Running head: CASE PRESENTATION Hamm 1

Allison Hamm
Case Presentation
SOWK 492- Miles
April 16, 2014














CASE PRESENTATION Hamm 2

Referral Source & Client Description
Trey Smith was involved in two of Colorados most recent natural disasters, the High
Park Fire, and the 2013 Floods. We learned of Treys situation through Crisis Clean-Up, a web-
based self-reporting tool that allows local relief agencies to acquire cases. Trey Smith is a single
White male about 64 years old. His original residence is in the Poudre Canyon, but he currently
lives in Fort Collins. Trey has been an artist his entire life and holds a Bachelors degree in Fine
Art. In addition to the two recent disasters Trey perceives an incident from his teen years as
traumatic as well; this often comes up in our meetings together.
Relevant Research
In one study, on 247 adults 14 months after disaster, participants were over 60 years old
and survived historical flooding in rural Australia. About 15% of these participants reported
symptoms of PTSD, yet researchers noted that many may be under reporting symptoms of
anxiety. They stated that older adults may be less likely to report these symptoms and may not
reach out to mental health professionals as often as younger generations. The researchers further
mentioned that multiple traumatic experiences may increase risk of mental health issues for
survivors (Bei et. al, 2013). One drawback about this study was the fact that many participants
were married and had substantial wealth. Trey may be face even more risk because he does not
have a permanent social support such as a partner and faces much more stress with the financial
costs of recovery.
Another study of Swedish tourists caught in the Indian Ocean Tsunami further clarified
the connection between social support and mental well-being. This reading clearly identified that
marital status has protective factors against suicide risk and mental health problems.
Furthermore, men were less likely to perceive any social support, as were single adults. One
limitation of this study is that the participants were able to return to an intact home and
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community (Arnberg & Melin, 2013). This study further supports our concerns that Trey may be
showing symptoms of posttraumatic stress and needs to be empowered in finding social supports.
Diversity Issues
It is important to be aware of Treys socioeconomic status (SES), culture, and age and
how they relate to disaster recovery. As mentioned above Trey is an artist and does not have a
steady or substantial source of income. This is stressful in itself as he may not be able to budget
or save up for recovery costs. The geography of his neighborhood is also a factor contributing to
SES. This is an issue for Trey because he does not have as many options for community support
such as social and vocational supports that may be available in an urban area.
Treys rural mountain neighborhood culture supports self-sufficiency and ruggedness. So
when working with Trey we need to remember that this may be the first time he has had to ask
for assistance, it may also be hard for him to accept pity from the wider state and national levels.
Many clients from mountain towns also struggle with resistance and slow change resulting from
the bureaucracy of disaster relief organizations such as FEMA.
His age also has a role in what services are available to him. Many organizations focus on
a disasters effects on young families and women, often forgetting the covert vulnerabilities of
older men. Though Trey may benefit from being in the majority for race, gender, and ability he
does lose out on needed resources, especially since he is marginalized by his SES, culture, and
age.
Practice Situation
Apart from losing his home in the fire he also lost all records of his artwork; the flood
caused further damage by washing away rebuilding efforts and destroying the road. He is unable
to receive FEMA funds because he was not living at the property when the flood came through.
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To make matters worse he is now in conflict with a contractor and architect, who have worked
for Trey independently. Both workers received payment without progress and Trey is interested
in filing suit with the contractor. Since the fire Trey is living off of Additional Living Expense
money from his insurance company until June 2014. He hopes to transition to a trailer on the
property at that time and continue making art at his property.
Trey is a little worried that by June he will need to have a new source of income. He has
looked into Social Security benefits and Medicaid to support him in the summer. Trey also
shows interest in appealing the FEMA decision on funding and is planning to work with the
senator in addressing this. Some other routes of funding he is interested in are art grants and
getting his work into galleries again. From what Trey has told us we know that he would like to
turn his apartment into a gallery with the help of an art intern, and get his work into galleries
around town. There is additional cost in this last option however as he would still need to pay
rent and pay gallery fees on his own.
Other than basic needs, Trey has additional stress from his family and neighborhood. He
does not speak to his three older brothers, and our understanding of his relationship with his dad
is unknown. Trey holds himself responsible for maintaining his younger brothers and mothers
relationship, however his mother is elderly and his brother is a manipulative alcoholic with
suicide risk. This is very stressful for Trey as he feels responsible for his brother and often
forgets his own needs to focus on his brothers. His neighbor is also an alcoholic and soon Trey
will be living down the road from him. Trey often takes on a caretaker role when he perceives
that the needs of others take precedence over his own.

