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Aberystwyth University Evolution of Case Management Practice
A needs assessment is a systematic assessment of the needs a person has and the resources necessary to meet those needs. Thus, you identify a specific need in an area, then the resource(s) that address(es) the need.
First, read this case study:
Mr. B is a 58 y/o DBM, presenting in a VA health clinic for assistance with ongoing depression and health issues, including chronic cough and shortness of breath. He was treated with 14 days of oral antibiotics following a previous clinic visit last month, but did not finish the medication and reports he cannot find the medication bottle. He reports that he is sad or blue most of the day, has difficulty falling asleep, but then sleeps until noon most days, has a lack of motivation to do things outside of home and family, and has a low appetite. He is HIV+ and has a history of substance dependence and criminal activity leading to arrest and incarceration. He is currently on probation for one more year; he is compliant regarding meeting with his probation officer. He reported no previous history of psychiatric treatment, outside of substance dependence treatment. He has a history of two previous inpatient substance abuse treatment stays (one year ago and five years ago), but returned to the substances shortly after discharge. He is a current daily smoker and user of alcohol; THC use is 3-4 times per week. He states that “treatment doesn’t work” and acknowledges that he does not want to stop smoking, drinking, or drugging.
Mr. B is the youngest of 5 children (3 males, 2 females; oldest sister deceased in 2002). He was raised in an intact family and denied abuse or neglect (However, his father had many affairs, and his mother was aware of them.). Otherwise, he describes his childhood as “beautiful” and his current family relations as “very, very close.” He describes himself as “the baby of the family” and the “fixer.” He reported that he continues to function in these roles. Mr. B performed well in school in spite of some “bouts of non-criminal delinquency.” He was involved in the school’s competitive chess team and other activities. He also has training as a Legal Aide. He began smoking cigarettes at age 14yo, drinking at 14/15yo, and smoking THC at 14/15yo. He stated that “it didn’t get to be a problem until the military” (Post Vietnam-era (1975-1977), Army).
Mr. B reported that he married his first wife after he was discharged from the military. The marriage lasted ~3 years and produced one daughter. Mr. B stated that the marriage ended because of his “drinking, fighting, and infidelity.” According to Mr. B, he “divorced (his) first wife and quickly married (his) second wife” when she became pregnant. He reported that this marriage also lasted ~3 years and produced a daughter. He stated that he continued all of the behaviors that led to the collapse of his first marriage. This marriage ended when he relocated to New York without her. He reported that he is “very close” to his daughters and second ex-wife, and they have a “good” relationship. However, his daughters are unaware of his HIV+ status. Mr. B has had a long-term friendship with a Houston-area woman who is also HIV+. While she would like to become romantically involved with him, he stated that he has been unable to break free from his self-imposed isolation to pursue this relationship. He reported no other active friendships, acquaintances, or peer groups outside of regular Narcotics Anonymous meetings (a condition of his probation) and family members. Mr. B also expressed that being Black and HIV+ was difficult because he “initially thought that only gays get HIV” and “condom usage” is not a widespread practice.
Mr. B has been “unemployed” (except odd jobs, exposure to TWE/TRE) since ~1998. His family has provided funds for all of his expenses including housing, utilities, clothing, and “pocket change.” Mr. B states that he is “more spiritual than religious,” but identifies as Southern Baptist. His recreation/social life includes television and spending time with family members.
Next, discuss the following:
Pick TWO of the following areas where clients’ needs are always assessed. Explain how each area is important within the framework of case management.
- Medical
- Psychiatric/Psychological
- Social/Relationship
- Financial/Employment
- Functional Living/Housing/ADL
Then answer the following for the first area you have chosen:
- Discuss the primary needs Mr. B has in this area.
- What are the most important aspects for the case manager to address in the short-term?
- What are the most important aspects for the case manager to address in the long-term?
- Identify the main resources that could help to address Mr. B’s needs in that area (i.e. related to his short and long term needs).
Then answer the following for the second area you have chosen:
- Discuss the primary needs Mr. B has in this area.
- What are the most important aspects for the case manager to address in the short-term?
- What are the most important aspects for the case manager to address in the long-term?
- Identify the main resources that could help to address Mr. B’s needs in that area (i.e. related to his short and long term needs).
Discussion Requirements:
- Your written response should be at least 500 words. You must use concepts, theories, facts, etc. from your book AND/OR other sources in your discussion and you must cite them using APA format.
- Forty total points are possible for this discussion.
0=no posting
1-13=simplistic; short; no insight; inaccurate use of course content, theory or fact; missing parts of assignment; poor writing
14-27=some interesting information related to the issue; shows some thought; moderate insight; some inaccuracies, but uses course content, theory or fact; missing parts of assignment; good writing
28-40=interesting; clearly addresses the issue; thoughtful assessment of the issues; all parts of assignment complete; good insight; accurate and complete use of course content, theory, or fact; excellent writing
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