Verbal Content Gut Feelings Observations/non verbal content Values/Ethics

Before the clients met with the clinician they were I felt as though the The client needed more time than the 1.03 Informed
spoken to from one of their case managers about their client had a lot of case manager expected to explain the Consent 1.01
upcoming appointment as a reminder. The brother of confusion in regards to schedule Commitment to Client
the applicant expressed confusion abou the schedule, the schedule, but I
so the case manager highlighted the events on the figured it was all
schedule for him. resolved after the
conversation.

The clinician greeted the three clients and the I have met this family
translator as they entered the room. Before beginning before so I felt
he asked them for their permission that a student confident they would
observe the process to which they confirmed. He then feel comfortable with
gave a brief description on the purpose of the mental the idea of me
health screening and it's process. observing.
The husband and wife sat next to one 1.03 Informed
another on the couch, and the brother Consent 1.07 Privacy
of the pricipal applicant (the wife) sat and Confidentiality
on the chair beside them

He provided the translator and the three clients in the The clients seemed The family listened proactively to the 1.03 Informed
room with a synopsis of the agency's terms of neutral to the terms translation Consent 1.07 Privacy
confidentiality and introduced them to their rights as outlined to them. and Confidentiality
a client.
Given that the consent agreement was in English and I was curious whether They did not seem to have hesitation 1.03 Informed
their spoken language is Swahili he explained that as or not they are familiar signing the agreements Consent 1.07 Privacy
a client they have a right to their disclosed with these policies, or and Confidentiality
information to be kept confidential. The clinician similar policies in their
addressed the occurences when confidentiality can be own culture.
broken in the evert of them or someone they know
hurt, or intending to hurt, themselves or someone
else, and abuse of a child or elder age 60 and up. He
also explained that the case manager does have to
release some of this information to book
appointments that facilitate their transistion to
America. To end the conversation on confidentiality
he explained the role of the translator, and had him
sign an agreement before the clients that all
information disclosed will be kept confidential.

When the clinician asked whether there were any The mother may feel It seems as though this question came 1.04 Competence
questions the woman did present one to him. She distrustful of authority, to mind before Timothy asked
asked what would happen if someone lied about them and there may have whether the family had any questions
being a perpetrator of abuse. To which he responded experienced deciet in for him, because she proposed the
that one is never to be assumed guilty, but it would the past inquiry almost immediately
have to be reported and therefore investigated.
He then granted them the option of choosing what I wondered if such a The family made the decision pretty 1.02 Self-
order they would like to perform the screenings in. process was a new quickly by having the men go first. I determination 1.05
They chose the order and the rest of the family was experience for them, wasn't sure if this was by chance, or Cultural Competence
seated in the lobby. and whether they had puposeful.
any hesitations or
nervousness towards
starting the screening.

The clinician asked him how he was and whether or The clinician was
not he has been feeling more adjusted to his making conversation
environment in effort to make the
client feel more
comfortable with the
situation at hand.
The client's demeanor seemed to 1.01 Commintment to
grow more comfortable showing that Client
he is getting more accustomed to the
situation at hand

The client confirmed that he was doing well, but did Based off of body The client had sporadic body 1.01 Commintment to
mention that he has been having difficulty navigating language, and the language to describe his experience Client
the city and returning to his home. Therefore the extended amount of when he was lost. He took a lot of
clinician asked him if he would like a map of time he took to explain time to explain his struggles with
providence, and whether or not he felt that would the situation it seems getting lost to the translator.
help him with this struggle. as though this is
something he has great
concern about

The clinician then began the Refugee Health 1.04 Competence

Screener-15 (RHS-15) and reviewed some potential I wondered if the
symptoms with the client and the traslator USCRI has to make
any mental health
screenings when
choosing applicants,
and whether they ever
done something like
this before.
The first question he presented to the translator to He used a lot of body language and
address was whether or not the client was having any effort to try the convey his hearing
muscle, bone, or joint pains. He denied all physical difficulties
pains, but he did mention that he has hearing
problems in one ear because of an incident with a
loud radio when he was in the refugee camp.

He questioned how long he was in the refugee camp This information He didn't show any expression in
to which he answered since 1996 shocked me and gave reflection to the length of time he had
me a very different been in the camp.
perspective on the
client than I had
previously. To hear
that he has been in the
camp for my entire life
made me percieve his
case with much greater
depth

He then addressed his medical concern and advised The matter didn't feel The client agreed to his instructions 2.06 Referral of
him to tell the doctor when he goes to his scheduled urgent to the client, of informing the doctor Services
physical and maybe his
condition feels more
of an inconvenience
Moving on to the next question he asked whether he This statement must He doesn't seem concerned about his
has been feeling sad or unhappy within the last thirty have caught his depressive feelings
days. He admitted that he frequently felt sad at the attention, and gave
camp, but now that he is so busy here he feels as him a sense that the
though he has been less focused on those feelings. client's mental health
may be of concern.

When he was questioned whether or not he is He did not seem interested in 1.01 Commitment to
experiencing too much thinking he admitted that he This incident was not disclosing the incident that occurred Clients
has been losing memory. The clinician asked how disclosed so it may be in the camp, and left it vague with
long this has been happening to which he explained it a traumatic event for purpose.
has been since an incident in the camp the client. PTSD has
symptoms of memory
loss.
The next question regarded whether or not he feels When a client Getting lost seems to be a reoccuring
"nervousness or shakiness inside". He confirmed and experiences physical mental preocupation for the client
gave an example of when briefly got lost and symptoms it could be
disconnected from his family he felt this feeling an indication he has an
anxiety disorder

When asked by the clinician if he felt restless he
confirmed, and as phrased by the translator claims,
"his head tells him to keep busy".
The wording of his He acted out himself feeling restless
statement called my and waved his arms around to
attention because this illustrate his experience of emotions
is often a symptom of
anxiety
The screening then transitioned into questions It took him awhile for the client to
regarding any traumatic history. He asked whether he deny the question, and while doing so
ever had a bad experience that feels like it's he was fiddeling his hands
happening again. He denied.

