Social Development and Adolescence: Human Services Ethics and Interventions

For this assignment, you will be reading a case scenario in your text and responding to questions related to the impact of the environment on behavior and choices, the impact of the client-human services professional relationship, and how identifying potential ethical issues and the National Organization for Human Services (NOHS) Ethical Standards can help guide you in working with clients.
Begin by reading the case study “Applying the Framework: A Depressed Adolescent” in Chapter 7 of your text (pages 344-345) about Susie. Then, go to the NOHS website and review the Ethical Standards for Human Service Professionals. Use the Unit 6 Assignment Template to reflect on the situations Susie finds herself in, her environment, and the possible ethical considerations in the case that the human service professional may need to consider as part of an ethical approach to working with the client and her family. Review “Exhibit 7.18: Developmental assets for youth” (found on page 333 in your text) as a useful reference for completing this assignment.
Please respond to the following:
Discuss a minimum of three ways that Susie’s environment has influenced her behavior and decision-making in her adolescence. Be sure to include a citation from the textbook related to the case study.
Considering the case study details and the NOHS Ethical Standards, identify one ethical concern you would need to consider when working with Susie and/or her family and discuss how you would apply it within the client and human service relationship. Make sure to include the specific NOHS Ethical Standard (taken directly from the NOHS site) in your response. Be sure to include proper citation for your selected standard.
Provide the name and contact information for one human service agency a human service professional could refer Susie to help provide assistance and support for her current issues. Identify a minimum of three specific services and/or interventions that this agency could provide to assist Susie and explain why these are helpful to the client.
Discuss how knowledge of ethical standards and available resources can strengthen the relationship between the human service professional and Susie and help her achieve positive outcomes.
Case
Developmental History Susie Lee, a 13-year-old Chinese American female, was brought to the agency by her biological parents. Susie’s parents are third-generation Chinese Americans and live according to American cultural norms and values. Susie has two brothers and one sister, all younger than her. Susie’s parents discussed her early development, including pregnancy and childhood illnesses. Susie’s mother reported that her pregnancy was normal with no complications. She also states that she was very careful throughout her pregnancy to avoid food, drink, medication, or illegal substances that could harm her developing fetus. The only medical problems out of the ordinary were Susie’s seizures at the age of 5 as a result of influenza. Her mother reported no developmental delays and that Susie crawled, walked, and talked at the appropriate times.
Biophysical Considerations
Susie often has trouble sleeping at night and reports periodic nightmares (one or two per month). She also has experienced night eating syndrome—being unable to sleep at night, she eats. In the morning, she does not feel like eating breakfast. She has a tendency to consume a large amount of food quickly and feels bad about having done so afterward. She does not eat a bal- anced diet. She denies any self-induced vomiting. This sequence of events often leads to severe self-criticism. Susie was an early-maturing female who had her first menses at 11 years of age. She has been diagnosed with dysmenorrhea (painful menstruation) and often com- plains about having stomachaches.
Psychological Considerations
Cognitive Development and
Information Processing
Susie appears to be of average intelligence and per- forms well academically. Last year she had above- average grades of A’s and B’s. In discussing her self-criticism, Susie demonstrated abstract thinking ability as she commented introspectively about her own thought processes. She demonstrates complex thinking about the psychological processes she is experiencing. However, Susie is often unable to make simple deci- sions because she is literally thinking too much about
a decision. Susie believes she is invulnerable—that no harm can come to her. Although this is an aspect of normal cognitive development, it can lead to negative outcomes if her thinking influences her behavior.
Communication
One of Susie’s strengths is her ability to communi- cate her thoughts and feelings clearly and directly. She expresses concern about her eating habits and about feeling down and irritable much of the time.
Attitudes, Emotions, and Regulation
Susie expresses intense emotions that range from extreme anger to hopelessness. She describes feeling sad, irritable, touchy, “on edge,” and depressed. She described some of her feelings:“I feel like I’m falling into a dark tunnel that I cannot climb out of; scream- ing all the way down but no one hears me.”Sometimes she’s deeply sad and spends a lot of time crying. Other days she’s extremely irritable—everybody and every- thing bothers her. When asked about how she perceives herself, she reports feeling like the ugliest girl at school. She often looks in the mirror and sees a fat, ugly per- son. She is extremely preoccupied with how“bad”she thinks she looks.“I hate my body,”she reports. A lot of her self-criticism is related to her binge eating and her negative body image.
