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Running head: BIOPSYCHOSOCIAL PAPER AND PLAN CHANGE

Biopsychosocial Paper and Plan of Change


004106050
Wayne State University
SW 3020

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Presenting Problem
Caleb Lawrence (pseudonym) is a 44 year old divorced, African American male who
currently lives with his mother and his adult son (26 years old). He has three living sons and one
deceased (ages 26, 25, 25 deceased, and 3) with four different women, none of whom are his
previous wife. He has been employed as an oil change technician for the past six years. Mr.
Lawrence is coming to see a social worker to help him deal with the stress of losing his son and
stepfather to gun violence. He is also seeking assistance dealing with anger problems.
Family of Origin History
Mr. Lawrence reports that his mother and father were both 20 years old when he was
born. His parents were never married however, his mother married his step-father five months
prior to his birth. His stepfather was 18 years old at the time of his birth. His mother and father
separated due to his fathers incarceration prior to his birth. The client states that his biological
father was imprisoned for 17 years for reasons unknown to client. Clients mother and biological
father are still living, and both 64 years old. His stepfather died at the age of 62 as a result of
gunshot wounds sustained by stray bullets. His mother and stepfather were still married at the
time of his death. He states that his mother is very supportive of him as was his step-father prior
to his death. He reports a distant relationship with his biological father and attributes it to his
fathers lack of socialization skills.
The client has one brother from his mother and biological father, and two half siblings
from his mother and stepfather. His oldest brother Carter (pseudonym) is 45 years old, and has
no children. He has never been married, is unemployed and receives Social Security Disability
Income (SSDI). His sister Laila (pseudonym) is 42 years old, and married with 3 children, and
works as a Human Resource Coordinator. His youngest brother Christian (pseudonym) is 29

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years old, has one child, and works as a customer service manager. He has never been married.
The client reports that all of his mothers pregnancies were unplanned.
Client states that his biological father completed the 10th grade, his mother completed her
Associates degree, and his stepfather completed high school. Client reports that his oldest
brother, completed high school, his sister completed four years of college, and his youngest
brother has completed two years of college.
The client reports that his father and all siblings are in good physical health. He reports
that his mother is overweight and has an extension health history including diabetes, high blood
pressure, heart disease, neuropathy, herniated discs, and sarcoidosis of the lungs.
According to the client, he, his older brother, and younger sister have always had a very
close relationship. He states that he did not have an opportunity to develop a close relationship
with his younger brother due to his own incarceration when Christian was 4 years old. He states
that his home environment was usually very loving and supportive. He also reports that his stepfather worked as a line worker for an automobile factory and was often not home. He reports
physical abuse from his stepfather on two to three occasions during his childhood. The client
described holidays as a big deal, he reports that the family would spend Christmas, and
Thanksgiving at his maternal grandparents home with extended family. Extended family
members would host large gatherings for Memorial day, Independence day, and Labor day. They
would have large meals cooked by various family members, potluck style. The client reports
Easter Sunday was usually celebrated by dressing in their Sunday best and going to church.
After church, they would have an Easter egg hunt. The summer holiday meals always included
barbeque. He recalls New Years Eve being spent at home with his parents and siblings, and
staying awake until midnight toasting the new year with sparkling cider. The client also reports

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birthdays always being celebrated with a party or family dinner outing. The extended family
gathered every summer in August for a family reunion as well.
The family celebrated death as opposed to holding funerals. They considered the
ceremony to be a home-going celebration that usually included at least one of the deceaseds
favorite songs. Ceremonies were held in churches or funeral homes depending on the deceaseds
relationship with the church. The client reports the ceremonies being both happy and sad but
usually not overly emotional, unless the death was tragic or that of a young person. The family
was very comfortable expressing feelings of grief or despair with one another.
The client reports that his stepfather once punished him by hitting him across the buttocks
with a wooden board, and once by telling him he had to leave the home walking alone in the dark
when he was approximately 10 years of age.
The client denies any history of sexual abuse.
Developmental History
The client was a full term baby, delivered vaginally, after ten hours of labor. He weighed
7 pounds, 10 ounces at birth. He reports being breast fed for approximately 3 months. The client
reports learning to walk at 13 months old as well as being weaned from the bottle. He reports
that he never ate baby food and went straight to table food at 13 months when his mother refused
to give him a bottle any longer. The client does not recall the age he was potty trained, and does
not report any developmental delays nor known advancements.
Health History
The client reports being a healthy child from birth. He reports the only childhood illness
he suffered was chicken pox. The client reports discovering he had epilepsy at age 10 after
having chicken pox, and an allergic reaction to penicillin. The client reports being allergic to

