analysis of how the social environment has contributed to Marcus’s…

BaronFireButterfly8analysis of how the social environment has contributed to Marcus’s…analysis of how the social environment has contributed to Marcus’s psychological functioning. In what ways has trauma impacted Marcus’s daily functioning? Describe how you as the social worker would integrate elements of psychoeducation with Marcus and his family. How would you adapt psychoeducation for the cognitive level of the family member? Marcus is a 28-year-old, African American male who recently returned to his hometown after having served in multiple deployments in both Iraq and Syria. Marcus lives with his wife, Tamika, and their 5-year-old son, Jayson. While serving overseas, Marcus was exposed to combat and to blasts from three explosions caused by improvised explosive devices (IEDs). As a result of his experiences, Marcus sustained several physical injuries, including wounds from shrapnel released by the IEDs, a mild traumatic brain injury (TBI) in the form of a concussion caused by being thrown from a blast site after an explosion, and mild hearing loss in one ear that does not require the use of a hearing aid. Marcus’s physical wounds had healed completely at the time of his discharge. Marcus joined the military immediately after his graduation from high school and planned to begin working at least part time while studying for an associate’s or bachelor’s degree after his honorable discharge from the U.S. Army. Marcus sought mental health treatment with me because he “felt different” after arriving back home from military duty. Marcus reported that he was having difficulties adjusting to domestic life and found it hard to feel emotionally connected to his wife, though he knew that he loved her. Similarly, Marcus felt that he had difficulty being an attentive father to his son. Marcus also reported that despite his goals for continued employment and education, he could not motivate himself to look for a job or enroll in courses at the local community college and spent most of his days sitting on the back porch of his home smoking cigarettes, “staring into space,” and remembering violent scenes from his combat experience. Additionally, Marcus was having difficulty sleeping due to nightmares, had lost weight because of a general loss of appetite, had an increasingly “short fuse” with his family, and reported that he felt constantly nervous and “on edge, like something is going to blow” inside him. Treatment Strengths and Goals Marcus came to treatment with several strengths, including the ability to identify his symptoms and their effect on his life, his strong connections to his family, vocational and educational goals, and the ability to work well within structured environments under a great deal of pressure, as evidenced by his successful wartime military career. Marcus reported that his goals for treatment included being able to be a more active husband and father, to stop thinking so much about his combat experiences, and to reengage in working and going back to school. Neurological and Physical Evaluation Because Marcus has a history of mild TBI, I referred him to a neuropsychologist for an evaluation to rule out cognitive and/ or behavioral complications that could be attributed to his past concussion as well as to a general physician to be sure that there were not any undiagnosed medical conditions exacerbating Marcus’ symptoms. After determining 2 © 2021 Walden University, LLC. Adapted from Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Foundation year. Laureate International Universities Publishing. that there were no physical complications and no detectable ongoing symptoms of the TBI, the neuropsychologist diagnosed Marcus with post-traumatic stress disorder (PTSD) and referred him to a psychiatrist for an evaluation for medication. Marcus was prescribed a selective serotonin reuptake inhibitor (SSRI) antidepressant and began taking the medication as directed as soon as the prescription was filled. After several weeks, Marcus reported an increased ability to sleep through the night as well an increase in his ability to concentrate and improved appetite during the day. Cognitive Behavioral Therapy To address his other symptoms, including emotional numbing and intrusive memories of his combat experiences, I employed both cognitive behavioral therapy (CBT) and exposure-based treatment. The CBT was used to help dismantle negative and irrational thoughts that fueled Marcus’ symptoms. For example, Marcus reported a negative belief that if he had been a better soldier, other soldiers would not have died during IED explosions. Treatment focused on helping to replace these negative cognitions with more positive, realistic cognitions, such as “I did the best work I possibly could as a soldier, even when I couldn’t control everything.” Exposure therapy was used to reduce the intrusive thinking about combat experiences. Marcus used a special computer program that exposed him to scenes typical of what he experienced during his deployment, including events involving IEDs. Marcus could control how much of the scenes he watched and worked on reducing the amount of psychological and physical arousal that exposure to these scenes caused. Additionally, I referred Marcus to resources in the community tailored for veterans and their families. After 6 months of treatment occurring twice weekly, Marcus reported that he was having significantly less conflict with his wife and was able to connect to his loving feelings for her and enjoy spending time together as a couple. Marcus was also able to spend more time with his young son without losing his temper or getting frustrated as quickly. In addition, Marcus reported significantly improved concentration, the ability to sleep well nearly every night, as well as a marked decrease in intrusive thoughts and enhanced coping skills for managing the intrusive thoughts when they did occur. By the end of his treatment, Marcus had also obtained a part-time job working as an accountant’s assistant and had enrolled in two business courses at the local community college. In addition, he had begun to volunteer, running a social group for veterans and their families at his local church, and was enjoying the social and spiritual support he received. He reported that he saw a future for himself in a life outside of the military and felt that he could forge a productive place for himself in the community. Herzog, J. R., Whitworth, J. D., & Scott, D. L. (2020). Trauma informed care with military populations.Links to an external site. Journal of Human Behavior in the Social Environment, 30(3), 265-278. https://doi.org/10.1080/10911359.2019.1679693Sherman, M. D., & Larsen, J. L. (2018). Family-focused interventions and resources for veterans and their families.Links to an external site. Psychological Services, 15(2), 146-153. https://doi.org/10.1037/ser0000174Social SciencePsychology