Social Work Assessment and Intervention on Marta Ruiz Essay Example for Free

neighborly Work Assessment and Intervention on Marta Ruiz EssayThe patients name is Marta Ruiz, 52 eld old, female, clinic completelyy diagnosed as human immunodeficiency virus Symptomatic with a CD4 count of 600+ with a detectable but not high viral load. She has been a person bread and butter with HIV/ help (PLHA) for five years. She resides at Jackson Heights, Queens, New York City after migrating from the Domini send packing Republic and is living on assistance provided by DASIS. She put across assistance from this social worker on a crisis precipitated by a idolise of contagion transferred sexu anyy by her to a lover named Ruben, with whom she has recently resumed knowing relations with after being separated for many years. This paper presents stigma as seen in this exercise, its effects on social systems and proposed social work interventions for the node. print and Its Effects HIV stigma is defined as prejudice, discounting, discrediting and discrimination directe d at people perceived to leave HIV or support which whitethorn be enacted or felt (Green and Platt, as cited in Emlet, 2006). What is apparent in this good example is a form of felt or internalized stigma characterized by Martas feelings of shame, guilt, and fear of enacted stigma.Marta has not yet experienced stigma deliberated upon her by society because she has placed herself in protective silence in order to shield herself from what she views as terrible repercussions once she tells the truth about her condition. This is a type of stigma management used by PLHA. She treats her complaint as something shameful, because of a preconditioned flavour prevalent in her home country that AIDS is a disease contracted by loose women, drug addicts and homosexuals. Moreover, she has an overwhelming fear of rejection and abandonment that could ultimately result from a disclosure of her disease.This type of stigma has resulted to self-discriminating behavior and poorly-made decisions tha t led to several effects, including a possible contagion transfer Non-disclosure, feelings of denial. As a office of managing stigma, Marta chose to be silent about her condition and did not reveal it to anyone except with her medical providers. This reflects feelings of denial which eventually had negative effects in terms of the tint of her judgments and decision-making. Physical isolation. Fearing anticipated stigma, Marta subjected herself to physical isolation.She left her brothers home in New York to live alone in a one-bedroom apartment in Jackson Heights. This is a type of avoidance behavior common among PLHA (Delahanty et. al. , as cited in Emlet, 2006). Depression and stoppage of social activities. Stigma also led Marta to break out social activities like music and dance which she regularly engaged in previous to her HIV diagnosis. She also experienced increasing arrive ats of stress and depression go with her illness. Failure to acquire social support.Stigma also r esulted to an absence of social support from family or friends, without which, Marta privationed the emotional backup to handle the problems and circumstances related to her condition. feasible contagion transfer. Perhaps the most damning effect of stigma in this case is the possibility of HIV/AIDS infection from Marta to her lover Ruben because of the formers decision not to disclose her disease. Effects of HIV/AIDS on Social Systems Various social systems are affected by HIV/AIDS (Emlet, 2006).The individual, family and community have experienced or are likely to experience the impact of Martas case in different ways. singular. Aside from degenerating health, HIV/AIDS had a negative impact on Martas psychosocial well-being. Because of practiced avoidance behaviors, she suffered stress, depression and loneliness. All this stems from fear of societal rejection that she believes would naturally come down on her as a result of her HIV status. This led her to isolate herself from he r family and abandon some of her previous social engagements.It also led to poor self-confidence, emotional picture and poor self-efficacy. It is important to note this because empirical literature seems to suggest that above all factors, personal characteristics and beliefs predict successful hamper interventions among PLHA. Family. Martas nondisclosure has created no viewable effects on her family system as of yet because her family does not know of her condition. However, by physically separating herself from her immediate family in New York, she has effectively cut all lines of communication and support from her family in the Dominican Republic.Judging on a description she made of her family, it is likely that if she reveals her condition to her family, the reality of rejection will come in. bandage this whitethorn be true, and granting that her family seems predisposed to discriminate and stigmatize her, PLHA can derive so much emotional support from family. If she continue s to keep her condition secret from her family, managing her disease would be difficult, considering that she has no strong social support systems in New York. This has grave implications on how social workers can address social support concerns among PLHA.Social support has been repeatedly associated with psychological well-being and mental health, positive states of mind, coping with the disease-related stress and quality of life (Catz, Gore-Felton,McClure, as cited in Emlet, 2006). Community. Martas case, along with all HIV/AIDS cases, continue to become a community concern especially because much of the stigma that befall PLHA come from a collective fear of the disease collectable to ignorance or lack of HIV/AIDS awareness or education.This is the premise why anti-stigmatization campaigns have been directed on the community level because