The clinician asked whether he ever experienced any The description of the I noticed that the translator gave 1.05 Cultural
physical reactions when he is reminded of bad things phenomenon as examples of this feeling to the client. Competence
that may have occurred in his past. He admitted that translated by the
he does, and as the traslator stated feels like translator shows flags
something is falling down or passing inside him of anxiety

On one of the final questions he was asked if he ever Crying is probably He first giggled at the topic of crying 1.05 Cultural
feels emotionless, which the clinician described to something he does not Competence
him as things such as feeling sad but unable to cry or feel comfortable doing
unable to have loving feelings. The client disclosed
that his mom did something and the camp, and he has
felt the feeling before of wanting to cry but felt as
though he couldn't.
To wrap up the screening the clinician asked whether This behavior is The client forgot the information 1.01 Commitment to
he had any questions. The client was curious about accredited to the regarding the schedule that was Clients
how he was getting to his doctor's appointment. He memory problems he discussed before the screening.
gave him a print out of his appointment schedule, and addressed.
highlighted his appointment times. He assured him
that Dorcas will be transporting him there, and to
seek his case manager if he ever gets lost or has
questions.
Policy Core Competencies Culture Theories Roles/Skills Supervisory Comments
The designated Competency 6: Some cultures are Task and Coordination
case manager's Engage with more lenient when it Solution based
role is to Individuals, comes to being Social Work
coordinate the Families, Groups, schedules. It's
arriving family's Organizations, and important to stress
schedule, and to Communities American's culture of
facilitate their punctiality.
ability to attend
these events.

Clients must be Competency 6: Some cultures may Anti- Engagement

informed when Engage with not have an Oppressive Summarization
a Individuals, understanding of Empowerment of services
volunteer/intren Families, Groups, mental health, so it's
is working with Organizations, and important that he
them, and gain Communities explains the purpose
their consent of the screening
before
proceeding

Clients have to Competency 5: In the line of Anti- Educator

be informed on Engage in Policy American human Oppressive
our terms of Practice service we rely on Empowerment
confidentiality client consent because
and sign a of culturally ethical
document standards.
consenting to
our policy
before receiving
a service
Clients have to Competency 5: He addressed the Critical Social Educator
be informed on Engage in Policy culture of Work
circumstances in Practice confidentiality in
which workers context of the United
may break States by explaining
confidentiality that it is a protocol
as allotted by that we take very
federal law seriously in America

Federal law Competency 5: Educator

prohibits guilty Engage in Policy
by assumption, Practice
and every
individual has
right to fair trial.
 Competency 2: Given that some Feminist Enagement
Engage Diversity cultures prefer that
and Difference in men lead, Timothy
Practice gave them the option
of choosing their
order so that he isn't
at risk of
disrespecting the
family

Competency 6: A common form of Person Engagement

Engage with engagment begins Centered Communication
Individuals, with asking someone Approach Developing rapport
Families, Groups, how they are doing
Organizations, and and this is universally
Communities common.

Competency 6: Empowerment Providing resources

Engage with
Individuals,
Families, Groups,
Organizations, and
Communities

The RHS-15 has Competency 7:

to be conducted Assess Individuals,
as a part of Families, Groups,
agency policy Organizations, and
Communities
Competency 6: Communication
Engage with Active Listening
Individuals,
Families, Groups,
Organizations, and
Communities

Competency 6: 1996 was the year in Person Communication

Engage with which a dictator lost Centered Active Listening
Individuals, power and many Approach
Families, Groups, people fled
Organizations, and
Communities

Competency 8: Cultures respond Broker

Intervene with differently to medical
Individuals, issues, and utilize
Families, Groups, different
Organizations, and intereventions or
Communities practices.
Competency 6: Timothy chose to CBT Communication
Engage with exclude some words Active Listening
Individuals, used in the RHS-15
Families, Groups, description because
Organizations, and he wan't sure it would
Communities have the same cultural
connotation. Some
phrases such as
"feeling blue" is only
metaphoric in the
english language.

Competency 6: CBT Communication

Engage with Active Listening
Individuals,
Families, Groups,
Organizations, and
Communities

Competency 6: The symptoms of Behavioral Communication

Engage with anxiety may not be Active Listening
Individuals, acknowledged in his
Families, Groups, culture.
Organizations, and
Communities

Competency 6: So cultures are very CBT Communication

Engage with work oriented, and Active Listening
Individuals, people feel the need
Families, Groups, to be continuously
Organizations, and working.
Communities
Competency 6: Behavioral Communication
Engage with Active Listening
Individuals,
Families, Groups,
Organizations, and
Communities

Competency 2: It is possible that Psycho- Communication

Engage Diversity PTSD is not analytic CBT Active Listening
and Difference in something the client is
Practice familiar with because
it may not be
acknowledged or
studied in his culture.
Therefore he used a
description of PTSD,
instead of questioning
him about it by name

Competency 6: Crying can be seen as Attachment

Engage with taboo for men in some
Individuals, cultures
Families, Groups,
Organizations, and
Communities
Competency 8: Case management
Intervene with Coordination
Individuals,
Families, Groups,
Organizations, and
Communities