C A R V From Investigation to Case Closure With a …€¦ · Health and Human Services C A R V E R...

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Transcript of C A R V From Investigation to Case Closure With a …€¦ · Health and Human Services C A R V E R...

Page 1: C A R V From Investigation to Case Closure With a …€¦ · Health and Human Services C A R V E R C O U N T Y From Investigation to Case Closure With a Mother Diagnosed with Dissociative
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HealthandHumanServices

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FromInvestigationtoCaseClosureWithaMotherDiagnosedwithDissociativeIdentityDisorder.

CaroleCole,Investigativesocialworker,CCHHSJessicaRobertson,CaseManagementsocial

worker,CCHHS

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• Population=100,262total/27,167children• Within7countymetroarea/CitiesandFarms

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PrinceLet’sGoCrazy©1984

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• Guideourwork• Slowdownourthinking• Reduceanxiety• Benefitfamiliesandchildren

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Johnny– age5- missedaweekofschool.Johnnyreportedbruiseonface/momslapped.Johnny- liveswithMom- Ruby/Grandma-Judy.Momtoldreportershedidn’twantCPcalled.

Momreportedchildfellonplaygroundequipmentandwenttothehospital.

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PracticePrinciple:Don’tconfusecasedetailswithjudgements.

-RubydiagnosedwithDID-7personalities-6previousassessments/Investigations

-CustodytransferredtoGrandmotherJudyin2013butRubyappearstobeparenting.

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JohnnypossiblysuffocatedbyRubyTwoalternativepersonalitiesweredangeroustoJohnny.IncreasedAnxietyforRubyincreasespresentationof

alters.Rubyovermedicatingtocontrolincreasedanxiety-moreandmoremedsneeded- runningoutofmeds7-8days

early.

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PracticePrinciple-Rubyisapersonworthdoingbusinesswith.

Alters- Characteristics-RolesBefore/during/after–Alterpresentationfrom

Ruby’sperspective.“Star”addressesCarole

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PracticePrinciple- Cooperatewiththeperson,nottheabuse.

PracticePrinciple- Findoutwhattheservicerecipientwants.

-Family- WouldlikebothRubyandJohnnytoremaininthehome.

-Family- Wanttoaddressmedicationissues.County:Bottomlines:100%supervision-Johnny

Nophysicaldiscipline.

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RubytalksaboutprotectingJohnny-evenwhenaltersarethreatening.

Rubytalksaboutpositivesduetomedicationchanges.GrandmagoesupandsleepswithJohnnywhenhewakes

up.EventhoughGrandmathoughtitwassilly,sheheldthe

possibilitythatworrieswerehappening.

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-ClearHarm/Dangerstatements/Safetygoals-Presenttofamilyandnetwork

-Lookforexceptions-Planforworries/holdoutallpossibilities

-Scalefamilyandnetwork-Wordandpicturestory-Explainmom’sillness&

Rulesforfuturesafety

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HealthandHumanServices

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PracticePrinciple:Don’tconfusecasedetailswithjudgements

1st- HonorMomandwheresheisintheprocess,herfeelings,andherDID.

MomistheexpertaboutherdiagnosisMomlivesherDIDeveryday- nottheworker

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PracticePrinciples:Recognizethatallfamilieshavesignsofsafety

Letthefamilyowntheplan- it’stheirplanTheyneedtobethedriversoftheplan

Whatisworkingandwhatisachallengeintheplan?

Thisisalivingbreathingdocumentforthefamily

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PracticePrinciple:Focusoncreatingsmallchange

Momwasabletotalkaboutheruseofcopingskills.Momwasabletotest/usethoseskillsinworker’spresence.

Momwasmakingbigstridesinhertherapy.Familywasfollowingtheplanevenwhenitwashardtodo.

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PracticePrinciples:treattheinterviewlikeaforumforchange

Asaworkeryoucan’texpectaclienttobetransparentwithyouifyouaren’ttransparentwiththem.

Familywasabletotalkabouttimestheplanwashardtofollowandthentheydidn’tfollowtheplan100%.Familyandworkerwereabletotalkabouthowto

enhancetheplantobetterfitforthefamilythroughthistransparency.

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PracticePrinciple:Learnwhattheservicerecipientwants

Therapist/psychiatristSkillsworkerGrandma

Whatiseveryone’srole?Whatiseveryone’sexperiencewithmom’sprogress?

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PracticePrinciple:MaintainafocusonsafetySpenttimetalkingaboutmom’slongtermgoals

were:KeepmentalhealthsymptomsstableContinuetohelpcareforJohnny

GetherownplacetoliveinthefutureOverarchinggoal:gaincustodyofJohnnyagain

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Johnny’sfavoriteplace:“TheSalsaPlace”

SocialworkerpromisedJohnnythatattheclosingmeetingJohnny,hismom,grandmaandtheSocialworkercouldgotodinnerattheSalsa

Placetocelebrateallthehardworkthefamilyputin!

Sharedamealandtalkedaboutwhatwasgoingwellandtalkedaboutthefuture!

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JohnnyrecentlycompletedsummerschoolGrandmareportedhelovedsummerschoolandall

thefieldtrips

RubycontinuestohavehealthconcernsbutgrandmareportsthatRubyisworkingwellwithherhealthcareprofessionalstogetherhealthconcerns

undercontrol.

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.CaroleCole• [email protected]

• JessicaRobertson• [email protected]

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Yale & Sentry 2010 Closure Catalog - R&M

Yale & Sentry 2010 Closure Catalog - R&M

A€¦ · Web viewA11.A.5(a) Closure of Container Storage Areas [R 299.9614 and 40 CFR 264.178] This section describes the procedures for closure of [Unit Name]. The general closure

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ashan.gl.ntu.edu.twashan.gl.ntu.edu.tw › publication › chinese › SpecialPublicationCGS-M… · 137 Sample Nannofossil R R c R R c c R R c R C Sample ÑánnofossiI HI PI P2 P3

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