Susie scored in the depressed range on the Beck Depression Inventory. She admitted that she thought about suicide previously—especially after a friend had committed suicide. At present she denies any thoughts of suicide. She does not have access to a gun.
Susie expresses strong egocentric thoughts. She is preoccupied with her feelings and behaviors in a self-conscious manner. This is demonstrated in her body perceptions—she is very concerned about how others are going to view her body and looks. She feels self-conscious about not having a boyfriend at the present time. This style of thinking is an entry to more intensely self-critical statements. She reports being quite concerned about what her peers are saying and doing and has difficulty expressing any independence around them. Her parents report that she“gives in to peer pressure all the time and that this gets her into a lot of trouble.”Her mother expressed specific concern that she would not be able to say no to sexual advances by boys. In the one-to-one interview, Susie discussed having been sexually active with a previous boyfriend. She reports inconsistent use of birth control methods.
Social Considerations
Family Situation
Susie experiences serious family conflict, including a highly conflict-ridden relationship and lack of close- ness with her father—her father still spanks her. Fur- thermore, Susie suffered a major loss when her favorite grandfather died last year of cancer. In addition, she started junior high school this school year, which has been a difficult transition for her.
Susie expressed concern over her inability to get along with her family. In particular, fairness is a big issue with Susie. She reports that her siblings are treated more fairly than she is. Her parents describe situa- tions where Susie feels she is being treated unfairly and throws a temper tantrum. For example, last week she found a box from a fast-food meal that had been her brother’s lunch, stating it wasn’t fair that he got one and she did not. She threw things around the living room, started yelling, and ran to her room crying. Susie reports being gruff and harsh with family members on a daily basis. Her oppositional behavior is also evident on a regular, but not daily, basis when she lies, loses her tem- per, argues with her parents, fights with her siblings, or refuses to do her chores. She says she“feels unimport- ant to this family”and that everyone sees her as a“bad” kid. She is angry at her father and believes he mistreats her—especially by spanking her. She also believes that her parents, particularly her father, do not love her.
Groups, Social Supports,
and Communities
Susie feels like an outsider at school, although she has three or four friends she regularly interacts with. Recently Susie has found it difficult to go to school. When she is in school, she feels empty and dull. Although she used to be involved in after-school activ- ities, she has no extracurricular activities now. When asked if she has an adult she is close to, she said there was no one for her to talk with, especially since her grandfather died. Her parents are frustrated with her and do not provide her with much emotional support.
Multicultural, Gender, and Spiritual Considerations
Susie disclosed concern regarding her identity. Although her family is very acculturated, she has recently been questioning the significance of her Chi- nese American background since meeting a student at school who is very involved in Chinese culture. She has expressed concern about how others view her. For example, at school she believes teachers expect more from her than other students when she turns in assign- ments or takes exams. She resents the additional pres- sure she feels from her teachers and her parents. She wants to be treated“just like everyone else.”Her par- ents fear that they are losing control over her, and Susie complains that her parents are not giving her enough freedom. In spite of their acculturation, they are having a difficult time reconciling their family values with the values and norms of the dominant society
Summary and Impressions
As a result of assessment, it is apparent that Susie has several problems that need to be addressed:
1. Depression 2. Irritable, with extreme mood swings 3. Resentful behavior toward siblings 4. Uncontrolled anger outbursts 5. Poor family relationships 6. Possible unresolved grief 7. Adjustment issues involving her developmental
stage (e.g., identity concerns) 8. High-risk behaviors such as unprotected sexual
intercourse
Although the family members are experiencing dif- ficulties, they do provide a stable, predictable living sit- uation for Susie and her siblings. Susie’s father earns a steady income that provides adequate resources. Susie’s mother works part-time while the children are at school, and she states that she is usually home when they return from school. They have lived in the community for five years and have established a net- work of family friends and church support. In addition, both parents appear genuinely concerned and willing to evaluate their parenting techniques in order to work toward a positive outcome. Susie’s strengths include her intellect and thoughtfulness, her good communication skills, and her desire for improved family relationships.