Youth Focus Case Study - Case Management Framework Assessment Answer

Internal Code: 1AHABI

Youth Focus Case Study Assesment Answer

Assignment Task: Specialist Homelessness and Domestic and Aboriginal Family Violence Services (SHS) Homelessness Strategy Division, Housing SA, Department for Communities and Social Inclusion July 2013. Youth Focus Case Study - A 22-year-old man was provided a referral to you via the youth gateway service. He has spent the last five years cycling in and out of homelessness and living on the streets. In the first day he engaged with you he presented as angry, stressed, delusional and abusive. He is keen to have his own house in which to live but appears resistant to most other supports you have tried to offer. Intake Your initial focus is building a rapport with the young man, and as he is resistant to discussing other needs in his life, you agree to work with him around his main priority which housing. With his permission you also contact the youth gateway service which has had some level of contact with him over the past two years, to inform his presenting issues. Although he refuses to talk with you a great deal, you spend time with him helping him to understand your services, and talking about his interests, including music. You also observe his tendency to be aggressive about issues that frustrate him, such as lack of immediate independent housing. He informs you he would prefer to remain on the streets than stay in emergency men’s housing. However, he agrees to keep in contact with you because you agree to prioritise his housing need, above other issues you feel are just as important, such as his aggressive tendencies. Assessment Your assessment takes time and involves several short discussions with the young man and a lot of observation. During this period you also prioritise securing housing for him and within a few weeks, locate a supportive housing option for him within your own agency. To support his efforts to make this a sustainable option, you organise Centrepay payments with him to manage his rent and related bills. As you work with him to prepare practical needs for his housing, such as furniture, and talk with him about maintaining his tenancy, he begins to open up about other concerns he has. During these conversations you readily acknowledge his strengths, such as his willingness to sort some of his issues out, and help him to identify his goals around some of his needs. His key concerns are feeling depressed a lot, not having any friends he can trust, difficulty sleeping, frequent tooth aches and a recent Hepatitis C diagnosis. He also informs you that he was once under the Guardianship of the Minister (until he was 18 years) and that he hated most of his childhood and has no contact with his family, who live in Melbourne. You also observe some erratic thoughts, such as his assumption that everyone hates him, he is underweight and has poor hygiene. With his permission you talk to a number of other services who have had previous involvement to help inform your assessment. Case planning Based on a balance of what you have assessed as priorities and what your client sees as the priorities, you begin to put together a case plan with clear time frames. As you put the document together, you talk with your client about these priorities and the need to connect him with other supports to help achieve the case plan goals. Considering his reluctance to engage with you initially, you inform him that you will attend initial meetings with him to help him connect with other needed supports. Together you add time frames and although some seem too distant to your client, you reassure him that you will both regularly review progress to ensure you are working towards his success together. Implementation of case plan Across his life domain areas, you begin to implement the case plan as follows: • Financial: introduce budgeting and planning into his fortnightly pay • Mental health: you organise a mental health assessment and care plan through his GP who in turn organised specialist psychological counselling. Engage him with anger management therapy for young people, assistance for drug addiction and emotional trauma and continue to clarify with him adequacy of support implemented. • Physical health: a dental checkup followed by removal of wisdom teeth; discussions with him about personal hygiene; and help him to develop shopping and nutritional cooking skills. You connect him with a Hep C Program and have boils and infections removed through engagement with the GP and then surgery. • Training/employment: You engage him with a job search agency and group recreational program where he participates in bush walking and fishing, and a hip hop recording studio, both of which build his social and personal confidence. He starts to get a feel for his personal interests and abilities. • Living skills: You apply for ‘Leaving and After Care’ funding to establish independent living supports. You provide him with cleaning products and develop a weekly cleaning and shopping plan with him. You use a calendar to help him set goals and provide small rewards (eg a lunch outing) when he achieves significant milestones. • Family/social: As his support worker, you provide a positive role model. You help him develop a ‘life story book’ and focus on communication and social skills. At his request you also work with him to establish regular phone contact with his brother in Melbourne and ensure the therapeutic supports in his life are aware of these significant changes. Monitoring As engagement continues, you continue to clarify and correct his assumptions (“everyone hates me”) to help him maintain a real view of his situation and encourage him to focus on his own strengths and the achievements he has been making. You notice that he begins to take pride in his appearance and also shows a special interest in gardening around his house. You note he has become proud of his home and is handling the responsibility of his tenancy. He prepares well for his regular house inspections. He manages personal hygiene, housekeeping, shopping, cooking and budgeting well and you continue to praise his efforts in these areas. Considering the number of agencies involved, you hold regular monthly case conferences to keep everyone informed on progress and the case plan direction. Specialist health and mental health workers report that his Hep C infection is now being managed and his drug dependency has reduced. You note that he is less delusional and is beginning to acknowledge some deeper underlying traumas of 14 years under guardianship with 15 foster families. Despite his extraordinary progress, you are aware that he is still a long way from employment and financial independence however he is learning new skills and making small steps forward. He continues to get frustrated easily and on occasion blows his income on binge drinking and drug misuse. He is often as challenging for you and the support staff as they are challenging to him. However, through regular reviews of the case plan, acknowledgement of progress and a high level of communication with your client and those involved, his stability continues to improve. Evaluation, transition or exit You anticipate that your service may be working with the young man for some time, but are also aware that when he turns 25 years, he will no longer be eligible for your services. You ensure that within the case plan, consideration is given to begin engaging him with other services from 24 years of age, in order to ensure an extended transition period. You also plan for some generic services to continue even though case management will be taken over by an adult service.

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