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Contract Goals & Objectives
Serve 6.8s interest is in developing Trey goals and empowering him to reach those
during our time together. One objective is stabilization: getting Trey to take steps towards
progress without additional stress or fear. This means that Trey will be able to complete one of
his goals before a meeting without distraction or loss of motivation. Another objective for Trey is
to seek out community supports and/or therapy to combat his posttraumatic stress. Trey has
expressed interest in meeting with other survivors, and through assessment we see a need for
social support. Meeting this objective will mean supporting Treys self-determination to connect
with a social support before our termination.
Assessment & Planned Change Process
We are in the intervention stage with Trey right now because we are still working on
reaching some goals we have set. We used an informal assessment to verify what Trey needed to
work on. He expressed needing assistance in navigating grant applications, therapy, and working
on his employment situation. The solution focused approach helps guide our work in setting
goals with Trey. It is obvious he needs and wants a solution to long-term housing and
employment; we can focus on those solutions by developing goals and exploring ways to reach
them. We also use a strengths based approach in conjunction with the generalist model. The
strengths approach focuses on what Trey has accomplished so far and naturally empowers him.
This is an important model for someone who has the stress of a traumatic incident and social
marginalization. At our meetings with Trey we praise his attempts in working towards goals and
reflect his assets. We take the generalist approach when thinking about interventions that would
work for Trey. As a generalist we focus on any and all needs Trey may have, so far we have
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acted as a broker, counselor, educator, and advocate for him. This model has proven to be
effective for Trey as he needs high levels of support and diverse intervention methods.
Interventions
We have been doing a lot of basic counseling, similar to the skills learned in practicum.
We often reflect and paraphrase what Trey is telling us. He has expressed that our general
support is very helpful in processing everything that is going on. Other interventions include
educating Trey about resources that are available to him, such as therapy resources, and
additional grant applications. At our most recent meetings we have been setting goals and
assigning homework for each party (i.e. we research a resource while he makes a step towards
accommodating that resource). We did this with his long term goals of needing employment and
housing, so we have been researching art internship options while he obtains a sustainable shelter
in replace of the apartment.
Research Design
From the Sheafor (2012) text, the Service Plan Outcome Checklist (SPOC) seemed most
appropriate for our model of social change. This method of evaluation is nice because it fits the
clients goals and is malleable to their specific case. As of now the agency does not have an
effective tool for measuring clients progress or change process, this would be a great tool to
introduce. This is a good method to measure goal progress because it gives the client opportunity
to declare which goals are of top priority to them and how far they got in reaching those goals.
We have been trying to create a termination evaluation form and the SPOC could easily become
our new tool.

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Issues and Concerns
Currently Trey is struggling with the emotional effects of his trauma. Trey has a
very hard time revisiting the fire, but accepts the floods. He does not even like to look at photos
of the fire, his speech quickens and he seems panicked when discussing anything related to the
fire. When talking about the flood he often leans back in his chair and will talk for long periods
of time about one subject. He also stated that he watches videos for hours in the afternoon just to
think about something else. We are planning to have a meeting with our supervisor and Trey to
further investigate the emotional effects of the trauma and to promote healing. This is a basic
need that needs to be addressed in conjunction with progress to the property.
Other main issues include getting utilities set up at the property for June. If Trey follows
through on plans to live there he will need access to heat, water, and sewage. He has made
progress on getting the property in line for his arrival in June; he has poured a concrete pad,
moved the trailer onsite, and set up a basketball hoop for stress relief. He also plans to make his
art on the pad.
Problems or Dilemmas
It is very difficult to stay on task with Trey because he has a desire to talk about all
aspects of the disaster and how his past connects to the present issues he is facing. This is a bit
too much to cover in a one hour meeting where we are focusing on all of his general needs in
recovery. We need to encourage Trey to seek therapy to work through the overwhelming stress
of the events but also respect his right to self-determination.

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Questions for the Class
1. Suggestions to get Trey involved in a social group or therapy as a supportive measure in
reaching other goals?
2. How do I address colleague and supervisors concerns about suspected client substance
use?
3. How do I prioritize Treys needs when they are all motion with timelines (utilities,
employment, and therapy)?
4. Any other way to support him to check off goals he has set with us?















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References
Arnberg, F.K., & Melin, L. (2013). Can demographic and exposure characteristics predict levels
of social support in survivors from a natural disaster? PLoS ONE, 8(6), e65709.
doi:10.1371/journal.pone.0065709
Bei, B., Bryant, C., Gilson, K. M., Koh, J., Gibson, P., Komiti, A., Jackson, H., & Judd, F.
(2013). A prospective study of the impact of floods on the mental and physical health of
older adults. Aging & Mental Health, 17 (8), 992-1002. doi:
10.1080/13607863.2013.799119
Sheafor, B.W. & Horejsi, C. J. (2012). Techniques and guidelines for social work practice.
Boston, MA: Pearson.