeting is usually about 15- 20 minutes. During which, he often stresses the importance of obtaining housing and his fear of attack. Mr. RF is very fearful of his safety at the shelter because of the MICA clients and his inability to fully see. Mr. RF is a great candidate for housing, and we believe will find housing shortly.

Mr. RF family system is almost non-existent. This is because his parents are both deceased, one of his brothers are deceased, and the other brother has been deported back to Jamaica. Mr. RF stated that he did not grow up with his father, and that he grew up in poverty, in a low-income neighborhood. He went on to state that majority of his male family members were gang members and sold drugs. This led him to the do the same as well. Eventually he was incarcerated, which caused him to have criminal record. Mr. RF also has issues with his passport, and therefore unable to travel. Mr. RF has a young child, which is a boy. The child currently lives with the mother of the child;however, Mr. RF is not with the mother of the child and have very little to no contact with her. Mr. RF only family structure currently is his girlfriend, who he hopes to be his caregiver in the future.  Mr. RF explained that he is currently in a program where his insurance will pay a friend or family member to be his caregiver. Mr. RF is hoping on moving to a neighborhood where he can have a new start.

After examining once again the details of the assessment of Mr. RF’s case, it we are reaffirmed of his common risk factors. His risk factors would go as followed:

1. Being vision impaired and losing the little remaining sight that he has.
2. Being vision impaired, while living in a MICA homeless shelter.
3. Having very little to no social support, such as friends and family members.
4. Coming from a low-income family and having an extended criminal background.
5. Suffering from depression and anxiety.
6. Poor nutrition and lack of sleep.

We are now fully aware of Mr. RF protective factors as well. His protective factors include the following:

1. Resilient and determined in believing that he will be successful in obtaining housing.
2. Is responsible and is cooperation with his different service providers in obtain assistance.
3. Is able to groom and care for himself, even with limited vision.
4. He is very optimistic, regardless of his current situation.
5. He is able to get along with others and is very respectful and mild mannered.
6. Has a plan to obtain a caregiver once out of shelter.

Mr. RF and I briefly discussed his stance on diversity. Mr. RF feels that blacks, especially black immigrants have it very difficult in the United States. He feels that they are often alienated by other race and are forced to rely on each other for survival. He explained that growing up, he got into many altercations because of the color of his skill and for being Jamaican. He expressed that even at the shelter, his only friend was Jamaican born resident. He stated that he could no longer hang out with the young man, because he would often get into altercations and he is no longer into that life. Based on what Mr. RF has shared thus far, we can say that he is on a positive road and he recognizes his faults and short comings. He understands what has placed him in the shelter, and he also understands what he has to do to get out of the shelter.

Going forward, we would like to make certain changes in regard to how we conduct assessments with clients. One of the things that we would change in particular in regard to this client is that we would ask for more detailed information about his family. We were not able to get more detailed information on the details of the client’s family mental history. The client did not seem to be too comfortable with speaking about certain members of his family, and we also did not try to draw it out. More information on Mr. RF family might have possibly led to family reunification. That is one thing that we can change in the future. We would also like to have more reference resources to provide clients such as Mr. RF. He would greatly benefit from additional information on resources for the vision impaired.

The information on Mr. RF was gathered in several ways. The first way that we gathered the information on him was from his caseworker that provided us with a short summary on the client. The second source of information on the client was the client himself. We interviewed him on several occasions, and he provided us with the information requested. We also did a review of his medical information and his physical social, which was provided to us by his doctors. Client was recorded using the agency standard case note system. Other tools used included the internet, to search for housing resources. HIPAA release forms and company consent forms were also completed as well. The principles of the culturagram and ecomap were applied to fully understand the client’s background and his current condition. The communication skills employed during the assessment process were those learned during process recording. At the start of every conversation, we would create boundaries and limits and provided details on client confidentiality. We would ask Mr. RF open-ended questions, as well as leading questions. When it came time, we would also apply active listening. At the end of the conversation, we would also set a goal and attempt to make steps towards those goals for the following meeting.

Mr. RF the client was very involved in providing information. He was very cooperative and provided us with detailed information, whenever it was requested. We believe that the level of involvement by the client was very appropriate because it helped us to better improve the quality of his life. This is something which our agency’s mission clearly states. The fact that the information provided came directly from the client helps us to have a first-person account of the client’s information. This information is then applied and put into perspective and helps us to paint a better picture of the client and the life that he has lived and is currently living. Based on our critique, we would state that we would make a few slight changes in the way that we gather information. We would change the way we gather information on the client’s family history because we have very little information on that.  We would also attempt to have additional resources such as pamphlets and other service provider information to provide to clients.