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mold, penicillin, amoxicillin and peanut butter through his adolescence. He states that he has
outgrown his allergy to peanut butter. The client reports that he has not suffered from an
epileptic seizure in over 12 years. Although he does report having contracted sexually
transmitted diseases on more than one occasion, the client does not report any broken bones,
chronic illnesses, childhood or adult surgeries, or adult illnesses. He reports that his weight is
proportionate to his height and does not look to be overweight. There is a family history of
diabetes, and cancer on his mothers side, and no known family illnesses on his fathers side.
Relationship/Sexual History
The client was very popular as a child and adolescent. He reports having many friends
and often being known even outside of his neighborhood. Many of his friends died as a result of
street violence, some others have succumbed to drugs. The client reports a lack of close
relationships now. He states that his most recent romantic relationship has caused him to lose his
close relationships with family and friends. Mr. Lawrence states that he recently ended a five
year relationship with the mother of his youngest son Aaron (3 years old). This relationship was
reported to be verbally, and on at least two occasions, physically abusive. The client has stated
that this partner infected him with gonorrhea on two occasions. He states that his former
girlfriend often belittled him, calling him names, and ugly. She has been unfaithful during most
of the relationship, according to the client.
Mr. Lawrence is heterosexual and began dating around age 14. He often dated girls
whose age was within a year or two of his. His first sexual experience was at the age of 12 with
a babysitter who was three years older than he. He reports having an orgasm during his first
sexual experience and states that he enjoys sex very much. He currently does not use any form
of contraception during sex but stated that he usually does during his first few sexual encounters

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with a woman. Recently, he started a sexual relationship with a young lady ten years younger
than he. He states the relationship is fun but he has no plans on it becoming serious. The client
also mentioned that since his release from prison he tends to date women five to ten years
younger than he is.
Family of Creation History
Mr. Lawrence has been in two committed relationships and a few that have lasted over
one year. The first mentioned relationship started when he was 16 years old and ended when he
was 18. He reports this to be a good relationship with no physical or verbal abuse but states that
both parties were unfaithful. His oldest son Caleb Jr. (pseudonym), was born as a result of this
relationship. Caleb Jr.s mother, Amanda (pseudonym), was 16 years old when he was born and
Caleb Sr. was 18 years old. This relationship ended due to the infidelity of both parties but was
ended by Amanda after she started a new relationship. The client also had a relationship with a
girl with whom he had his second son Cody (pseudonym). When Cody was born, the client was
19 years old and Codys mother was 17 years old. This was a casual sexual relationship, and
concurrent with the relationship with Amanda. It ended when the client was incarcerated. The
clients next relationship also started while dating Amanda and Codys mother. The client also
had a son (Aiden, pseudonym) from this relationship when he was 19 years old and Aidens
mother was 17 years old. The three young ladies all attended the same high school with the
client, and became aware of each other during that time. The relationship with Aidens mother
was primarily sexual in nature and ended months prior to Aidens birth. Mr. Lawrence reports
that he currently has a fairly good relationship with all three women. After the client was
released from prison, he met Lauren (pseudonym), the mother of his youngest son Aaron
(pseudonym). The couple dated for approximately two years prior to the birth of Aaron. The

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client was 40 years old and Lauren was 32 years old at the time of Aarons birth. The couple had
one pregnancy prior to Aarons birth that ended in abortion. This relationship ended
approximately one month ago, after years of verbal abuse by Lauren, and infidelity by both
parties. Lauren recently gave birth to a child and does not know if the client is the father. The
parties are awaiting paternity test results. All of the pregnancies were reported to have been
unexpected.
During the clients incarceration he was contacted by a woman named April (pseudonym)
whom he knew from high school but never dated. The two began to correspond and married
while he was in prison. After his release from prison, the client reports April as being overly
possessive and wanting to keep track of his every move. The client states that April did not want
the client to work because of her insecurities. He recalls April being a wonderful wife with
regard to cooking and cleaning. He also states that she always made sure he had anything he
needed but that the relationship was not fulfilling for him because he did not feel useful. He
reports that he wanted a partner who needed him financially and for support. Mr. Lawrence and
April separated in 2008, one year after his release from prison and divorced two years later in
2010. He reports the divorce being attributed to his wife being very tumultuous, possessive, and
dominant. April did not graduate high school and works as a home health aide. The couple has
no children together.
The relationship between the client and his oldest son Caleb Jr. (26 years old) is reported
as being the strongest. The client states that at times the relationship is strained because he was
incarcerated when Caleb Jr. was 18 months old and returned home when he was 19 years old.
Caleb Jr. was raised by the clients mother and she often brought the child to visit him in prison
which helped to two develop a relationship. The client reports that there seems to be some

