Working with Adolescents: Case Study on a 16-Year-Old Girl and Her GP

Synopsis

Synopsis

Imagine that you have graduated in your chosen profession, and that you are now undertaking a new role in which you will be working closely with young adults.  You subsequently enrol in a four-day ‘Working with Adolescents’ workshop.  In order to obtain your certificate for completing this workshop, each workshop participant is to prepare a poster that relates to working with adolescents (details of this are provided in the Task and Assessment section of this guide).  This poster is based on information you receive during the workshop involving a case study, based on a “real situation”, of a 16-year-old girl and her treating General Practitioner (GP). Although you will be submitting your posters individually for Enquiry 2, you will be working as a team throughout the enquiry to thoroughly understand the key principles that you will need to draw on when completing your individual poster. 

Specifically, this case enquiry relates to Lauren, a 16-year-old girl who has been seeing a GP about several physical conditions such as a lack of energy and her asthma.  Rob, the GP treating Lauren, is experiencing some difficulties working with Lauren.  Rob has been working with Lauren over several consultations.  However, progress has been slow and Lauren appears uninterested.  Indeed, Rob is worried that Lauren’s general health and well-being are becoming worse rather than better.   Things are not good from Lauren’s perspective either and Lauren has complained about Rob to her parents.

In order to prepare your assessment task successfully your team will need to do the following.

 1. Read this guide in detail.

 2. Examine the assessment task carefully.

 3. Consult key case-specific resources including: o the written narrative of the case enquiry; o a video recording of a consultation between Rob and Lauren; and o a video recording of a consultation between Rob, Lauren, Julie and David.

4. Consult key learning resources for the background knowledge necessary to prepare your assessment task including: o Case study material on the subject LMS site; o Text books; and o Reputable journals articles and appropriate web references. In your teams, examine and combine the multiple sources of information to build a rich understanding of Rob and Lauren and their interactions in the professional setting.  This information will be critical to solving the questions.   

  Scenario

Key people in the enquiry  Lauren: a 16-year-old girl who lives with her mother, stepfather and half-brother  Julie: Lauren’s 43-year-old mother  David: Lauren’s 46-year-old stepfather who has an 8-year-old son, James, with Julie  Rob: a 44-year-old medical practitioner who is treating Lauren.  Rob has a wife Jenny, aged 38, and two children, a girl aged 14 and a boy aged 10 YOU: a graduate who is attending a four-day workshop on working with adolescents.   Narrative of the case enquiry Lauren is 16 years old, is doing her VCE, and lives in Ballarat with her family.

Scenario

Lauren is the second of two children to her parents, who are now divorced.  Lauren lives with her mum Julie (a librarian, 43), her stepfather David (a real estate agent, 46), and her younger half-brother, James (8). Lauren’s father Tony (an electrician, 48) lives not far away and she sees him whenever she wants.  Lauren says she gets on well with both Julie and Tony, but describes David (her step-father) as “a waste of space”.  Lauren also has an older brother, Mark (a student in Melbourne, 20), whom she says she “misses big time”.  Lauren appears highly anxious and irritable much of the time and finds that she is always tired, and not thinking as clearly as she was a few months back.  Lauren suspects that she has glandular fever or chronic fatigue syndrome and has seen a GP on a number of occasions.  She spends most of her time when she is not at work or school in her room going online, studying, or watching TV.  She’s not doing very well at school, and the class teacher noticed that she always seems tired and is no longer as sociable as she once was.  The teacher has since referred her to the school counsellor, but Lauren hasn’t gone, as she is sure her problems are related to having either glandular fever or chronic fatigue syndrome. Lauren is asthmatic.  She fractured her left wrist in a motor vehicle accident when she was in Year 10.  While her wrist injury is something that troubles her occasionally, she played netball quite competitively until this season, but has given it up because of a medial ligament injury to her knee which she sustained in a recent game.

