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Sample case study report format


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Sample case study report format

  1. 1. SOCIAL CASE STUDY REPORT Date: ______________ Family ID No: I. Identifying Information (Grantee) Name : Address : Birthdate : Highest Educational Report : Gender : Family Circumstances : (category of the HH) II. Family Composition Name Age Family Members Category (per member) Relationship to Client Civil Status Highest Educational Attainment Occupation Estimated Monthly Income III. Presenting Problem • From the Point of View of the Client (presenting problem) • From the Point of View of the Case Worker (immediate problem to work on and underlying problem anchored on the SWI results) IV. Background Information/ History A. Client – (Clear target who among the family members ,e.g. Grantee it should be grantee focused) –Biopschosocio-spiritual Republic of the Philippines Department of Social Welfare and Development
  2. 2. • Biological (Physical and Health Status) • Social Context (Role performance, relationship with others) • Psychological Context (Emotional and Cognitive) B. Family • Socio-economic status of the Family C. Environment/Community V. Current Family Functioning a. Role Performance b. Rules c. Relationships d. Rituals (decision-making, interaction, communication & problem-solving patterns) VI. Assessment (Based on findings/assessment based on the above and used of tools) • Strengths, motivations, opportunities for change • Limitations, weaknesses/constraints or obstacles to be overcome • Problem prioritization VII. Rehabilitation/Intervention Plan INTERVENTION PLAN/S FOR THE FAMILY Goal: Objectives: Need/Problem Interventions Activities Time Frame Responsible Person Remarks Efforts for economic sufficiency Compliance to Program conditionalities INTERVENTION PLAN/S FOR THE CHILD/CHILDREN Objectives: Problem Area Intervention/Activities Time Frame Responsible Person Remarks Compliance to health Health grant Compliance to education Education grant
  3. 3. VIII. Recommendations • Priority Actions to be taken based on the above Prepared by: Reviewed by: ___________ ____________________ Case Worker Registered Social Worker License No._________ License No___________ Approved by: ____________ Head of the Organization