Personalized Service Plans – Meeting Diverse Needs Effectively

Personalized Service Plans – Meeting Diverse Needs Effectively

Service Plan

Initial Contact/Service User Information

Contact and Demographic Information Name: Robbie and Adam (last names unknown) Address: Unknown Date of Birth: Robbie (unknown), Adam (16 years old) Phone: Unknown Email: Unknown Gender: Robbie (male), Adam (male) Marital Status: Single (both) Level of Education: Robbie (unknown), Adam (unknown) Working Status: Robbie (unknown), Adam (unemployed, likely due to age) Religion: Unknown Current Resources Receiving Custody: Abigail (grandmother) Financial Support: Abigail (part-time job) Health Insurance: None for Abigail and the boys Medical Coverage: Abigail and the boys do not have health insurance. Confirmation of Informed Consent and Confidentiality It is assumed that Abigail, Robbie, and Adam have provided their consent for outside help, as Abigail is described as open to it. However, explicit confirmation of informed consent is required in a real-life situation. Confidentiality should be ensured to protect the privacy and well-being of all individuals involved.

Problems or Primary Concerns

Ø  Accessibility Ø  As Abigail, Adam, and Robbie do not have Internet service, it is crucial to ensure that the virtual appointment can be conducted using alternative means that they can access. The cordless landline phone will be the primary communication tool. Ø  Privacy Ø  Each family member should have a private conversation with the service provider. It is important to respect their confidentiality and create a safe space for them to share their thoughts and concerns individually. Ø  Scheduling Ø  Since the family members share the bedrooms, it is important to schedule the virtual appointment at a time when all three are present and then have individual conversations afterwards. Their availability and any potential conflicts with their daily routines should be considered. Ø  Clear Communication Ø  Given the limitations of not having face-to-face interaction or visual cues, it is important to ensure clear and effective communication during the virtual appointment. One should be mindful and speak clearly, providing ample opportunities for the family members to ask questions and use appropriate language they can understand. Ø  Engagement and Involvement Ø  During the virtual appointment, it is essential to actively engage all three family members and ensure their involvement in the discussion. They should be encouraged to express their thoughts, feelings, and needs to actively participate in developing the service plan.

SMART Goals and Objectives

SMART Goals and Objectives for the Service User: Ø  Goal 1: Enhancing the Well-being and Mental Health of Adam and Robbie Ø  Objective 1: By the end of the next month, schedule appointments for Adam and Robbie to see a mental health professional specializing in trauma therapy, assess their needs, and develop a comprehensive treatment plan. Ø  Objective 2: Within the next three months, research and connect with local community resources such as support groups and counseling services to provide additional support for Adam and Robbie’s mental health needs. Ø  Goal 2: Supporting Abigail’s Stress Management and Emotional Health Ø  Objective 1: Within the next week, provide Abigail with educational materials and resources on stress management and self-care practices to enhance her ability to manage stress effectively. Ø  Objective 2: By the end of the next month, schedule regular check-ins with Abigail to monitor her stress levels, provide emotional support, and identify any additional needs or concerns. Ø  Objective 3: Within three months, connect Abigail with a respite care program to offer her a break from caregiving responsibilities, reduce stress levels, and promote her overall well-being.

Sociocultural Factors Related to Goals and Objectives

Ø  Sociocultural factors, including mental health stigma and family dynamics, influence the service user’s experience. On the one hand, the stigma surrounding mental health creates barriers to seeking help and support. On the other hand, family dynamics, such as conflicts and strained relationships, can impact the service user’s progress. Ø  Therefore, addressing these sociocultural factors is essential for developing an effective plan that promotes the service user’s mental health and well-being.

Strengths and Interests

Strengths that the service user possesses and/or interests relevant to planning in this case include: Ø  Abigail’s willingness to seek outside help and support for herself and the boys, despite the challenges she faces in providing for them Ø  Adam’s sweet and timid nature, which could make him receptive to counseling or therapy to address his emotional struggles Ø  Robbie’s reported avoidance of social situations, which could be an area of focus for support and improvement through counseling or therapy

Plan for Services

Several appropriate services in the community can be considered to address this family’s needs. Firstly, mental health services for Robbie and Adam are crucial to help them cope with the trauma they have experienced and their emotional struggles. This could involve connecting them with child psychologists or therapists specializing in trauma-informed care. Additionally, financial assistance programs or community organizations that support families needing financial assistance could be explored to alleviate Abigail’s financial burdens.

Referral System

I have already reached out to Dr. X, a child psychologist specializing in trauma-informed care in the Individual Counselling Office of The Hart City Community Mental Health, to inquire about their availability for individual counseling sessions for Robbie and Adam. I am currently awaiting a response regarding their appointment availability. Once I receive confirmation, I will schedule an appointment for Robbie and Adam on a mutually agreed-upon date and time

 

Length of Service and Follow-Up

Based on the complexity of the situation and the goals outlined in the service plan, it is anticipated that a time frame of approximately six months may be needed to meet the overall service plan goals for Robbie, Adam, and Abigail. Case management follow-up is required on a regular basis to monitor progress, address any barriers or challenges that arise, and ensure the necessary support services are being accessed and utilized effectively (Leffler et al., 2022).