Lauren was in a motor vehicle accident  occurred when she was coming home from a party with her older brother Mark, and three friends – Mark’s best mate Cameron, Cameron’s girlfriend Jessica, and Jessica’s younger sister Sophie, who was Lauren’s best friend.  Cameron was driving, and lost control of the car, which ran off the road and struck a tree.  Jessica was in the front passenger seat with her window down.  Jessica’s injuries were so serious that she had to have her left arm amputated below the elbow.  The other passengers sustained relatively minor injuries. Lauren, however, was sitting directly behind Jessica, and was injured when Jessica’s seat was pushed back in the impact.  Since the accident, Lauren has put on weight, and hates how she looks now, but thinks that her weight will “just sort itself out”.  She also feels “weird” around Sophie, and doesn’t really talk with her any more.  Lauren has lost contact with most of her old friends.  She now tends to only see a small group of new friends.  They hang around at one of their homes most Friday and Saturday nights talking, and drinking “pretty much anything they can get their hands on”, “just to have fun, you know, pass the time”.  Lauren wakes up most Saturday and Sunday mornings feeling very hung over. As well as these issues, Lauren is not adhering to her asthma management regime which impacts negatively on her health.  On Saturdays Lauren tends to spend most of the day switching between lying in bed and watching  the TV.  On Sunday she has trouble getting out of bed for her part-time job at the local bakery and has started showing up late for work.  Her manager has recently given Lauren an official warning. Lauren’s GP is Rob, who is 44, and married to Jenny (a midwife, 38) with two children, Sarah (14) and Anthony (8, who is a friend of James).  Rob is well respected in his profession and prides himself on his achievements.  In his work with Lauren, Rob has suggested that Lauren would benefit from engaging in more physical activity, reducing her alcohol use, taking her asthma medication as recommended, and from broadening her social activities and increasing her social networks.  Although her lack of activity, drinking and withdrawal behaviours are not the principal focus of Rob’s work with Lauren, Rob believes that change in these behaviours are critical to making progress with Lauren.  Refer to the video of a session between Lauren and Rob.

Key people in the enquiry

Rob suspects that Lauren has not been following his advice, particularly in relation to her asthma management regime. When he talks to her about her behaviours, Lauren becomes visibly upset so he often redirects his discussion away from what Lauren should be doing.  On these occasions he notices that Lauren’s mood lifts slightly and she appears a little more engaged for a short period of time before again showing signs of disinterest.  Although Rob likes working with Lauren generally, he is finding himself becoming increasingly frustrated with her general lack of progress.  In fact, he is wondering if Lauren’s general health and well-being are becoming worse rather than better in recent times so Rob suggests that Lauren’s mother and stepfather join them for one of the sessions. Refer to the video of a session between Rob, Lauren, Julie and David.

Task and Assessment

What you need to submit individually:

INDIVIDUAL POSTER (1,500 words) As described earlier, when completing your poster, you are to imagine that you have recently graduated in your chosen profession and are undertaking a four day ‘Working with adolescents’ workshop. This poster is to present information, as if it is directed to fellow participants in the ‘Working with Adolescents’ workshop, on how to facilitate behaviour change in adolescents.  You will be asked to use the case study of Rob and Lauren as illustrative material, focusing on how Rob should assist Lauren to take her asthma medication as recommended.  Specifically, you are instructed:

 1. To identify one of Lauren’s problematic behaviours (e.g. irritability due to low mood). Please explain how this behaviour is problematic and may be influencing her adherence to her asthma medication

.   

 2.  (a) To assess Rob’s helpful actions and comments that could assist Lauren to modify her behaviours and to take her asthma medication as recommended and;

 (b)To assess Rob’s unhelpful actions and comments that could inhibit Lauren from modifying her behaviours and adhering to her asthma medication regime;

 3. To identify potential modifications Rob could make in his actions and comments to optimise outcomes for Lauren, based on his unhelpful actions and comments you identified in Question 2b; and

 4. To describe the theoretical techniques Rob should employ to assist Lauren to take her asthma medication as recommended.

 Once you have created your online poster using Piktochart, it is available to download as an image (JPEG or PNG). In order for your assessment to be run through Turnitin, you are required to copy the downloaded image of your Piktochart onto a Word doc, with the text below. That way feedback can be given on the image and content (Turnitin doesn’t accept images as files by themselves).

  Resources

Case specific resources

• The written narrative of the case enquiry

• A video recording of a consultation between Rob and Lauren

• A video recording of a consultation between Rob, Lauren, Julie and David

Foundation reading

#All foundation reading can be found in the custom publication for the unit – Gerrig, R.J., et al. (2014). Individual Determinants of Health (3rd ed.). Frenchs Forest, N.S.W.: Pearson Australia This text has two sets of page numbers – the page numbers of the original texts are at the lower outside corner (in the case of Gerrig et al. 2011) or upper outside corner of each page (in the case of Morrison et al., 2012), whereas the page numbers of the resultant custom publication are in the box at the top of each page.  We have included both sets of page numbers in the reference below:  Gerrig, R. J., Zimbardo, P. G., Campbell, A. J., Cumming, S. R., & Wilkes, F. J. (2011). Psychology and Life (2nd ed.). Frenchs Forest, N.S.W.: Pearson Australia  Social psychology, pp 611-658 (p. 411-458 in the custom text)  Motivation, pp 408–420, 428–442 (p. 224-236, 244-258 in the custom text)  Psychological disorders, pp 529–573 (p. 137-181 in the custom text)