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Posted: April 27th, 2023
Cassell case study
SOWK 321
The original source for this case study comes from Cases for intervention planning: A source book (1993)
by Molly R. Hamcock and Kenneth Miller. It has been revised for SOWK 321 use at Metropolitan State
University by Dr. Monica Roth Day.
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Agency: Children’s Hospital and Clinics, St. Paul, Minnesota
Referral date: March 1, 2021
Referral source: Pat R, nursing staff in the Diabetes and Endocrinology Clinic
Client: Joanne Cassell, age 13 (birthdate 2/28/2008)
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1234 Tree Lane, St. Paul, Minnesota
218-111-9876 (home phone)
Family members:
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Father: John Cassell, died in 2009
Mother: Jean Cassell, age 49, lives with the client, works as a driver with Amazon
Siblings:
Marvin, age 33, married and lives and works in Onamia, Minnesota
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Lorraine, age 32, single, lives with the client and works as a cook in a local retirement
home
Frances, age 29, single parent of Lucy (6-months old), lives with the client and works
part-time at a local youth shelter
Presenting problem
Joanne requires dialysis three times a week. She was diagnosed as a Type I diabetic at age seven. Her
mother states that at that time, the doctor told her Joanne had very little time to live, and that the
family should make that time as easy and pleasant for her as possible.
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Joanne needs dialysis because she is in kidney failure. It was brought on by her persistent non-
compliance with the dietary and insulin regimen prescribed as necessary to control the diabetes. In the
past year, she has begun to experience some very gradual vision loss caused by the non-compliance.
Mrs. Cassell shared that she encouraged her to take her insulin by promising her rewards when she did.
Joanne was inconsistent and the reward system diminished because of Joanne’s lack of follow-through.
Transportation
Joanne sees this as her only problem as the family doesn’t have a consistent or reliable source of
transportation and it is difficult to get to the hospital by bus for her dialysis. The family has one car
which Lorraine and Frances use for work. It is old and needs significant repair.
The family lives about 3 miles from the hospital. While there is a bus line nearby the family’s home, it
takes several transfers and over an hour to get to the hospital. After Joanne was discharged from the
hospital and began dialysis, a neighbor drove Joanne and her mother to Children’s Hospital. The
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Cassell case study
SOWK 321
neighbor had been laid off from his job because of the pandemic. This transportation is no longer
possible because the neighbor has been called back to work. On those few days when Joanne has tried
to take the bus on her own, she has missed her transfers and arrives too late for her dialysis
appointment.
For some patients where transportation is a problem, a system of continuous dialysis which occurs in
the home is possible. This requires a sterile environment. For Joanne, it is not recommended
Setting
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Joanne lives with her family in…
Identifying Information
Joanne Cassell is a 23 years old young female who identifies as she/her/hers…
Reason for Referral
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Joanne Cassell’s case referral was made by….
Relevant History
Joanne has experienced health issues of Diabetes…
Assessment
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1. Joanne has multiple issues….
2. The current issues exist because….
3. The strengths and resources currently available are…
4. Additional information that is needed to work with Joanne and the family includes…
5. When working with Joanne, it is important to consider…
Intervention Plan
Issue 1:
Goal 1:
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Intervention 1:
Client tasks:
Social Work tasks:
++++++
Identifying Information:
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Joanne Cassell is a 13-year-old female who was diagnosed with Type I diabetes at age seven. She requires dialysis three times a week due to kidney failure caused by non-compliance with prescribed dietary and insulin regimens. She lives with her mother, Jean Cassell, and siblings Marvin, Lorraine, and Frances.
Reason for Referral:
Joanne Cassell was referred to Children's Hospital and Clinics in St. Paul, Minnesota by Pat R, a nursing staff member in the Diabetes and Endocrinology Clinic, due to her need for dialysis and transportation difficulties.
Relevant History:
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Joanne has a history of non-compliance with her diabetes treatment, resulting in kidney failure and gradual vision loss. Her mother encouraged her to take her insulin by offering rewards, but Joanne was inconsistent and the reward system eventually diminished.
Assessment:
Joanne requires dialysis three times a week and experiences transportation difficulties getting to the hospital for treatment.
Joanne's health issues stem from non-compliance with prescribed treatment and lack of reliable transportation.
The family has one car, which is old and needs significant repairs. Joanne's mother works as a driver for Amazon, and her siblings also work part-time.
Additional information needed includes the family's financial situation, access to social supports, and any other medical or mental health concerns.
When working with Joanne, it is important to consider her age, developmental stage, and family dynamics, as well as the impact of her health issues on her daily life and future prospects.
Intervention Plan:
Issue 1: Joanne's transportation difficulties
Goal 1: To improve Joanne's ability to get to dialysis appointments on time
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Intervention 1: Connect the family with transportation resources, such as medical transportation services, community volunteers, or public transportation subsidies.
Client tasks: Joanne and her family will need to provide information about their financial situation and availability for transportation services.
Social Work tasks: The social worker will research and connect the family with appropriate transportation resources, and provide support and advocacy as needed.
Goal 2: To address any underlying issues contributing to Joanne's non-compliance with treatment
Intervention 2: Conduct a comprehensive assessment of Joanne's physical and mental health, as well as her family dynamics and social supports. Develop a treatment plan that addresses any identified barriers to compliance and incorporates strategies for promoting adherence.
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Client tasks: Joanne will need to participate in assessments and treatment planning, and work with her healthcare team to follow the prescribed treatment plan.
Social Work tasks: The social worker will facilitate communication between Joanne and her healthcare team, provide education and support to promote treatment adherence, and connect the family with additional resources as needed.
The intervention plan aims to improve Joanne's access to healthcare and support her ability to manage her diabetes and kidney failure. By addressing transportation difficulties and underlying issues contributing to non-compliance, the social worker and healthcare team can work together to promote Joanne's overall health and well-being.
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