Bio Psycho Social Case Study Analysis

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Bio-Psycho-Social Case Study Analysis
Social Work 388
Tenier Sims
Every culture and governments around the world have put a lot of emphasis on the
wellbeing of the younger generation. The way the children are cared for since inceptions
determine the future of a community, a nation, and the human generation at large. In order for
any government to realize its objectives, it must cater for the well-being of its young
generation. These activities include supporting the parents, building proper infrastructure for
the raising of the kids such as hospitals, schools, rehabilitation centers among others. The
parents, however, have also a great role to play in the upbringing of the child. Most
importantly is the responsibility of the parents to make sure that their family stands and is
anchored in strong family foundations. This contributes to a stable family. There are several
factors that contribute to a child’s well-being. A stable family impacts most on a child as it
determines how successful a child will be in completing their developmental stages. Research
shows that children from unstable families are likely to be unsuccessful in future as well as to
develop psychological disorders like depression and anxiety. In addressing issues of
depression and anxiety, it is therefore important to determine the exact problem in order to
come up with an effective intervention.
Biological, Psychological and Social Factors Operating in Lisa’s Case
In Lisa’s case, there are several key biological, psychological and social factors that
are operating. In terms of biological factors, Lisa is diabetic and asthmatic. Being diabetic
means that Lisa has difficulties in controlling her blood sugar. This may be a genetic
condition considering that her grandmother is also diabetic, as diabetes is a hereditary
disease. Lisa’s asthma may have been caused by various factors including the fact that her
mother may have been smoking during her pregnancy.
The psychological factors that are at play here are that Lisa suffers from depression
and anxiety which are both mental disorders. Lisa exhibits symptoms that clearly indicate that
she is suffering from depression and anxiety. These symptoms include her sleeping too much
in class, not wanting to interact with other students, having outbursts, feeling tired and
lacking energy, and missing school as well as feeling like nobody cares about her (Fried, &
Nesse, 2015). Lisa’s depression and anxiety may have been caused by stress due to her past
experiences. She may also have been more susceptible to depression because her grandfather
has had several psychiatric hospitalizations.
The social factors, in this case, are that Lisa is multiracial, slightly overweight and she
lives with her grandparents because her father does not care about her and her mother uses
heroin and cocaine and as a result, her life has fallen apart. The fact that Lisa is multiracial
means that she is among the minorities in her school. Her teacher suspects that she is usually
picked on by other girls as much as she has never witnessed this. There are high chances that
Lisa is indeed usually picked on by other girls because she is different in terms of her race
and her body weight. This may be one of the factors that contribute to her having depression
and anxiety (Fried & Nesse, 2015). Lacking parental love is another problem that Lisa faces.
Due to the absence of such love and affection, Lisa cannot tolerate positive attention and feels
like nobody cares about her. Lack of positive attention has caused Lisa to be unable to value
herself and consequently to be unable to relate well to others.
Developmental Stages
Since Lisa is 12 years of age, she has gone through various developmental stages
according to Erik Erikson’s psychosocial development theory. The first developmental stage
that Lisa completed was the trust versus mistrust stage that took place when she was between
0 and 1 ½ years. During this stage, depending on whether a child is being well taken care of
or poorly taken care of, they develop either trust or mistrust respectively. At this stage, infant
experiences a lot of uncertainty about the world that they live in. But when they receive
consistent love, attention, and care, they start trusting their caregivers and being more
confident about facing the world (Dunkel, & Harbke, 2017).
The second developmental stage completed by Lisa is the autonomy versus shame and
doubt stage. This stage lasts until a child is three years of age. During this stage, children start
being independent and exploring their skills. It is important for children to be encouraged and
supported during this stage because it makes them believe in themselves more. Lack of
support and encouragement makes children lack self-esteem and to feel inferior. Lisa has also
completed the initiative versus guilt stage which ends at five years (Dunkel, & Harbke,
2017). During this stage, children interact with their peers and explore their interpersonal
skills. They are also very curious at this stage and ask many questions. Lisa is in the fourth
developmental stage that lasts from five to twelve years of age. This is the industry versus
inferiority stage. At this stage, a child starts learning certain skills taught in schools as well as
acquire knowledge to read, write and to do sums. At this stage, teachers and the child’s peers
play a significant role in a child’s life and impact greatly on a child’s self-esteem (Dunkel, &
Harbke, 2017).
Systems That Lisa Interfaces With
There are several systems that Lisa interfaces with, in her life. There is the family
system, the school system as well as the church system. In terms of her interaction with her
family, Lisa can be said to be functioning very poorly. This is because there is hardly any
contact between her and any of her parents. Also, it seems that Lisa does not have a very
good relationship with her grandfather since this is one of the subjects that she does not want
to talk about. In the school context, Lisa is also functioning poorly. She sleeps in classes, is
violent towards other girls and as a result hardly ever interacts with other students, curses her
teachers, miss school and is therefore also performing poorly. The school and family system
affect Lisa negatively. This is because she is having a problem when it comes to relating to
people in these contexts and ends up feeling lonely and like no one cares.