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jealousy between Caleb Jr. and himself with regard to his mothers treatment of Caleb Jr. He
reports that the two of them often spend time together playing video games and drinking alcohol.
He reports that they behave more like brothers than father and son. Caleb Jr. is a truck driver.
Mr. Lawrence reports the relationship with his son Cody (25) as a somewhat distant relationship.
He says he sees Cody on a regular basis but they do not show any affection toward each other.
Cody is an unlicensed barber and cuts his fathers and older brother Caleb Jr.s hair weekly.
Aiden is deceased. He was shot and killed at age 21 by a man he was involved in an altercation
with earlier that day. His death was very difficult for Mr. Lawrence and Caleb Jr. Cody was
contacted by a neighborhood friend after the shooting and was the person who identified his
brothers body at the hospital. Cody and Aiden were both born in December 1988, they were
seven days apart. The three boys were very close and spent a great deal of time together. Both
Caleb Jr. and Aiden were raised by the clients mother. The relationship between the client and
his youngest son Aaron (3) is off and on. The client reports that Lauren often refuses to allow
him to see Aaron. He states that during breakups with her he has not been allowed to see Aaron
unless he was bringing Lauren extra money and even then he only saw him for 20 minutes while
sitting in his car. He says that Aaron knows him and is fond of him but that Lauren does not
allow him any authority in Aarons life. He is not allowed to make any decisions regarding Aaron
nor is he allowed to discipline him. The client clarified that he does not believe in corporal
punishment.
According to the client, none of the clients children have ever been married.
Substance Use/Abuse History
Cigarette smoking has been reported by the client to have started around age 18. He
currently smokes approximately one pack of cigarettes a day. The client also reports the use of

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marijuana and alcohol. He does not recall the age he started using marijuana, but states he
started using alcohol around age 16 on a social basis. He reports that during the first few years
of dating the mother of his three year old son he started drinking alcohol and smoking marijuana
excessively to cope with the trials of the relationship. He drinks at least one to two beers daily,
and smokes approximately three marijuana joints each payday. He estimates that he smokes
marijuana at least two other days throughout the week. He denies ever being in treatment for
substance or alcohol abuse and states that he has no gambling issues or other addictions.
Mental Health History
Mr. Lawrence denies any mental health issues. He states that he has never received
therapy for any issues.
Military History
The client states he has never been in any branch of the military.
Financial History
The clients family was a middle class family growing up. Often they had a one-income
household but because the clients stepfather made a decent living they were able to sustain
without struggling. When his mother was employed, she often had decent paying jobs as well.
She worked as a bank teller, and later as a police dispatcher where she retired from. Currently,
Mr. Lawrence has problems managing his money. He lives with his mother because he says he
cannot afford to live on his own. He borrows money between every paycheck and when he gets
paid he owes at least half to repay loans. He currently has no financial responsibilities with the
exception of his three year old son for whom he pays $150 bi-weekly child support.
Legal History

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Mr. Lawrence was incarcerated in 1989 for 17 and a half years for firing a gun at four
people including Amanda, her boyfriend at the time, and two friends. He was released from
prison at the age of 37. He is not currently on probation or parole. He denies having any legal
issues since his release from prison.
Immigration Issues
The client states that he and his parents were born in the United States and are not
immigrants.
Religious History
The client does not declare any religious affiliation. His family attended Baptist church
during his childhood but he attended Catholic grade school. When he was a teenager his
grandparents became Muslims. He believes in God but states that he does not worship Jesus
Christ. He states that he is a very spiritual person believing in a higher being and outside forces
including God. He is very tolerant of all religions and says he seeks to understand their beliefs.
He does not attend church.
Educational History
Mr. Lawrence states that he did really well in elementary school but in middle school he
did not feel challenged. He states that his grades dropped significantly in 6th grade and he was
held back a grade. He says his poor grades continued into high school where he did enough
work just to pass to the next grade. He states the reason for his poor achievement was lack of
challenging work so he refused to complete the work. He states that in 11th grade his mother
decided that school was too dangerous for him because of altercations he had been involved in
and removed him from school. He obtained is GED in 1988. He was accepted into college but
was incarcerated before he could enroll. The client says that he knows he is very smart but

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believes that prison has prohibited him from obtaining the skills he needs to prosper. Mr.
Lawrence currently wants to attend truck-driving school.

