Dialogue 2

Doctor

As far as her pregnancy, if Paula doesn’t take her HAART  medications religiously, she risks having a baby who is HIV positive. I  am concerned about how she is going to care for a baby with her  multiple medical issues. On the practical side, I wonder how she will  physically care for this child. She has a semi-paralyzed right hand and  walks with a limp. Additionally, when her foot ulcers flare up, she can  barely put pressure on her feet. Newborns take a lot of time and energy,  and I am not sure she has the capacity to handle the needs of an  infant—let alone a toddler. I have not made any formal recommendations  to Paula regarding whether to continue the pregnancy, but I have told  Paula that, if she does decide to have the child, she must take her  HAART medications every day. I explained that this is vital to her  health and the health of her unborn child.

  Dialogue 2

 psychiatrist 

When her social worker, who I am in regular contact with, informed  me that Paula announced she was pregnant, I was obviously concerned.  Knowing Paula as well as I do, I felt I could be honest with her and  give her my opinion about the situation. I told her that she should  abort. Based on her medical history, including her physical and mental  health disabilities, I did not believe she had the capacity to care for  this unborn child. She has absolutely no support at all, outside of the  treatment team, and would have no familial assistance to take care of   this child. My recommendation for abortion was only solidified when we  had to involuntarily hospitalize her.   I fear that Paula cannot take  care of herself, and she cannot be trusted to take her medications. If  she does decide to continue with the pregnancy, my recommendation would  be that she stay on the psychiatric unit for her entire pregnancy. That  way, we will know that she is taking her medications and that    

  Dialogue 2

OB Nurse

Paula is most definitely a high-risk pregnancy, but that does not  mean she can’t have a healthy baby. If she keeps up with her HAART  medications and comes to her prenatal visits, there’s no reason this  baby can’t be born healthy and HIV negative. My larger concern is with  the pain medications she takes for her foot ulcers. There is a slight  chance the baby will be born addicted to them. We would have to plan for  a stay in the NICU  if that occurs. While Paula clearly started to decompensate and  exhibited some very risky behaviors recently, I think we should try and  understand the stress she has been under. While it is not my place to  tell the patient what she should do about a pregnancy, I don’t see that  we would have to recommend termination.

  Dialogue 2

Social worker

Paula has overcome many obstacles in her life, but a baby—at her  age and with her medical profile—is very different. Paula has made many  bad decisions in her life, and the decision to keep this baby may or may  not be the best for both her and the child. That being said, if her  decision is to continue the pregnancy, we need to find a way to face the  mountain of obstacles. She has little to no social support, and there  will be many difficulties she will face caring for the baby alone. Paula  also has limited financial resources and will need to apply for WIC  and Medicaid. There are the numerous supplies that we will need to  obtain, such as a crib, clothing, diapers, and formula. She has  historically been unreliable about following up with referrals, so she  is going to need a lot of encouragement and support. Honestly, I may not  believe this pregnancy is a good idea, although I would never tell her  that—that’s not up to me or anyone else. We all, ultimately, need to  accept her decision and move on. Our goal now is to help Paula make it  safely through this pregnancy and work on a plan to help her care for  this baby once it is born. I don’t agree that she should be kept on the  psychiatric unit for the next seven or eight months. Allowing Paula to  play an active role in preparing for the baby is an important task, and  she will need to be out in the community and in her home taking care of  things. We have to show that we believe in her and her willingness to  manage this situation to the best of her ability. We need to affirm her  strengths and support her weaknesses.  

As a clinical social worker it is important to  understand group typology in order to choose the appropriate group  method for a specific population or problem. Each type of group has its  own approach and purpose. Two of the more frequently used types of  groups are task groups and intervention groups.

For  this Assignment, review the “Cortez Multimedia” case study, and  identify a target behavior or issue that needs to be ameliorated,  decreased, or increased. In a 2- to 4-page report, complete the  following: Choose either a treatment group or task group as your intervention for Paula Cortez. Identify the model of treatment group (i.e., support, education, teams, or treatment conferences). Using the typologies described in the Toseland & Rivas (2017)  piece, describe the characteristics of your group. For instance, if you  choose a treatment group that is a support group, what would be the  purpose, leadership, focus, bond, composition, and communication? Include the advantages and disadvantages of using this type of group as an intervention.

  Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing [Vital Source e-reader].
“Working With Groups: Latino Patients Living With HIV/AIDS” (pp. 39–41)
  Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.
Chapter 11, “Task Groups: Foundation Methods” (pp. 336-363)
Chapter 12, “Task Groups: Specialized Methods” (pp. 364–395)
 

   Himalhoch, S., Medoff, D. R., & Oyeniyi, G. (2007). Efficacy of group psychotherapy to reduce depressive symptoms among HIV-infected individuals: A systematic review and meta-analysis. AIDS Patient Care and STDs, 21(10), 732–739
 

   Lasky, G. B., & Riva, M. T. (2006). Confidentiality and privileged communication in group psychotherapy. International Journal of Group Psychotherapy, 56(4), 455–476.
  Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston, MA: Pearson.
Chapter 1, “Introduction” (pp. 1–42)
Chapter 2, “Historical and Theoretical Developments” (pp. 45–66)