However, when it comes to the church context, Lisa is functioning very well. She
even leads two youth programs and she is very active. This system, therefore, impacts
positively on her. The fact that she leads at least two youth programs means that she interacts
better with the members of her church. At church, her moods are elevated and she is able to
participate in the various activities that happen there. This is a good place for Lisa to relieve
herself of stress. Being active in social activities and work is a good thing for Lisa and it
helps in building her socially. In this case, Lisa finds comfort in the church by interacting
with other youth members, preaching which raises her spirits, and also gets some close
friends who she is able to share some of the challenges that she may be going through.
Diversity Issues and Lisa’s strengths
The diversity issues that may be impacting on Lisa include socioeconomic class and
racial issues. Lisa lives with her grandparents in an impoverished part of town. Being from a
low social class and being multiracial are factors that make Lisa susceptible to being picked
on and discriminated against. It is worth noting that Lisa also has some strengths. These
include the ability to perform very well in her math class as well as to lead the youth in the
church. On this account, the resources that are available to Lisa are her math teacher as well
as her church leaders. They are the ones that are in a position to help her reinforce her
strengths. In this case, therefore, the church strengthens her physically, socially, and
The Interaction between Stages, Strengths, Issues, and Factors in Lisa’s Case
The developmental stages, Lisa’s strengths, class and racial issues and the biopsycho-social factors interact with each other in this case. According to Erik Erikson, failure
of a child to successfully complete a developmental stage reduces the ability of a child to
complete subsequent stages. As a result, a child ends up having an unhealthy personality as
well as a poor self-image (Dunkel, & Harbke, 2017). Since Lisa’s mother abused drugs and
even had to give her to her grandparents when her life fell apart, there are high chances that
Lisa did not get the love and affection that is required to complete the first developmental
stage. As a result, she ended up growing up with insecurities and the inability to trust people.
Her interpersonal skills were thus affected. The developmental stages, therefore, contribute to
Lisa’s social problems. The fact that Lisa is from a low social class and is multiracial also
contribute to her psychological problems. Her teacher claims that she suspects that she is
usually looked down upon. Being picked on and discriminated against can result in
Lisa’s family is not a very stable one. Her parents are always absent and her
grandfather also has psychological problems and deals with alcoholism. It is therefore clear
that Lisa has a troubled background. Such instabilities often play a major role in the
development of psychological disorders. I can confidently say that Lisa’s psychological
problem of depression is a manifestation of the diversity issues she faces, failure to complete
some of her developmental stages, and the negative social factors in her life. These diversity
issues, negative social factors, and developmental stages interact and affect her life
negatively. It is only her strengths that impact positively on her life since they enable her to
get approval from performing well in math as well as leading the youth.
In my opinion, there are several problems and challenges that Lisa needs my help in
addressing. The first and most important one is the psychological issue of depression and
anxiety. This psychological problem is taking a toll on her education and her well-being in
general. Lisa will also need my help in developing the appropriate interpersonal skills and
self-image. Consequently, she will be able to interact well with her peers and cooperate with
her teachers when they are helping her with her school work. A positive self-image will boost
her confidence and help her stand up to anyone who decides to pick on her. I will also have to
work with a medical facility to ensure that they help Lisa manage her medical condition so as
to reduce the number of attacks she gets. I will definitely also have to help Lisa to build a
relationship with her family, specifically her grandparents. With love and support from them,
she will be able to reinforce her strengths as well as to develop new ones.
How I Would Engage Lisa and Her Family
In order to help Lisa, I will have to engage both her and her family. In approaching
Lisa, I will have to be very sensitive since she is multiracial. I will have to ensure that I do
not make statements that Lisa will consider racist or discriminative. Also, I will have to keep
my opinions and judgments to myself so that she can be more willing to open up and talk to
me. I will also have to show her that I am there for her and that I am concerned about her, in
order to diminish the feeling that no one cares about her and to enhance the rate at which we
build a relationship. I will then tell inform Lisa that she has a problem that needs to be
addressed and giver her quality information about her condition. I will also ensure that I give
her enough time to internalize the problem and to accept my help. This is because most of the
times people usually resist help for mental illnesses due to the stigma that comes with them. I
will therefore not push her too much but I will be persistent in letting her know that she can
count on me.
In engaging Lisa’s grandparents, I will, first of all, let them know that Lisa needs their
help and support to get through her problems. This way, they will be more willing to listen to
me and follow my advice. I will then ask for a session with them at their home just to discuss
the issue and to decide on the way forward together so that they feel involved in Lisa’s
recovery process. Again, I will ensure that I do not sound judgemental when I am talking to
them because it is not their fault that their family is not a stable one. This will, therefore,
encourage them to cooperate with me in helping Lisa to recover.