Employment History
The client states that the only chores he had growing up was loading the dishes into the
dishwasher and mopping the kitchen floor. He does not recall being required to clean his room or
any other chores. He states that he never worked prior to his incarceration but worked in the
kitchen in prison. In prison, he cut hair, made greeting cards and did tattoos in exchange for
goods. After being released from prison, he worked as a cab driver for approximately six months
until he was hired as an oil change technician. He worked both jobs for approximately one year
then quit the cab job. As a cab driver, he reports enjoying the job freedom, meeting new people,
and running into old acquaintances. He states that he quit the cab driving position because he did
not earn enough money to support himself and help his children. The client currently works as
an oil change technician. He states that he does not enjoy his current job because he believes
that his supervisor is a racist and discriminates against him. The client makes $13 per hour in his
current position and states that he has not had a raise in 5 years for reasons unknown to him.
While his current job pays more than the cab driving position, the client states that he never has
any money and still struggles to make ends meet. He was trained on the job.
Strengths
Although the client does not enjoy his current job, he is very dedicated to work and
remaining gainfully employed. He has worked consistently since his release from prison and has
worked very hard at being a productive member of society. He loves his children very much and
has a very strong support system. He is very close to his mother and sister and shares most of his

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problems with them. He also reports that his brother-in-law often helps him out and hires him
for odd jobs to make extra money. He stated that his brother-in-law is launching a small business
soon and plans to employ him. He is very optimistic about the new business and getting a new
start.
The client understands that there are many things he needs to work through and that it
will be a lengthy process. He is very eager to get started and willing to take the time needed to
overcome his challenges.
Step 1: Working with the Client
Mr. Lawrence and I have discussed many things that he finds problematic for him.
Together we have compiled a list of the problems that are most important to him, and that he
would like to focus on. The problems are as follows:
1. The client suffers from low self-esteem that he feels affects his decision making with
regard to relationships and career goals.
2. He is extremely unhappy in his current job and would like to pursue a career as a
truck driver.
3. He believes that his marijuana smoking and excessive alcohol use is prohibiting him
from moving further in life.
4. He has difficulty controlling his anger.
Step 2: Prioritize Problems
1.
2.
3.
4.

Marijuana use.
Excessive alcohol drinking.
Lack of job satisfaction.
Uncontrolled anger.

Step 3: Translate Problems into Needs

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Problem

Need

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1. The client uses illegal marijuana.

1. Stop illegal marijuana use.

2. The client drinks alcohol excessively.

2. Reduce amount of alcohol consumption.

3. He hates his current job.

3. Pursue desired career path.

Step 4: Evaluate Levels of Intervention


Need #1: Stop illegal marijuana use.
Micro Strategy: Decrease social activities in areas that trigger marijuana use.
Pros:

Decrease in the stimulants that contribute to clients marijuana use.


Potentially motivate client to engage in more positive activities.

Cons:

Client could become bored and increase marijuana use at home.


Client could become less social.
Client could become more angry or moody.

Mezzo Strategy: Join a Narcotics Anonymous group


Pros:

He may feel more support in a group setting.


He could come up with more ideas on alternatives to marijuana.
He might feel less ashamed of his problem knowing that others suffer from it as well.

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Cons:

He might feel ashamed to share his problems with strangers.


He might not like labeling himself an addict.
In order to be successful, he will have to make meetings apart of his normal schedule.
He will need to be open and honest about his marijuana use.

Macro Strategy: Advocate with the clients union to make it mandatory for them to provide
drug and alcohol counseling to any union member who requires those services.
Pros:

Client can receive support services free of charge.


He could be subjected to random drug testing.

Cons:

He might not want his employer or co-workers aware of his marijuana use.
He might be subjected to random drug testing.

Need #2: Decrease alcohol consumption.


Micro Strategy: Replace all alcoholic beverages inside his home with non-alcoholic beverages.
Pros:

Alcoholic beverages will no longer be readily available at home for the client to drink.
He will still get the flavor of his favorite drinks without the alcohol.
On a daily basis, he can feel good about not drinking.

