Running head: THREE LEVELS OF PRACTICE

Three Levels of Practice

Social Work Practice Methods 3010
Shamekia Schoffner
December 7, 2013

Abstract
In this paper, several level changes occurred throughout the process
and sessions of seeing Ms. Heather Grant. I wanted to explore her

psychological state; so I asked open-ended questions as well as

confrontational skills when necessary. Ms. Grant was encouraged to
attend support groups once a month for teens aged 12-18 that have
been sexually assaulted. Lastly, to gain exposure and bring to light the
awareness of sexual rape; I initiated as an advocate to local agencies
and hospitals to have available The Plan B pill for sexual assault
victims. Having this pill as an option reduces the risk of unwanted
pregnancies in a way that is non-invasive and cost-effective.

Identify a Macro and Mezzo Level Change

Heather Grant was encouraged to see a local support group specifically for
sexual abuse victims females aged 12-18. This group has a high success
rate; with positive results shown as soon as 6 weeks. Six weeks of treatment
is quite impressive to see a noticeably change in ones growth. Some of the
results experienced in some clients include: less physical self-infliction by

30%, able to perform daily functions within 1 year post traumatic event and
lastly, reports include that the group helped them to forgive the abuser(s).
In addition, this support group offers bi-monthly classes to parents and
caregivers for free to help better understand what one may be going
through and also encouragement to the parents and caregivers as well.
Being a victim of violence in any form can also have effects on people
closest to them.
Identify the Specific Changes for the Clients Benefit
Some options presented for Heather Grant, that may be beneficial to her growth
and goal while in treatment includes: emphasizing Ms. Grants strength; shes very
courageous for reporting the sexual abuse to proper authorities, she has a positive
outlook on life and she has a strong support system. In addition, exploring more
open-ended questions to my client may help alleviate doubts and uncertainties that
she may have but it afraid to ask or explore. For example, during the sessions,
rarely is the abortion brought up while conversing. I would ask her do she still think
about the aborted fetus? Are there any special triggers or memories that may
remind her or her unborn baby? Was it her choice to abort or was she guided in the
decision?

Identify Needed Changes At All Levels

Micro- I would explore Heathers psychological situation; I want to know

her mental state when the session ends and keep notes on her progress of
what she is saying and presenting.
Mezzo- Treatment group that would be beneficial to Heather Grant is the
Growth Group. This group would help her grow individually, Ms. Grant has
expressed to me that she used to blame herself for the reason the attack
occurred, she thought the attacker (former pastor) was attractive. It is a
haunting that she is still dealing with.
Macro- I would like to advocate on the behalf of my client Ms. Heather
Grant and speak with the pastor or of his council to address the allegations
against him. My objective is to find some background information on the
case, and see if he is open to discussing. The general public has the right to
know and question their leader of authority, if one is abusing their power
and preying on girls is unacceptable.
Levels Differing
Micro- In the micro level, the social worker shares a more intimate
approach and style in addressing a clients concerns including: empathy,
genuineness and basic welcoming skills to build a rapport with the client.
Mezzo- The mezzo level and micro level is integrated; the mezzo level
includes an individual and also outside sources or people. For example, a

support group or working with families that may be going through a

divorce.
Macro- The macro level involves the interaction and engagement with
larger systems; some of the examples include: lobbying to change a health
care law, or organizing activist groups.
Skills Used at Different Levels
Micro- Skills used include: asking open-ended questions, encouragement,
use proper cultural eye contact, and lastly applying clarification and
reflective responding to the client.
Mezzo- I would use confrontational skills, relationship building and conflict
resolution.
Macro- On the macro level some of the skills I would use include the
involvement of other systems and environments. I can assist in providing
the right resources when they are scarce or not available by being
community activists, being a mediating are some of the responsibilities.
Specific Changes
Micro skills- I would ask open-ended questions to get a clear, concise
answer, not one that ambiguous or a simple yes or no, this way it helps the
client to open up. I would use encouragement as a compliment to express
some of things my client has improved on. While being culturally
competent, with my client, she is biracial and was born and raised in the

United States, she did not express or conveys that using eye contact is a
problem.
Mezzo skills- I would use confrontational skills while working with my client
if she isnt doing well in school. If there is a change in her grades or
behavior while at school, I would investigate the change and why it is only
occurring at school.
Macro- I would be an advocate on the behalf of my client to ensure that
minor girls under the age of 18 can purchase and have readily access to the
morning after pill after a rape has taken place. This service is provided and
explained by the medical personnel in a hospital setting with and without
parents consent.