Literature Review
There has been a lot of research that has been conducted concerning depression and
its causes. There are therefore several articles that attempt to deal with this issue. In the
article ‘Family structure instability, genetic sensitivity and child well-being’ the role that an
unstable family plays in children developing depression is discussed. According to this
article, children who come from families that are disintegrated have higher chances of
developing depression and failing in their future endeavors as compared to those who come
from stable families. The authors of this article also assert that children whose families
undergo changes when they are between 0 and 9 years, develop antisocial behaviors and find
it difficult to relate with their peers (Mitchell, et al., 2015). According to this article, the
stability of families plays a major role in the mental well-being of a child. The information in
this article is accurate because in unstable family’s children lack the love and affection
required for healthy development. This article applies to Lisa’s case in that it explains one of
the causes why Lisa is suffering from depression and anxiety. The fact that Lisa’s family is
not a united one impacts on her negatively.
The article ‘Depression: Loss of Reinforcers or Loss of Reinforcer Effectiveness?’ is
one that emphasizes the importance of parental support in the psychological development of a
child. It attributes depression to the absence of a person to motivate a child. According to the
article, when a reinforcer for behavior is removed a child tends to lose interest in their
environment and social activities (Costello, 2016). These reinforcers are in most cases the
children’s parents. The reinforcers usually give these children an incentive to undertake
certain activities in the society because they end up getting them approval. This article is
correct in this regard since even in our daily lives it is unlikely that we find ourselves taking
part in certain activities without a motivating factor. In Lisa’s case, therefore, the absence of a
person to give her the incentive to actively participate in social activities contributes to her
being antisocial and withdrawn.
In the article, ‘Cognitive theories of depression in online peer support forums:
exploring the cognitive triad’, cognitive theories of depression are explored. According to the
article, depression is caused by irrational distorted thoughts by people. These distorted
thoughts can be as a result of children seeing their parents failing to successfully deal with
certain challenges and at times they are as a result of failing to adopt coping skills (Pierce, &
Hoelterhoff, 2017). The authors of the article opine that depressed people think differently
from those who are not depressed. These people look at their environment negatively. The
severity of depression also depends on how negative one’s thoughts are. The article also talks
about the cognitive triad which includes a person thinking that they are inadequate, or that all
their efforts result in failure or that their future is hopeless (Pierce, & Hoelterhoff, 2017). The
depressed people also prefer focusing on the negative aspects of their lives even when there
are positive things in their lives. This article applies in Lisa’s case is since Lisa has some
strengths in her life that she chooses not to focus on. Instead of her focusing on the fact that
she does well in math and leads youth in the church, she still concentrates on the feeling that
nobody cares about her, her conflict with the other girls as well as her conflict with her
grandfather. It is therefore important for Lisa to get help to change the way she perceives her
life and her environment. Focusing on the positive aspects of her life will help her get past
depressive thoughts.
Intervention Plan
There are several actions that Lisa will be required to take in order to get past her biopsycho-social problems. The most important one will be one that will help her to deal with
her depression and anxiety. For this, Lisa will have to go through a therapy that will help in
correcting these mental disorders. The types of therapies that I recommend for Lisa as part of
the intervention plan are the cognitive behavioral therapy and interpersonal therapy. When it
comes to the cognitive behavioral therapy, the emotions and feelings of a person that cause
depression are effectively dealt with. This form of therapy helps someone to understand the
root cause of depression and therefore to deal with it. It deals with the wrong thinking
patterns that someone develops and corrects them (Pierce, & Hoelterhoff, 2017). It helps a
person to break down the problem that they have and consequently solve it, by changing the
way they look at it. Therefore, a person ends up feeling better.
The interpersonal psychotherapy will also be helpful to Lisa as it will play a great role
in helping her to address her interpersonal deficits. Since Lisa has a problem relating to her
peers and teachers, including this therapy in the intervention plan will contribute to her
treatment. This therapy will, therefore, aim at addressing social isolation, and issues brought
about by difficult transitions like moving from one town to another like Lisa did when she
started living with her grandparents. It will also help Lisa to deal with conflicts that may arise
with her family members. Aside from professional therapy, it is important that Lisa is given
antidepressants to help her manage her condition. The medication will help in elevating her
moods and thus giving her the energy to participate in interpersonal activities.
The church leaders at Lisa’s church will also have to participate in the intervention
plan. This is because it is clear that the church system impacts positively on Lisa. There are
therefore high chances that she will be more willing to listen to the advice that she gets from
her leaders as compared to anyone else. Her math teacher can also encourage her and let her
know that she can perform just as well in the other subjects as she does in mathematics. It
will also be crucial to talk to Lisa’s grandparents. They will need to know that they play a
very important role in Lisa’s life since they are her current guardians and are the ones who
Lisa depends on for support, approval, and encouragement. Sensitising the other girls at
Lisa’s school about her condition and the importance of their cooperation in Lisa’s treatment
is also important in helping her to recover. The other girls will, therefore, be required to
refrain from picking on her or provoking her. With this intervention plan, Lisa should be well
on her way to recovery.
Con …
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