Assignment 2

After much deliberation and thought into this assignment, I have chosen to work with  Bill for the purposes of this assignment.  He is a 65 year old male who has been living in a group home setting for the last five years.  Preceding his move into one of our higher functioning group homes, he lived with his parents his whole life.  To my understanding, he has one brother who also suffers from an undiagnosed disability.  Both his parents passed away from cardiac related illnesses.  Bill suffers from bipolar disorder, paranoid schizophrenia and mild retardation.  As previously mentioned, he is very high functioning as he attends workshop daily and is capable of carrying out many household responsibilities.  There are several reasons I chose to work with Bill, the first and most important being that he has a clear understanding of what is expected of him and the goals that have been personally formatted for him.  He also wants to achieve these goals, and shows pride and satisfaction when they are accomplished.

I approached Bill explaining that I have an assignment for school that I would like for him to participate in.  I explained that I have to pick one person to closely work with and try to help them achieve a goal they ultimately would like to accomplish.  He was very flattered that I had chosen him for this assignment.  I asked him to explain to me some of the goals he is currently working on, and his answers were such; taking out the garbage, cooking or baking every week, and to try and be more understanding of others.  I am already aware of these goals, but had a different one of his goals in mind that he failed to mention.  I reminded him of his concern and desire to be more sociable at home and outside the home.  Currently, Bill only leaves his room at home when it is time to eat a meal with his peers or take medication, otherwise he remains in his room upon his arrival from workshop.  He verified that this topic is still a goal of his.  He also relayed his concern that he would be unsuccessful and was afraid of failing.  Part of my job and also by ethical standards, I need to be aware of issues and situations that will set my client up for failure.  I must tread very carefully and not push or pose anything that may cause harm to my client or myself.  For this reason, I chose to carry out this study in the privacy of his own home where he is comfortable with his peers.  I will not force him in any way to participate in the activities that I have planned, but will offer him a reminder that not only would we love for him to participate, he will be accomplishing his goal for that day.

I have been in constant contact with my field instructor and Bill's house manager regarding this process to formulate a goal for me to accomplish through this assignment.  It has been extremely difficult in constructing a feasible goal that is not only realistic but significant in his lifestyle due to the fact that Bill has been having an extremely difficult time dealing with his life due to his bipolar and schizophrenic tendencies the last few weeks.  He has been unable to concentrate or cope with stress in any environment, making his temper short and fierce.  A portion of his disability is that he has no self confidence and truly believes that he will not succeed and that no one can help him accomplish this goal.  We have discussed making his goal for the purpose of this assignment something easier, along the lines of baking, but thought that this is too simple.  As per my supervisor's and the house manager's suggestions, Bill would benefit the most from me if I could enable him to participate more in the house activities.  Even though this poses a greater challenge, if we could show him that he can accomplish even a small portion of this, he might be able to internalize that feeling and ultimately have more confidence at least in his home. This will hopefully encourage him to be more sociable in his home setting.

I have chosen to modify Bill's behavior and show him through positive reinforcement and encouragement that he can be sociable.  The definition of sociability in direct relation to Bill means that he will initiate a conversation with someone he is unfamiliar with and/or participate in a social style activity either in his own home or outside the home.  If this occurs outside his home, he must be familiar with the area and settings.  His unsociability is an overt behavior as it can be directly seen by others.  For example, the staff or anyone around him will witness that he withdraws and will avoid a social interaction.  I will observe and record his behavior both at home, once a week, and at a nursing home that we volunteer at together once a week.  I will record the amount of times he participates in a social opportunity and will further record the duration of the successful behavior.  I will also record how many times he has denied the opportunity to partake in a social activity and will the ask Bill to record how he was feeling.  There is a possibility I will be able to question him about his success or lack thereof if I am present.  I will record the results through sampling, which involves observing the target behavior during specific times.  For the purpose of observing the target behavior necessary in this assignment I chose to observe his social skills in both his home setting and the nursing home every Tuesday between 10:00 and 12:00 and then again every Thursday between the hours of 3:30 and 4:30.  There may be random checks throughout the upcoming weeks if the opportunity arises and Bill self reports on a failure or accomplishment towards his goal.  One component of recognizing the behavior is to make sure there is a clear beginning and end to the behavior so that we can properly monitor the outcome, intensity, frequency and duration.  This will also serve as a guide for Bill as to how to initiate a social interaction.

After the behavior is observed or missed, the client will be asked to rate the experience in terms of anxiety level and satisfaction.  This will be completed by both a self anchoring scale through a questionnaire, possibly an anxiety scale.  I believe that the scale will be similar to a 1-10 self anchoring scale, where 1 is the lowest amount of anxiety and 10 being the highest or most intense form of anxiety during the target behavior.  I look forward to the results!