Overall, the process of conducting an assessment with Mr. RF went well. We know that his goal was to find housing and to move out of shelter. Mr. RF grew up in a single parent home in a low-income neighborhood, however he was resilient and was able to make it past that situation. Mr. RF was also incarcerated and was able to survive that as well. Mr. RF is currently losing his vision and is legally blind, which has affected his everyday life. He has expressed that he is no longer able to drive a car and has issues reading small print. Regardless to his current conditions, Mr. RF remains optimistic and is still making attempts at bettering his life. Mr. RF was eventually able to move out of shelter and is currently living independently. His caregiver has begun her services and is helping him in returning to a normal life. Mr. RF determination and resilience has helped him to move out of shelter and into his own independent housing. We believe that Mr. RF working with CAMBA, his caseworker, and us helped him to accomplish his goal.

Part III

During this part of the paper, we shall critique or state our case formulation.  This will be the “theory of the case” that we have developed. This will explain how we made sense of the data gathered. In our case formulation, we will state the core “causes” or contributing factors of the problems or key issues at hand in this case. We will make sure to include relevant risk and protective factors in regard to the micro, mezzo, and macro levels. We hope to answer all questions with clarity and in their entirety. We will apply the principles obtained during this course as well ask skills obtained in the professional setting to expound on our responses.

The Interventions goals for client, we had one specific goal in mind, and that was to help him obtain housing. We did this by setting SMART goals. The very specific goal was to help Mr. RF obtain housing with the use of a housing subsidy in a safe neighborhood. We set a plan to help him obtain housing as soon as possible and set a 60-day plan. We acted by contacting several landlords and brokers. We also escorted the client on several housing appointments in order to find him suitable housing. After reviewing the New York City housing market, we came to the realization that the client most likely would not find an apartment in the City for that amount. Therefore, we had to be realistic in letting the client know that he would most likely have to settle for a room rental. The client stated that he would be willing to take a room if it had a bathroom in it. This provided him with more options to obtain housing. The client was very involved in the housing process because he would visit myself and his caseworker every other day at one point. This was proof of his determination, however we had to set boundaries in regard to how often he can come to the office. We did not want the client to get too comfortable and so limits were set. In regard to what we would do differently, we would set the boundaries with the client in regard to how often he comes to the office much earlier in the process. The client would be informed earlier that he could come to the office once or twice a week, but not everyday or to call every single day.

The action steps that we took to help Mr. RF in attaining the aforementioned goals was speaking to several sources until we were able to find an apartment with several room rentals. Mr. RF came to view the apartment and the available rooms and was satisfied with the room and the apartment. We incorporated the client’s risk factors by finding him housing in a good neighborhood. Even though we used a government housing subsidy to pay for the home, the home was not a low-income unit. The client was also familiar with the area and stated that he felt comfortable in the neighborhood. The room that the client chose in the apartment had its own bathroom and so the client would not need to share a bathroom with his roommates. This was a major help for the client because he did not have to leave his room at night to use the bathroom. The client stated that he did not like to leave his room at night because he was vision impaired. We also paired Mr. RF with client’s that had similar demeanors as himself in order for them to all live comfortably.

The client was very involved in finding housing. The client was able to setup services for himself once he moved out of shelter by signing up with a caregiver program. The client also made himself available to attend all housing appointments. The client interviewed very well with the landlord and interacted well with the other roommates. When it came time to complete paperwork, the client showed up and time and completed all of the paperwork according to instructions. The client was also very good at communicating with his caseworker. The client’s actions were very appropriate to the agencies setting and for the purpose of obtaining housing. The fact that the client was so involved helped us to be successful in helping him to obtain his housing. This also showed that the client was independent and was proof that he was able to live independently.

We do not believe that we would make any changes to the way CAMBA handles its case formulation assessment. Every client goes through an intake process where general information is obtained. During this time a client completes a short psychosocial where additional information is obtained. Once that is complete, the client is assigned to a caseworker who then obtains even more information. Once the client is ready to move, they are assigned to a housing specialist to help them find housing. If there were changes to be made, it would be the amount of the subsidy vouchers. Unfortunately, the vouchers are provided by the City and by the Federal Government and so CAMBA has not control over that. It would also be more helpful if there were more housing options. CAMBA would be able to do this by creating contracts with contractors, landlords, and brokers to exclusively working with only them.

The best way to go ahead in evaluating the extent of which the goals were attained and whether or not the intervention plan was helpful to the client would be contacting the client and tracking their progress. In the case of Mr. RF, his goal was obtained because he was able to selection a room rental that he was comfortable with and signing his lease. Mr. RF completed all of the necessary paperwork and applied his housing subsidy for the payment of his rental. Because he had an active subsidy, his rent was paid by the subsidy for 4 months in advance. He was also provided with a furniture check to furnish the room. Mr. RF was successful moved out of shelter on 9/26/2019. A follow up appointment was conducted on 10/11/2019, during which Mr. RF stated that he was satisfied with the housing and that he was grateful for all of the assistance received. The case was successful resolved and closed.

Reference Page

1. https://www.camba.org/about/historyofinnovation
2. https://www.camba.org/about/missionandvalues
3. https://www.camba.org/about
4. https://www.uaf.edu/socwork/student-information/checklist/(D)-NASW-Code-of-Ethics.pdf