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SUMMATIVE ASSESSMENT THREE Crisis Scenario #1
Self-Harm Disclosure Georgia,
Female aged 15
You are engaging with Georgia, a young female client, aged 15, who has been referred to speak to someone after her GP showed concern for her MH during a recent check-up. Georgia is quietlyspoken, her body language is closed off, and she doesn’t appear to be overly comfortable in expressing her emotions. She is wearing jeans and a hoodie, and her hair is tied up in a knot on top of her head. She is fidgeting with her sleeves, pulling them over her hands, and twisting them around her fingers. Or she fiddles with the frayed fabric from the designer rips in her jeans.
You discuss simple topics to generate conversation and dialogue. She tells you she is part of a group of girls that are the more popular girls at school. She used to play team sports previously but stopped at the end of last year. She reports this was because she hated the new uniforms. She doesn’t have a romantic relationship – she states because it’s too hard with school and her parents.
You ask her to explain this last statement in more depth and Georgia states that her parents aren’t really seeing her as a young adult, she is feeling that she must be their little girl and do what is expected of her. When you ask her how she feels about this, she explains using words like frustrating, sad, disconnected, and alone. Unpacking these worlds with her, you ask how she copes with such big challenges, how she manages those feelings of loneliness and sadness. She tells you that it feels like such pressure inside that she feels she wants to just scream sometimes. She feels that she will explode if she has to take one more day of feeling she will let people down or be in trouble if she shares how she really feels.
You confirm that having someone to talk to and seeking out some counselling and MH support was a good choice, explaining that we all can feel overwhelmed, sad and disconnected at times, but it’s important to know how to relieve some of that pressure when it’s getting as big as Georgia describes it. You then add, “I know it can be an uncomfortable thing to talk about, but I really want to make sure that you are okay, so I need to ask if there are any times where you are releasing that pressure in any ways that could be harmful?” Georgia cries silently. As tears roll down her cheeks, she nods slowly and avoids eye contact.
1. What do you do next?
2. Keeping the Crisis Intervention Principles in mind, share your ideas on what you would say to her?
3. As a support worker, what would you be responsible for with this disclosure?
SUMMATIVE ASSESSMENT THREE Crisis Scenario #2
Domestic and Family Violence Shelly,
female aged 35,4 children
Shelly is a 35-year-old woman who has recently separated from her husband, Wayne. Shelly has 4 children to 2 different partners. Shelly had her two eldest children, who are 10 and 7 years old, with her first partner, Tim.
Shelly separated from Tim due to his violent and alcoholic outbursts. He was physically violent with her on a few occasions. Shelly left Tim and then met Wayne a couple of years later. Wayne and Shelly had 2 children, and their ages are 3 and 1. Wayne is a business manager, though he has recently lost his job due to his addictions. Wayne was an addict in his early 20’s and has come back to his addictions recently due to his stress at work. Things changed about a year ago when Wayne got onto ice. Unfortunately, he has started taking his frustrations out on Shelly and his children.
Shelly has been physically hurt and threatened by Wayne on a number of occasions. Shelly has now chosen to leave the family home, as the most recent outburst and physical violence landed her in the hospital. Shelly had to call her mother up from the South Coast to help out with her children and her mother has been providing her with temporary accommodation since then.
Shelly has come to your service, Shire Community Hub, which provides assistance to the community. She is seeking emergency accommodation for herself and her children and is hoping to obtain housing near the children’s schools and friends so there is not too much disruption. She needs to ensure the accommodation will be safe and secure so that Wayne is unable to find them, at least for the moment, whilst he is not obtaining help for his addiction.
You are a Case Worker at the community centre and it is your role to assist local women with information and referrals to local services, including housing assistance.
1. What are the current risks for Shelly and her children?
2. How would you encourage and enable Shelly to make informed choices to get the help needed to deal with this current crisis?
3. What might be some ongoing needs for Shelly? For her family?
4. What processes need to be followed here to ensure all steps are legal and ethical?
SUMMATIVE ASSESSMENT THREE Crisis Scenario #3
Alcohol and Other Drug Rehabilitation Services
Jason, male aged 49
Jason is a 49-year-old man who has two children to his wife and they are 24 and 26 years old. Jason was diagnosed with schizophrenia when he was 27 years of age and since this time has struggled to maintain his family relationships. He has had trouble holding down jobs and is struggling with life in general.
When Jason was younger, he regularly smoked pot (marijuana) and this helped him sleep, as he was diagnosed with a sleep disorder as a child. His doctors told him when he was 29 that they believe it was the marijuana that could have exacerbated his experiences, leading him to be diagnosed with schizophrenia.
Jason regularly hears voices. He regularly forgets to take, or avoids taking, his medication which escalates the intensity of his voice-hearing experiences, and the voices become increasingly criticising, threatening, and confusing. The medication he is on makes him drowsy and unable to do much.
Jason doesn’t have many friends and he now lives an isolated life. He hasn’t been attending the Hearing Voices support groups for some time now, nor has he maintained contact with his mentor from the support group. His children avoid him and his wife doesn’t speak with him. He is living in supported accommodation for men with mental illness. He hasn’t found the assistance at the supported accommodation to be that helpful. His carers are concerned that he may be contemplating hurting himself or others.
You are a support worker/counsellor at the Men’s Supported Housing agency, who offers information and referrals for Men with MH concerns, a range of support services, and advocacy assistance.
Jason is bought in urgently by a carer from supported housing where he lives, as the voices are talking of Jason punishing himself, not to trust anyone, and phrases like “they don’t want you here, you’re worthless”. The voices are telling him that if he leaves this place things will be better, his kids will love him again, and he will be able to go back to a good life. He never heard voices until he met his wife, so it must be her fault.
1. What do you do next?
2. What questions would you ask Jason? (Keep the principles of Crisis Intervention in mind.)
3. What are the next steps that need to be taken to help Jason stay safe and those connected with him?
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