I included the examples and the reading. I also included my old client. It is a discharge summary for that client. If you know how to do it please no cover page need and no headers or footers….pleas

I included the examples and the reading. I also included my old client. It is a discharge summary for that client. If you know how to do it please no cover page need and no headers or footers….please ask questions if needed. This is my last assignment for the semester I need it to be pretty good.  I live in central time

Assignment 1: Termination Summary

As helping professionals, employees in the human and social services field want their client to be successful. They try to interview clients to create a social history, set goals, make recommendations, and refer clients. However, things do not always go as planned. As a human and social services professional, it might be necessary to terminate the client relationship for other reasons, such as the client becoming aggressive towards the professional or other situations such as a client no longer wanting services or moving away which makes it no longer possible for him or her to receive services.

To Prepare

  • Review your interviews and documentation related to your Final Project.
  • Review Chapter 11 of your Summers text regarding addressing and disarming anger.
  • Imagine that before you ended your services with the client, the client displayed some inappropriate confrontation, crisis and/or had an angry outburst in front of you.
  • Consider how you would document this in a Termination Summary.
  • Although your Termination Summary does not need to follow a specific format, refer to pp. 443-447 in your Summers text for ideas.

For this Assignment

Create a 2-page Termination Summary of your work with your interviewee/client from your Final Project interview and document the progress related to the service plan/goals that you created in Week 10. As part of your Termination Summary, document the inappropriate confrontation, crisis and/or angry outburst incident you imagine could happen. Include what your response and the client’s response might be, that might not be the most appropriate (refer to Chapter 11 for ideas). Then, include a plan for managing this type of crisis in the future.

HERE IS THE CLIENT:

Client is a 32-year-old African American black female that has reported bouts with depression. Client lives alone and reports no family living nearby. Client’s latest referral was on 11/5/2017.Client has been referred to the salvation army and also to the red cross for items that she has needed. Originally client spoke about needing clothes and help to pay utilities. Client has had some trouble managing life and her skill level is not appropriate to handle advanced issues of life. Client has dibbled in drug use but has never really used long enough or often enough to meet criteria for abuse.

Client’s next referral is to see a therapist and begin discussing her issues. Client’s initial sessions with our agency helped to motivate her to begin the process and believe in herself enough to receive help. Client has an appointment to meet with Deidre Frasier LPC on 11/12/2017 at1:00pm. It is recommended that an assessment be conducted with client and the LPC to determine other areas that she may need. I also recommend some classes that will help her navigate in life skills areas. Maybe client can benefit from some aggression management even though her anger is usually geared toward herself.

It would be helpful if the client’s progress could be reported to us so that we can track the progress for future referrals. A copy of the client’s consent will be forwarded to you along with this referral. We will be calling to verify attendance for the appointment within three days of the date. My name is Harriet Mitchell and I am the case manager that has been working with her since she began her journey with our agency.

Your agency may have a standard format for discharge summaries that you can use as a guide to writing good discharge summaries. If not, you can use the “Discharge Summary” form provided in Appendix C.

Here are important items to include in the discharge summary:

  • 1.Name, date of birth, date of admission, and date of discharge
  • 2.Diagnosis (if there is one)
  • 3.Any medication that was prescribed by physicians who were working with the case management unit and whether it has been discontinued. (Make sure to note the name of the medication, the dosage, the frequency, and any adverse reactions.)
  • 4.The reason for discharge
  • 5.The major presenting problem that brought the person to you
  • 6.Your goals and objectives for the individual
  • 7.The extent to which the client participated in formulating these goals and objectives
  • 8.Progress that was made or goals that were accomplished
  • 9.Problems that were identified but were not addressed
  • 10.How the individual appeared to be at intake and how the individual appeared to be at termination
  • 11.Attempts to locate the person if she has disappeared

Examples

We can look at several cases and how they were terminated. First is Alex, whose insurance stopped payment for services, which stopped Alex from having further contact with the agency. Alex did not want to leave and felt he had gained support he needed to continue to work through his difficulties on his job. The reason for discharge was “insurance no longer available.” The goal for Alex to begin a course that could have led to a promotion was not met. This was noted and the need for further support to obtain this advanced training was noted under problems that had been identified but not addressed. Because Alex seemed as agitated about his work situation when his insurance ran out as he did the day he came in for assistance that too was noted and in fact, the case manager noted that the loss of insurance coverage was contributing to his difficulty. Before discharge the case manager worked with Alex and his minister to give Alex some support for attending the advanced classes. This gave Alex someone to work with before the insurance was reinstated the following year. This was not an ideal solution, but the case manager made sure there was some support system in place before the final termination.

