Common indicators or signs of crisis noted in this case study and explain what these signs could possibly indicate under the following key headers

List five common indicators or signs of crisis noted in this case study and explain what these signs could possibly indicate under the following key headers:

CLIENT RESPONSES/BEHAVIOURS

WORKER RESPONSES/BEHAVIOURS

Scenario:

You are a worker at a Family and Community service. You have been referred a new young person as a client (primary client) and his family (secondary client) from the local Youth Mental Health (YMH) Unit of QLD Health. In the referral form received from YMH the worker stated that the client was prone to violent outbursts and had physically injured a previous worker at YMH. The client and his family have requested family mediation together and possibly counselling for the young person.

Information about the primary client: 

Shaun, 16 years old, male from a divorced family. According to YMH, the primary client is experiencing severe anxiety and depression as a result of his parents’ divorce six months ago. Shaun is currently taking medication for these mental health issues and is about to begin psychological Cognitive Behavioural Therapy (CBT). The client is a chronic (daily) marijuana user and has identified that he will use other illicit substances (Speed) on a regular basis (weekly or more). Both parents use illicit substances (marijuana) and the father drinks regularly to excess and has become violent in the past towards his family. Shaun has been a witness to and a victim of physical domestic violence and will often perpetrate against his mother and older sister when confronted with his drug usage.

The situation:

During the initial assessment Shaun was withdrawn and unresponsive. Shaun was late and unapologetic at his first appointment. You have had a total of four sessions with Shaun since then and you feel that you have begun to make some headway as he is beginning to disclose some goals and aspirations to you, is open with his body language at appointments and has even smiled at times throughout sessions. Shaun is also prompt to his appointments now. You have seen his parents individually twice each as they refuse to have appointments together. You are not making good headway with the parents as you are with Shaun and the father has missed several appointments, without explanation. You have had to reschedule at a later time to suit the father. Today you were scheduled to have an hour long appointment with Shaun and he was significantly late – over a ½ hour late. When Shaun arrives he has red eyes and will not look at you in the face. You are not sure if he is stoned or has been crying. He mumbles when you ask how he has been going for the last couple days and looks dishevelled. When you enquire about how he is going today he does not answer you, though you notice that he is gritting his teeth and clenching his fists. You remind him that you had previously agreed to appointments being on time and that you would have to cut short this appointment as the next client would be then running late if a whole hour was used. Shaun reacts to this news violently and begins to trash the interview room, yelling abuse at you, swearing. You are able to duck under the coffee table and are not hurt physically by this attack, though you notice that your breathing is shallow and that your pulse is racing as a result. He then picks up the coffee table and throws it. The coffee table breaks and leaves a large hole in the wall. Shaun corners you and you are unable to escape from the room. A co-worker has heard the noise and has called the police for assistance. The police arrive and take Shaun away. He is charged by the police and has to do community service for the assault against you and the damage that he caused to the interview room and furniture.

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