lately, discriminatory practices against PLHA are often unleashed by entire groups, not by individuals. Addressing the spread of HIV/AIDS is a community challenge, too. Stigma and discrimination have been identified internationally as major barriers to HIV control and legal profession (UNAIDS, 2003). Because of stigma, people refuse to undergo testing and take part in prevention and awareness campaigns.In Martas case, poor education and complicity toward unprotected sexual behaviors led to a nondisclosure of HIV status and eventually, the possibility of infection. This is the type of situation HIV/AIDS education campaigns and advocacy is trying to prevent. Proposed Interventions There are more than one possible modes of intervention for the social worker to handle Martas case as far as crisis management and her adherence to intercessions. Her current predicament can possibly affect how she views and regards management of her disease and must be resolved.From the crisis report, it could be gleaned that Marta demonstrates a willingness to participate in treatments and programs that may be instrumental in component her co pe with the disease. She is currently enrolled in a DASIS program that assists her in terms of housing and basic needs which she also supplements with employment as a house cleaner. It could be safely assumed that she is undergoing medication under a treatment regimen possibly set for her by health care providers. Case management does not need be used in Martas case but the social worker can still do follow-ups on treatments and medical therapies recommended.Interventions must ensure that Marta sustains a positive view of future treatments in light of the immediate emotional crisis she is experiencing. The forms of intervention that find application in Martas case are (1) individual counseling or therapy and (2) social support. Individual counseling and therapy is the most immediate form of intervention needed to resolve Martas immediate crisis. Marta has demonstrated incapacity to formulate good judgments and decisions, possible due to a confused state of mind.One initially marvels at how a 52-year old woman could yield sexually to a man who has suddenly resurfaced in her life knowing full well that she has a sexually contagious disease. Her near-hysterical behavior after her sexual encounter with her former lover is indicative of a weakness she describes that strength be a result of past experiences and beliefs. Individual therapy will be advisable in Martas case because it allows her to discuss confidentially and on a personal level, unresolved issues she currently face such as guilt, anger, fear, and remorse.During counseling sessions and therapy, she may be able to overcome her fear of disclosure, the superlative obstacle in her case. Therapy must be done in order to resolve these issues on an ongoing basis. Another intervention appropriate for Marta is social support. Her lack of social support systems is one of the salient features in her psychosocial evaluation. Since she was diagnosed five years ago, Marta has distanced herself from close associatio ns and has lived in isolation. She is a PLHA with virtually no stable emotional beachhead to start from.The only immediate family she has in New York is a brother with whom she finds difficulty in reaching out to, because of mistrust in a sister-in-law she views as hostile. However, she still maintains a few woman acquaintances which could be helpful to her. The social worker can assist Marta by introducing her to self-help groups which would be a great locale for her to feel acceptance. These groups provide an opportunity for PLHA to share experiences with others of like situation and condition. By participating in self-help groups, PLHA meet their own needs as well as others.It will make feel Marta belong to a community which is ready to accept her and treat her normally. These new relationships will be crucial in helping Marta overcome fear and allow her to be comfortable with disclosing her HIV status to others. Barriers to Intervention In helping Marta come to terms with her disease and sustain her adherence to much-needed treatment regimen and therapy, factors such as transference and counter-transference pose a probability of affecting her relationship with the social worker.Transference is the conscious and unconscious facsimile of emotions relating to repressed experiences, especially of childhood, and the substitution of another person for the original object of the repressed impulses (Racker, 2001). This phenomenon may lead to the patients mistrust of the worker because of a minor resemblance to a person associated with the emotion. In Martas case, the worker must avoid exhibiting a dominant or authoritative stance because this might cause her non-cooperation.As a girl living amongst nine overly dominant brothers with violent tendencies, she might unconsciously transfer her feelings of fear to the worker and this may be an obstacle to her counseling or therapy. She might also associate a female worker with her sister-in-law, Betty, who she mistru sts above all. The social worker must take this into consideration because any transference on Betty will make her feel doubtful of the workers ability to maintain confidentiality. In this regard, transference can become a barrier to effective intervention.On the other hand, counter-transference, or the redirection of a therapists feelings toward a client, or a therapists emotional entanglement with a client can influence with the development of a functional working relationship. The social worker must not allow herself or himself to be swayed or oppose against whatever emotion the client is trying to elicit in him or her. Instead, any attempts on counter-transference must be examined and discussed so that the client can objectively view his own motivations, fears and desires.