Serina had been homeless and very independent. Case managers had visited her on the street where she frequently stayed and made certain she had her medications. However, Serina was found dead one morning of an apparent homicide. No one was ever charged in her death. The discharge summary noted the reason for termination was that she was deceased. There were, however, issues for case managers compiling a discharge summary for Serina. Had there been goals for her? The one goal was to get Serina into a single-room occupancy shelter, particularly given her age, but there were few notes in the record that indicated that case managers had helped Serina pursue this goal or even that Serina agreed with such a move. In addition, the record begged the question: Had case managers done enough to protect Serina? The discharge summary, while well written, left many unanswered questions. In part, Serina’s unwilling cooperation made the case management work in this case difficult. Nevertheless, the discharge summary could not ethically show a vigorous plan and work in support of Serina.

Finally, Augustine had met all his goals. Diagnosed with a bipolar disorder, he had learned to take his medications consistently, obtained a job in the local symphony orchestra, and had worked successfully to stabilize his marriage. His reason for termination was that his goals had been met and the case manager could list his goals and the progress that was made. There were no apparent issues left unaddressed and Augustine remarked during his last interview with his case manager that while he hated to leave he felt like “I’m more normal doing this from now on, on my own, rather than needing someone to help me stay on track.” Unlike Serina, Augustine had worked hard on his goals, cooperated with the work put forth by his case manager to help him meet the goals, and even came up with some ideas of his own for meeting his goals.

Summary

Termination should be approached as skillfully as all other aspects of case management. When cases are closed well, both clients and agencies benefit. People feel reassured and supported as they take leave of your services. In the community, the perception of your agency as a caring and professional place is strengthened.

Termination involves good documentation as well. The discharge or termination summary you prepare outlines concisely the history of the person’s relationship with your agency. This is enormously useful to others who may work with your client later

(Summers 444-447)

Summers, Nancy. Fundamentals of Case Management Practice: Skills for the Human Services, 5th Edition. Cengage Learning, 20150101. VitalBook file.

The citation provided is a guideline. Please check each citation for accuracy before use.

Chapter 11

Why Disarming Anger Is Important

You cannot be as effective in your work if you are dealing with a client who is angry. The client cannot be expected to move the relationship to another level; but you, as the professional, can be expected to practice the techniques that will allow the relationship to move beyond the anger. The major reasons for disarming anger are as follows:

  • Eliminates an obstacle to true understanding. Disarming anger diffuses the anger, making it less of an obstacle to true understanding. People who are angry cannot really hear each other. If you are genuinely interested in why the client is reacting in this manner, you need to reduce the anger so that you can better understand what is fueling these strong emotions.
  • Shows clients you respect their message. Disarming anger shows the other person that you respect the message even if the way it is expressed is not helpful. By moving to another level beyond the anger, you can indicate to angry clients that their concerns are important to you even when you are having trouble with the way they are addressing these concerns.
  • Enables you to understand the problem. Disarming anger allows you to become aware of the actual problem. Only when you have disarmed the anger can you and the client actually address the underlying concern. As clients feel heard and understood, they are more likely to begin to collaborate with you in looking at their problems and the solutions.
  • Allows you to practice empathy. Disarming anger allows you to practice empathy, seeing the situation as the other person is seeing it. Disarming anger is an important part of establishing rapport. If you become angry yourself, you are caught up in your own feelings and needs at the moment. On the other hand, if you think about the reason the person is angry and you speak to that situation or to those feelings, you are responding empathically. This lets the client understand that you are not going to engage in an angry exchange, but you are going to respect the client’s concerns and feelings.
  • Focuses work on solving the problem. Disarming anger focuses on solving the issues and problems, and not on who is to blame. Disarming anger techniques do not allow for exchanges of blame. Angry clients may hope for such an exchange with you wherein they blame you and you defend yourself, often by blaming them in return. The purpose of disarming anger is to fix those things that legitimately need to be fixed.

Many people sound angrier than they mean to. They are often anticipating the angry response of the other person. As human service workers, we read anger as a signal that the client’s needs have not been met, and we focus on resolution of the problem that has caused the angry emotions, regardless of whether we think the client’s anger is legitimate.

(Summers 226-227)

Summers, Nancy. Fundamentals of Case Management Practice: Skills for the Human Services, 5th Edition. Cengage Learning, 20150101. VitalBook file.

The citation provided is a guideline. Please check each citation for accuracy before use.

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