Cons:

He might replace alcoholic drinks with unhealthy sugary drinks.


He might buy alcoholic drinks on the way home or stop at a bar.

Mezzo Strategy: Attend Alcoholics Anonymous sessions.


Pros:

The sessions are free and conveniently located in his community.

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He can meet new people and develop more support systems.

Cons:

He must attend meetings regularly to get the full benefits of the program.
He must be open and honest about his drinking habits.

Macro Strategy: No Macro strategy is needed because these programs exist nationwide and
many are free of charge.
Need #3: Pursue a career as a truck driver.
Micro Strategy: Recommend schools that have truck driving programs.
Pros:

He can find out what is required to become a truck driver.


He can start to prepare financially to attend training.

Cons:

Researching schools could be time consuming for the Social worker.


Client might be required to take a leave from work to attend school.
Client might not be able to afford training.

Mezzo Strategy: Apply for admission to school of choice within 2 months.


Pros:

Client will have a chance to change career paths.


His chosen career path pays more than his current job.

Cons:

Client might have to take a leave from work to attend school

Macro Strategy: Help client apply for financial aid within 2 weeks of applying for admission to
school of choice.
Pros:

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Client may qualify for grants to cover full program tuition


Grants will ease the financial burden from the client.

Cons:

The client has a previous felony and might be denied government grants.
Goals, Objectives, and Tasks

Goal #1: The client will stop smoking marijuana.


A. The client will not socialize in places where there is known marijuana use.
1. Make a list of 4 of your favorite activities within one week.
2. Within one week, find at least 1 facility accessible to you that hosts one of your
enjoyed activities with no alcohol or drug use.
3. Attend at least one social activity per week for 4 weeks where there is no marijuana
use.
B. The client will join a Narcotics Anonymous group within one week.
1. Call the toll free number I provided and obtain a list of meetings in your area within 3
days.
2. Contact a meeting facility within one day of obtaining the list and get days and times
of meetings.
3. Attend a minimum of 2 meetings per week for the next 4 weeks.
4. Become familiar with your personal sponsor and contact him/her when you have the
strong urge to use marijuana.
Goal #2: Decrease alcohol consumption.
A. Replace all alcoholic beverages inside the home with non-alcoholic beverages within 3
days.
1. Research different non-alcoholic beverages through word of mouth or internet within
24 hours.
2. Throw out all alcoholic beverages today.
3. Go grocery shopping within 24 hours and purchase food and drinks to substitute for
the alcohol.
B. Start attending Alcoholics Anonymous (AA) sessions within one week.

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1. Contact the AA hotline that I provided within 2 days and obtain a list of convenient
meeting locations.
2. Call the preferred meeting location with 24 hours and arrange to attend a meeting.
3. Attend a minimum of one meeting per week for 4 weeks.
4. Obtain sponsor information and contact sponsor when you feel the strong desire to
drink alcohol.
Goal #3: Pursue a career as a truck driver within 3 months.
A. He will apply for admissions to the truck driving school of his choice within 3 months.
1. Review the list of schools within 2 weeks.
2. Decide which program best fits his needs and apply to it within 2 weeks.
B. Apply for financial aid for school training.
1. Contact school financial aid office and get federal code for financial aid on the day he
applies for admissions.
2. Go to www.fafsa.ed.gov to apply for financial aid within 1 week of applying for
admissions.

Contract for Intervention Plan


Client Name: Caleb Lawrence

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1. Description of the Problem:


Mr. Lawrence is unhappy with his current job situation and wants to pursue a career as a truck
driver however, he smokes illegal marijuana and drinks excessively which both will prohibit him
from becoming a truck driver.
2. Primary Goals:
a. The client will stop smoking marijuana.
b. Decrease his alcohol consumption.
c. Enroll in truck driving school.
We the undersigned, agree to the objectives in the following pan:
A. The client will not socialize in places where there is known marijuana use.
B. Join a Narcotics Anonymous group within one week.
C. Replace all alcoholic beverages inside the home with non-alcoholic beverages within 3
days.
D. Start attending Alcoholics Anonymous (AA) sessions within one week.
E. He will apply for admissions to the truck driving school of his choice within 3 months.
F. Apply for financial aid to pay for truck driving school.

Signature of Client

Signature of Worker

Date____________________________

Date____________________________