Brain Injury and Social Service Interventions

Social System: Cheryl’s Brain Injury Case

Cheryl grew up in Idaho, where she went to school and interacted with many people, including her large family. After the basic military training, she was deployed to Iraq and returned home with lots of fractures and brain injury. This situation changed her life greatly; she spent three weeks in a coma and, fortunately, had no residual impairments after it. Still, soon it turned out that Cheryl has altered cognitively and socially.

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Now she cannot retain the information she read a few minutes ago, and it takes her more than five minutes to write her name, and she is not able to calculate without the calculator. Moreover, she became hot-tempered and turned confrontational without any provocation. Cheryl also fails to perceive reality correctly and believes that she is going to marry her ex-boyfriend soon. Because of such changes, her family believes her to be another person who is hard to interact with (Hutchison, 2011).

They decided to consult a social worker, so it should be considered how the social system treats her issues from various perspectives. The attention will be paid to the issue in cognitive (perception of reality), emotional (temper) and neuropsychiatric (memory) perspectives. Still, the problems faced by Cheryl are connected and should not be treated separately.

Cheryl suffers from cognitive issues that are suggested to be treated with the help of cognitive-behavioral therapy. It can be seen from the case that she consults the social worker. Moreover, her family also searches for one’s help and shares the concerns regarding her state. It means that the representatives of the social system can have enough information to evaluate the information they receive from two sides and make a clear conclusion regarding Cheryl’s condition.

In general, cognitive distortion can be also noticed during consultations when the social unit shares information about one’s life and behavior, as some experiences look normal, and others are dismissed. The conversation with the person who knows the consumer seems to be unethical in such a case, as a social worker is not allowed to uncover the information one receives during the consultations without permission (Code of ethics, 2008). Unfortunately, without additional knowledge regarding the current situation, Cheryl’s problems would be unnoticed.

It means that even though the person with a similar cognitive disorder receives the help of the social worker, one’s state is likely to be ignored for a long time. In this way, social systems and their ethics block the achievement and maintenance of the health and well-being of the individual. The fact that they perceive reality in a wrong way occurs to be noticed only by people who know the consumer’s environment while the social workers have nothing to do but to gain information from the client’s words and wait for some discrepancy in the thoughts and claims. Social workers are also not allowed to impose their views on the consumer (Code of ethics, 2008).

While a physician is to treat the patient and alter his/her point of view, in other words. For the practice to be ethical, this person is to allow the social worker to help one to deepen into the cause of his/her perceptions being unable to fit the environment.

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So it can be seen that the cognitive schemata, which was forming during Cheryl’s life, was influenced by the brain injury. Her relationships with people and the way she perceives the world altered, and it does not correlate with reality anymore. Her experience became subjective and biased by the things she wants to perceive. Social workers are likely to connect such issues with diverse ones and solve them in this way (González-Prendes & Brisebois, 2012).

Such an approach can enhance the consumer’s condition as the injury could influence one’s perception of them. So if earlier Cheryl was satisfied with her life and knew what she wanted, now she realizes that she will not return to active duty and does not know what to do for a living. Her refusal to perceive reality as it is maybe caused not only due to the physical trauma that she had but also because of the psychological one. So the social worker can help her to find her place in society, which is likely to help her with the problems. It may also explain why Cheryl’s behavior changed. Her automatic thoughts that occur based on cognitive schemata got affected due to their changes.

Her family mentioned that they were afraid that Cheryl will hurt someone as she reacts rather aggressively. The issue is that because of the brain injury she started to perceive reality in another way, and those who try to prove that things are different are interpreted by her as a negative influence and threat. Her behavior changes immediately, and it cannot be controlled. Still, the nature of social work makes professionals have well-developed communication skills. Utilizing them, a social worker can bring about alteration. During the conversations, the professional can turn the consumer’s words into assumptions that can impact one’s behavior. Empowering the individual, the social worker can promote positive changes in one’s perception of the situation and people around as well as in actions.

Emotions play a significant role in the way people behave, so it is not surprising that after the brain injury Cheryl’s character changed, according to the words of her family. Like many other survivors, she became irritable and aggressive. Such behavior frightens her relatives and is likely to separate her from other people, as they will not be willing to communicate with her. Efficient social work starts with the evaluation of the consumer’s emotion, so the professional is to utilize one’s empathic skills to assess the client’s condition. Even though the social worker did not know Cheryl before the injury, one will surely notice that she is rather anxious and easily yields to anger.

To calm her down, a social worker is to help Cheryl to realize her problem and deal with it. One can start anger management and self-awareness training, for example, the six-hour program This Emotional Life (DeLauro, 2010). The social worker explains why the behavior caused by negative emotions has an adverse influence on the consumer’s life and promotes one’s realization of the problems caused by losing the temper. The professional is not supposed to provide invasive treatment or convince the consumer that one will face more issues unless the behavior is changed, and emotions are taken under control. Still, one is to help the client realize this him/herself (Code of ethics, 2008).

