Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Case Studies

The following case studies were included to highlight different ways that social workers

many lenses to get the whole story.

● The case of Miranda, which looks at the need for assessment of social isolation

in parents

● The case of Mr. Smith, which shows the need to assess the social support

network of caregivers.

● The case of Mary Adams and her family, which highlights the need to expand the

social network to provide more support.

● The case of Karima, which examines how clients may need to balance managing

existing supports while creating new ones.

Ph.D., Sandra Edmonds Crewe, Ph.D., MSW, ACSW, Meredith W. Francis, MSW,

James Lubben, DSW/PhD, MPH, MSW, Michelle R. Munson, MSW, PhD, Elizabeth M.

Tracy, MSW, PHD, LISW, Adeline Wyman-Battalen, MSSW, LICSW

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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George: Using many lenses to assess cases

George is brought to a community outpatient mental health clinic due to his parent’s

observation that he is “not acting like a normal 13-year-old.” George’s parents report

that he is failing school, has no peer group, and he is often angry at home, “lashing out

at this younger brother and sister.”

They brought him to the clinic because they think he is suffering from the same mental

illness his mother has, and the last straw was that he was found with marijuana in his

bedroom. The family reports a long and detailed family history of substance abuse. And,

Discussion:

What are some of the “lenses” that social workers can view this case?

● Medical (Mental Health and Substance-Use)

● Family context

● School context

● Structural context

● What about the social context?

○ Does that matter?

○ How

How might our treatment plans differ depending on which lens we use?

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Miranda: Social isolation and parenting

Miranda is a 28 year old married, heterosexual woman, who comes to this family

Miranda, her husband and children when she died. Miranda’s mother was diagnosed

with stage 4, metastasized lung cancer 8 months ago. Her death one month prior to

Miranda’s initial appointment was surprising to Miranda as she had hoped that the

treatment would work and would result in remission.

Miranda reports with pride that her elder daughter Marta is doing well in second grade.

She describes her as a “good girl” who helps around the house and helps Miranda care

for the younger children. Jose is currently attending pre-school. Miranda reports some

concerns about his behavior as preschool teachers have been expressing concern to

her that he may have ADHD. He is often in trouble at school, has difficulty following

“good man”, but that he is frequently away from home due to his job, which sometimes

Miranda presents as very sad and tearful. She is seeking some relief from her sadness

and some way to cope with the general stress of her current life circumstances.

Questions:

● Considering the context of Miranda’s life, and recent stressors, what specific

factors might place her at risk for social isolation?

● In what ways might Miranda’s social isolation compromise her parenting?

● What questions might the social worker ask Miranda in order to fully assess the

extent of her isolation? Consider the domains of parenting support that were

discussed in the presentation.

● In what ways might the social worker intervene to help decrease Miranda’s

isolation?

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Mr. Smith: Social support for caregivers

From: Lubben, J. E., & Gironda, M. W., (2000). Social support networks. In D.

neighborhood in a house they had inherited from Mrs. Smith's parents. The Smith's two

children both live more than 2000 miles away but regularly talk on the telephone. At

least once a year, the children along with grandchildren visit the Smiths. From all

external appearances, the Smiths are an octogenarian couple successfully aging. That

misconception was shattered late one evening when Mrs. Smith tumbled down a flight

of stairs breaking both wrists and cracking a vertebrae in her neck. The fall was partially

caused because Mrs. Smith did not want to turn on a light while she went to the

bathroom for fear that the light would awaken Mr. Smith. Given Mrs. Smith's extensive

osteoporosis, her broken wrists required extensive reconstructive hand surgery and

many weeks of hospitalization.

that he had incurred a number of falls around the house. These falls may have been

after his retirement. Thus, he never developed new friends to compensate for those he

once had at work. When he retired from his job, he essentially retired also from his

friendship network and, overtime, developed a severe case of depression. His

home health care services to facilitate Mrs. Smith's recovery. The children also provided

extensive periods of social support to both infirm parents during Mrs. Smith's

rehabilitation. Once she regained much of her strength, the children backed off allowing

Mrs. Smith to again resume much of the responsibility for caring for her husband.

However, children also empowered close friends and neighbors to regularly check on

the older Smith couple and to call either of the children at first sign of any difficulties.

Discussion

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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The case of Mr. and Mrs. Smith illustrates why geriatricians, nurses, social workers and

problem. The final results demonstrated that both family and neighbor social support

networks were willing to rally around the Smiths. However, for far too long, no one

wanted to "interfere" with an elderly couple who perpetuated a myth of successful aging

when in fact they were an unnecessary accident waiting to happen.

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Mary Adams and her family: Expanding the social support network

The Adams family consists of Frank and Mary (the parents) and two teenaged children,

Julie and Bill. The family was referred by CPS when Julie ran away from home following

an argument with her mother over chores which resulted in a beating from her father.

exclusively of church contacts. Mary’s network consists of five people, including Frank,

Julie, Bill, her pastor, and her pastor’s wife. The family has just moved to an apartment.

They know no one in the building. Mary agrees to work with you on expanding her

social support network.

Discussion:

● Brainstorm ways in which you might help Mary expand her social support

network.

● What skills might you teach her to enable her to expand her network?

● What might be an appropriate homework assignment?

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Karima: Creating new supports and managing existing ones

Karima is the mother of a 4-year-old boy, Jamal, who is enrolled in Head Start. Karima,

● Karima’s brother, who helps with transportation from time to time.

● Jamal’s father, who is only seen infrequently, but who provides child support.

Sometimes Karima and Jamal’s father argue over how to handle Jamal.

● Head Start personnel (mainly the teacher and parent advisor), who have helped

Karima deal with Jamal’s behavior and helped her learn about community

resources.

● Karima’s teachers and classmates at the community college, who are helpful, but

not very close.

● Imams and members of Karima’s mosque.

if she had to miss class, she would have people to rely upon for notes. She

her mother’s help with Jamal.

Discussion

direction of support, and relationships with tension or conflict.

While Karima has already formulated her goals, ecomaps can be an effective,

collaborative tool for clients to identify strengths and weaknesses in their network. What

strengths and weaknesses do you see in Karima’s ecomap?

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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The materials presented in this resource list were compiled to supplement and support

Presenters and collaborators for this Institute are as follows:

Suzanne Brown, MSW, PhD, LISW, Robert Cosby, Ph.D., Sandra Edmonds Crewe,

Ph.D., MSW, ACSW, Meredith W. Francis, MSW, James Lubben, DSW/PhD, MPH,

MSW, Michelle R. Munson, MSW, PhD, Elizabeth M. Tracy, MSW, PHD, LISW, Adeline

Wyman-Battalen, MSSW, LICSW

General Resources on Eradicating Social Isolation

Eradicate Social Isolation Grand Challenge website http://aaswsw.org/grand-

challenges-initiative/12-challenges/eradicate-social-isolation/

Eradicating Social Isolation in the Media

McGregor, J. (2017, October 4). This former surgeon general says there’s a ‘loneliness

epidemic’ and work is partly to blame. The Washington Post. Retrieved from

https://www.washingtonpost.com/news/on-leadership/wp/2017/10/04/this-former-

surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-to-

blame/?utm_term=.17f47db47fa9

Brody, J. E. (2017, June 13). Social interaction is critical for mental and physical health.

Grand Challenges Faculty Development Institute: Eradicate Social Isolation

CSWE, Dallas, TX, Oct. 19, 2017

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Parent’s Assessment of Protective Factors Scale

connectedness and social support. The instruction manual and scale are available here:

Assessment-of-Protective-Factors.pdf