Overlap Between Levels

An overlap between micro and mezzo level is when Ms. Heather Grant
attends her support group, I would like to inquire about her progress and
struggles while in the program. Another possible overlap, is when my client
went to the hospital to have a rape kit performed on her, I would like to go
over her medical information and know if she was offered counseling or any
literature on rape at the time of services. Lastly, from a macro level
perspective, an overlap would be me lobbying to change the age and
requirements for one to receive the morning after pill. The morning after

pill or plan B is a pill that is taken within 72 hours after unprotected sex to
prevent and stop the releasing of the egg to fertilize. This option is lot more
financially feasible as well than an abortion and also less invasive.
Challenges Affecting Special Populations
My client Ms. Heather Grant is of biracial race; African American and
Caucasian. Her father is Caucasian and her mother is African American.
Because she biracial she expressed to me some issues she face as a woman
of color, she attends a school that is more than 75% Caucasian. Sometimes
she doesnt fit into the social norms of demographics.

Problems Experienced and Problems Single Mothers Encounter

As a woman of color there are certain disadvantages that she may have to
face such as an adult or even as a teenager, such as the unequal treatment
of discrimination and unbalanced opportunities in advancement as her
counterparts.
Some specific disadvantages that women of color and single mothers
encounter are: stigmas associated with being a color such as laziness or
uneducated. Women in general earn less money than men and also than

white women. Single mothers face having to be the sole provider and
caretaker. Because most single mothers work full time jobs; the conflict lies
in balancing family, work and education. Lack of resources and support
inhibits some women of pursing their goals.
Value and Ethical Dilemmas Problems
An ethical dilemma faced during the session with Ms. Grant is that she
expressed to me that she is in a relationship with her boyfriend of 2 years
and she would like to discuss birth control options. Because Ms. Grant is a
minor, I would feel more responsible discussing the options with her
parents, however Ms. Grant did not specify if she wanted her parents to
know that she inquiring about birth control.
To remain ethical, I prefer to see Heather Grant to discuss some of the
options that are available such as; would she feel more comfortable with me
talking to her parents for her? Would she feel more comfortable discussing
the options with her parents or just her mother specifically?
A priority and main concern for me is 1. Does she want to be on birth
control or is she being convinced by her boyfriend? 2. My other concern is if
she is not on birth control she may become pregnant which presents even
more problems. My best advice is to present to her available options of
literature on birth control and proper engagement of sex so she doesnt
contract a sexual transmitted disease or infection, and ask her to think

about over the week and call me once she has decided which option she
wishes to take.
As an ethical dilemma what she and I discuss is between she and I although
she is a minor, I want to respect her privacy. My personal feelings and
intuitive thought is that she may be feeling guilty of choosing to terminate
her fetus and she may want to replace her baby. Secondly, I want to
remain as professional as possible so I do not feel it is my responsibility to
tell her to wait, but more so present to her options as well as go over
complications and problems associated with engaging in risky sexual
behavior of unprotected sex. This way I am empowering her to make a
decision that she feels comfortable making and she wasnt coerced to do
and also she will be 18 years old next year, she is not a child and if she
decides to make adult decisions, she needs to know the adult consequences
associated with them.
Ethical Principles to Help Resolve Problem
One of the ethical principles I can utilize to help resolve the problem is the
importance of human relationships. Heather Grant and her mother have
developed a close relationship since coming to therapy and I would like to
continue to see the positive progress they have made thus far. However, to
further extend the relationship, and use a strength based-approach I would
firstly, acknowledge the strong relationship the two shares and then further

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explain to Heather that I think her mother would understand and proud that
she chose to come to her than make an important decision without her.