Singapore social work past year exam paper: Working with clients and families in social work practice.

Case Study

Carrie Theo, 38 had approached your social service agency. She seemed a little hesitant and requested to speak with a social worker about her intent to proceed with a divorce. She mentioned that this was the first time she was seeking help from a social service centre and was concerned about how her information will be kept confidential. You have been assigned to follow up with her. You gather the following information from her. Carrie has been married to Kelvin Thien, 45 for 12 years. Kelvin initially took very good care of Carrie. According to her, Kelvin had mentioned many times that Carrie “meant the world to him.” Carrie was confident and attractive at that time. After her university graduation, she had “pursued flying for a few years to experience the world.” The first year of marriage was full of bliss. The couple travelled often and were involved in many recreational activities together. Kelvin works as a veterinary surgeon at a private pet clinic in the city area. Carrie used to work as a Singapore Airlines (SIA) flight stewardess. She quit her job after her marriage as Kelvin wanted her to stay home to manage the household and take care of their children. Though Carrie was not keen to quit her job as she always enjoyed her financial independence, she decided to proceed as she wanted to please Kelvin. The couple wanted to start a family of their own as soon as they got married. However, Carrie had two miscarriages in the first three years of her marriage. After that, Carrie had difficulties conceiving a child. The couple went through various fertility options. This resulted in high cost and disappointment in most instances. Two years ago, Carrie, finally gave birth to a baby boy, Ken. He was delivered as a premature baby in week 30. He was born with Down Syndrome and multiple medical issues. As a result, he spent about 6 months in the hospital. The couple knew that they were going to have a special needs child when Carrie was into her 12 weeks of pregnancy. Kelvin suggested going for an abortion. However, Carrie was totally fixed on keeping the baby. She felt that she cannot reject “God’s blessing.” Carrie felt blessed having being chosen by God as the best parent for Ken. The couple’s extended family members were willing to go along the couple’s decision. The first year of Ken’s life presented a lot of challenges. As a new mum, Carrie was too overwhelmed. She had to juggle with many responsibilities. Kelvin used to help her occasionally with the child. However, he slowly started to distance himself from the child and her. He only contributed financially. Both Carrie’s aunt and Kelvin’s retired parents drop by occasionally to support Carrie in the caregiving of Ken. Carrie’s mum, Mdm Theo, 70 and the family’s Burmese domestic helper, Aung are the main support for Carrie. Throughout the 45-minute session you had with Carrie, she was sobbing on many instances. She feels that her husband no longer loves her or her son. She feels that she has been the only one trying to attend to all her son’s needs and manage the household chores. Sometimes she feels angry towards herself for being foolish to proceed with the pregnancy. Other times, she feels guilty about even having that thought. Though Ken has been difficult to care for, she does love and treasure him very much. Over the weekend, Kelvin had not returned home. The night before, he had called to inform that he did not want dinner as he needed to stay up to finish some work at his office. A few days later Carrie was shocked to see a receipt that the helper handed over to her while doing the laundry. It was for a weekend stay at a hotel for two in Orchard. She rushed into his room and ransacked his entire cupboard. It was then that she found an expensive lady’s watch and a valentine note addressed from Kelvin to his female colleague, Clara, aged 25. Carrie was devastated. She came to realise that her marriage was on the rocks and decided to speak to a professional before making any decision about her marriage. You close the session by checking on Carrie’s emotional well-being. It is then that she reveals that she had thought about hurting herself before but feels that she will not pursue this decision due to her religion as well as her young child who is totally dependent on her.

Answer the following questions based on the case study above.

Question 1 (24 marks)

Study the issues presented in Carrie’s family holistically, based on a synthesis of knowledge of (BPSS) biological, psychological, social, cultural, and spiritual influences. Outline and analyse any FOUR reasons for Carrie’s suicidal ideation?

Question 2 (20 marks)

Carrie was said to be sobbing throughout the interview with you. Demonstrate and explain any FOUR ways that you would manage her sobbing.

Question 3 (34 marks)

Describe Germain and Gitterman’s ecological perspective. Analyse and illustrate how you would use the following THREE concepts of Germain and Gitterman’s ecological perspective when intervening with Carrie and her family. Use examples from the above case study to illustrate your points.
a) Goodness of Fit
b) Stress
c) Self-direction

Question 4 (22 marks)

Appraise the Social Work Code of Ethics of the National Association of Social Workers in your work with your clients. Discuss how you would use any TWO concepts under the Social Workers’ Ethical Responsibilities to Clients when working with Carrie and her family, citing relevant examples.