Analysis

An Analysis Justifying the Plan

The selected service plan is justified based on a comprehensive analysis of the service user’s strengths and needs. Robbie and Adam, who have experienced trauma and loss, possess strengths such as their willingness to engage in counseling services and their individual characteristics that can be harnessed for their benefit. The specific needs, including mental health support and financial assistance, are identified and aligned with appropriate services in the community (Moore et al., 2023). The plan aims to provide holistic support that promotes their well-being and resilience by addressing these needs and building on their strengths.

To ensure that the plan remains person-centered, it is essential to empower the service user(s), in this case, Robbie and Adam, to actively engage in the goal-planning process. The service user can be empowered through open and honest communication, active listening, and respecting their autonomy and choices (Walker et al., 2023). Rather than relying solely on the practitioner for answers, the service user should be involved in decision-making, goal-setting, and implementation. This can be done by regularly seeking their input, asking questions to understand their perspectives and preferences, and collaboratively developing the plan based on their individual needs and aspirations. By taking a person-centered approach, the service user becomes an active participant in their own care, which increases their sense of ownership, motivation, and the likelihood of achieving their goals.

What Is Missing From the Plan?

Based on the case study, there are a few gaps in the plan that require further information to create a more comprehensive and effective plan. Firstly, it is unclear what kind of financial assistance Abigail receives and her overall financial situation. This information is crucial in determining what kind of support or resources she may need in caring for Robbie and Adam. Secondly, there is no information on whether Robbie and Adam are currently attending school and how they are performing academically, which could have implications for their overall well-being and future opportunities. Thus, to gather the needed information, I would ask the following questions:

1. Can you tell me more about your current financial situation and what kind of assistance you are receiving to care for Robbie and Adam?
2. Are Robbie and Adam currently attending school? How are they performing academically, and do they have any special education needs?

If the service user only answers with “I don’t know,” I would explain why this information is important for their overall well-being and how it can help us create a more personalized plan. I would also try to ask more specific questions or provide prompts to help them recall or think about the information more deeply. For example, I might ask if they have any documents or paperwork related to their finances or their children’s education that we could review together.

References     

Leffler, J. M., Clarke, S., & Peris, T. (2022). Strategies to Navigate Day-Treatment Services and Follow-up Plans: A Guide for Families and Providers. Handbook of Evidence-Based Day Treatment Programs for Children and Adolescents, 461–474. https://doi.org/10.1007/978-3-031-14567-4_26

Moore, S., Long, A. C. J., Coyle, S., Cooper, J. M., Mayworm, A. M., Amirazizi, S., Edyburn, K. L., Pannozzo, P., Choe, D., Miller, F. G., Eklund, K., Bohnenkamp, J., Whitcomb, S., Raines, T. C., & Dowdy, E. (2023). A roadmap to equitable school mental health screening. Journal of School Psychology, 96, 57–74. https://doi.org/10.1016/j.jsp.2022.11.001

Walker, K., Griffiths, C., & Jiang, H. (2023). Understanding the Underlying Mechanisms of Action for Successful Implementation of Social Prescribing. Open Journal of Preventive Medicine, 13(02), 41–56. https://doi.org/10.4236/ojpm.2023.132004

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Service plans take many forms and can be highly specialized according to the agency and type of case management. For example, a plan created through a nonprofit organization for people with disabilities may look very different from a plan created through county corrections for recently released parolees. However, both act as contracts between the service user and the service provider and establish justification for services.

In this Assignment, you synthesize the information you have gathered on your fictional service user into a concrete plan. You then provide a rationale for your plan and identify any missing elements or further directions to pursue with follow-up questions.
Download the Service Plan Template from the Learning Resources.
Review the sections of the service plan you have addressed in your Assignments thus far. Integrating Instructor feedback as needed, paste the sections into the appropriate places in the template.
Fill in additional sections of the template that were not yet covered in Assignments.
Complete the full-service plan for your selected service user, including the following elements: problems or primary concerns, SMART goals and objectives, sociocultural factors, strengths and interests, plan for services, referral system, and length of service and follow-up.

Additionally, write a 1- to 2-page analysis addressing the following:

Justify your plan, based on your service user, their strengths, and their needs.
Explain how to ensure that the plan is person-centered. (That is, how would you empower the service user to engage in the planning instead of relying on you for answers? How would you ensure the service user has choice and dignity?)
Assess what is missing from your plan, based on gaps in the case study. List 2–3 further questions you would ask to get the needed information. Then, explain how you would engage the service user if they only answered the questions with “I don’t know.”

Instructor feedback
-Sociocultural factors can be strengths, as well as barriers
-Be sure to listen to what your clients are telling you. Specifically, what about their financial insecurity? What about their food instability? What about the lack of health insurance? Don’t forget to proofread.