In this way, the improvements may be seen only over time, but the effect is likely to be long-lasting, which is of advantage for the client’s well-being. The social worker is likely to pay attention to the cultural and social factors that may also influence Cheryl’s state. For example, she is sure that her ex-boyfriend still wants to marry her and refuses to accept that it is not so and he has another fiancé. Of course, the injury influenced such a condition, but the impact from outside should be evaluated, as it can help to reduce her anger towards those who claim that her assumptions are wrong. The social worker is likely to listen to her personal story and help her to explore why she is so resolute.

Of course, such treatment cannot cope with the reactions that occur due to the injury, but it can reduce them. Finding out what makes her angry, Cheryl is likely to calm down quicker realizing that her actions are ungrounded. Moreover, she might be willing to get married because it is one of the main values that she inherited or because she feels lonely and wants to create her own big family, or she might be willing to change her status. Except for that, if earlier Cheryl paid no attention to some aspects of her life, now her irritation may be caused by the fact that she is not satisfied with her physical and mental abilities. Feeling that her relatives started to treat her differently and seeing that she is not able to cope with some simple tasks as writing and calculation, she is likely to give way to temper.

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It is also important to remember that the social worker is to control one’s involvement. The professional is to show emotional competence, which will allow one to be objective and avoid influence on the consumer (Morrison, 2006). In this way, a sensitive person like Cheryl will have fewer problems while communicating with the professional, as he/she will not show that her words or actions differ from expected ones.

This competence allows social workers to deepen into the clients’ cases and make them willing to share new issues. So the social system tends to provide the consumers who are in similar to Cheryl’s situation with a person to whom they can refer when they have unsolved problems that should be considered rationally. All in all, it aims to make it visible to the client that there is a connection between emotional unhappiness and social relationships. Moreover, as negative emotions influence people’s health negatively, social work is likely to enhance it.

Unfortunately, these are not the only issues to be considered. In the neuropsychiatric perspective, Cheryl’s problems with memory (she cannot retell the story she has just read) are to be discussed. Lux (2007) claims that for many people who had brain injuries it is sometimes hard to concentrate and memorize some information. Still, these systems usually fail to work appropriately when the individual occurs in the multitasking environment.

That is why a social worker looks at this situation from another point of view. Being unable to heal the consumer’s brain, the professional tries to assist a client and teach one to live with this condition. He/she explains that the consumer can manage an almost normal life in a quiet environment and helps to find an occupation for work and spare time. Except for that, a social system usually applies meditation under mindfulness-based cognitive therapy while working with such clients. Reference to metamemory makes the individuals realize their capabilities and assists in memory improvement.

With its help, the professional can assist the clients in learning how to use their memory, as they cannot do it themselves anymore. Jackson (2014) mentions that the therapy based on meditation was successfully utilized several times and caused “a reduction in anxiety, stress, and isolation, for example, along with improvements in memory, attention, and other cognitive functions” (p. 18). Thus, social workers bring good health outcomes and enhance consumers’ condition as well as physicians. If they are allowed, they can also contact the consumer’s family to explain how they should act and what environment to create to streamline the process.

For example, relatives can make sure that the individual avoids overstimulation situations. Even driving at night can hurt the client’s condition and treatment. So social workers make sure that Cheryl and people with similar problems can adjust to a new lifestyle and learn how to explore the world in another way.

Thus, the social system demonstrates the cognitive perspective of the issue by promoting consumer’s self-acceptance and respect. The social worker recognizes clients’ abilities to change and assists one in coping with this task without influencing particular views directly. One empowers the consumer to be an active participant in every step of the process. The professional deepens in the influence of social context on schemata.

The social system aims to help the consumer to understand what makes one feel angry, irritated, etc., and how he/she can control such emotions. Moreover, social workers utilize therapies that stabilize the client’s emotions and improve their cognitive capabilities.

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Code of ethics of the national association of social workers. (2008). Web.

DeLauro, R. (2010). This emotional life. Social Work Today, 10(4), 22.

González-Prendes, A., & Brisebois, K. (2012). Cognitive-behavioral therapy and social work values. Journal of Social Work Values and Ethics, 9(2), 21-33.

Hutchison, E. (2011). Dimensions of human behavior: Person in environment. Thousand Oaks, CA: Sage.

Jackson, K. (2014). Mindfulness-based approaches to traumatic brain injuries. Social Work Today, 14(6), 18.

Lux, W. (2007). A neuropsychiatric perspective on traumatic brain injury. Journal of Rehabilitation Research & Development, 44(7), 951-962.

Morrison, T. (2006). Emotional intelligence, emotion and social work. British Journal of Social Work, 37(2), 245-263.

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