The document presents a case study of a 26-year-old woman experiencing anemia and other symptoms related to her menstruation, which worsen during physical activity, especially golf. It details her medical history and laboratory findings that indicate potential microcytic anemia, and it prompts a further exploration of her background, current situation, and coping strategies in a structured format for analysis. Additional guidelines for a client system analysis are provided, emphasizing ethical considerations, cultural competency, assessment techniques, and goal-setting within a social work context.

1. Case Study 1
Case Study 1
Ms. A. is an apparently healthy 26-year-old white woman. Since
the beginning of the current golf season, Ms. A has noted
increased shortness of breath and low levels of energy and
enthusiasm. These symptoms seem worse during her menses.
Today, while playing in a golf tournament at a high,
mountainous course, she became light-headed and was taken by
her golfing partner to the emergency clinic. The attending
physician’s notes indicated a temperature of 98 degrees F, an
elevated heart rate and respiratory rate, and low blood pressure.
Ms. A states, “Menorrhagia and dysmenorrheal have been a
problem for 10-12 years, and I take 1,000 mg of aspirin every 3
to 4 hours for 6 days during menstruation.” During the summer
months, while playing golf, she also takes aspirin to avoid
“stiffness in my joints.”
Laboratory values are as follows:
Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count = 3.1 x 10/mm
RBC smear showed microcytic and hypochromic cells
Reticulocyte count = 1.5%
Other laboratory values were within normal limits.
Question
Considering the circumstances and the preliminary workup,
what type of anemia does Ms. A most likely have? In an essay
of 500-750 words, explain your answer and include rationale.

2. In a short essay (500-750 words), answer the Question at the
end of Case Study 1. Cite references to support your positions.
Prepare this assignment according to the APA guidelines found
in the APA Style Guide, located in the Student Success Center.
An abstract is not required.
You are required to submit this assignment to TURNITIN
© 2013. Grand Canyon University. All Rights Reserved.
Client System Analysis PowerPoint Guidelines
Select a client system for beginning problem analysis. This can
be an individual, couple, family, small treatment group, or
community task group. Limited contact—i.e. 1-2 encounters
with the client system—is acceptable and expected, since this is
your first semester in your field placement.
Client description and engagement:
Briefly describe your client system. Date of interview, name,
address, age, gender, ethnicity, religion, marital status and
history, referral source, etc. Caution: Remember
confidentiality: Do not use the client's real name and disguise
any other identifying information.
· Source of data: Include the individual(s) who provided
information and reason for the report. What brought the person
to treatment at this time? (A person does not come to treatment
because they have been depressed for nine months. They come
to treatment because they have reached the end of their rope.
What was that precipitating event?). Hint: Write this from the
client's perspective, e.g., "Mr. Jones reports that" or "Sammy
state that"...to maintain objectivity and report the source of
information.

3. · Client History: Include chronological developmental history
including all major events from prenatal to present. Include
information on: Medical and psychiatric history; intellectual
and emotional functioning; education; employment status and
patterns (including military); economic functioning; home and
neighborhood environment; drug or alcohol usage, including
assessment of addiction risk or history; relationship, intimacy,
and sexuality issues; history of violence, legal issues; religion;
recreation; etc.
· Current Situation: Including physical functioning and health
practices; intellectual, spiritual, and emotional functioning;
current significant relationships, including spouse, significant
others, friends, extended family, support systems; problem-
solving capacity; financial situation; legal involvements;
housing and transportation; use of community services.
Assessment
Describe the presenting problem: Include an analysis of the
problem as the client sees it, as defined by significant other
systems involved, and as you see it.
· Presenting Problem: How does the client define the problem?
When did the problem begin and how often is it currently
occurring? How long does the problem last? What happen right
before and after the problem? Where does the problem occur
physically? Why is this problem happening to the client at this
time? When was the problem not happening, or happening
differently?
· Coping Strategies: What has the client used in the past to
address, reduce, manage, or resolve the problem? Why is the
client having difficulty with the problem at this time? What is
the outcome the client wants with the problem? What is
preventing the client from using former coping strategies? What
is the capacity of the client to employ previous coping
strategies?
· Strengths: Discuss the prosocial behaviors, positive attitudes
or thoughts, strengths, resources, access of services and

4. motivation of the client, which you discovered during the
process of problem identification and assessment. Describe
how at least one of these prosocial behaviors, positive attitudes
or thoughts, strengths, resources, access of services, and/or
motivation of the client could be pivotal in the development of
an intervention plan.
· Interplay of presenting problem and coping: Briefly discuss
how the presenting problem and coping strategies effect the
client’s daily life, the purpose the presenting problem and
coping strategies serve, and the ways they operate in the client’s
intrapersonal, interpersonal, or environmental experience.
· Provide at least 2 plausible hypotheses for the etiological
factors (underlying or root causes) of the problem and/or the
sustaining factors (features maintaining the problem). A
hypothesis is a tentative explanation about the cause and nature
of the presenting problems, including both etiological and
sustaining factors. Make sure that your hypotheses reflect at
least two levels: intrapersonal (within the client’s mind e.g.
self-talk), interpersonal (between different people), or
environmental (outside of the client, but impinging upon the
functioning of the client e.g. sexism, classism, racism, policy,
discriminatory practices, police brutality, unaffordable housing,
barriers in access to quality services, failing school systems to
name a few).
· Practice theory application: Using 5 scholarly sources outside
of the course textbook, select a practice theory, such as
cognitive-behavioral, humanistic, trauma-informed practice, to
guide your understanding of the client’s problem. Review
scholarly literature on practice theories and select the best
theory that identifies the etiological and sustaining factors of
the underlying dynamics, causal roots, or explanatory
mechanisms contributing to the client’s problem. Present the
guiding principles of the theory, Then, discuss how those
principles guide your understanding of the client’s problem and
steps toward goal attainment. Use the theory and evidence
provided by the client to develop the contracting and planning

5. for intervention.
Contracting and Planning for Intervention
Describe the process of moving from problem identification to
contracting and goal setting with your client system.
· Evaluate the status of your relationship with the client. How
will you maintain (or if needed) improve it?
· Describe diversity and cultural differences (race/ethnicity,
class, education, gender, sex, socioeconomic status, religion)
that exists between you and the client system. How did you
address diversity and cultural differences within your
relationship with the client? What effects will these differences
have on your relationship with the client? What were your
stereotypes, biases, and assumptions about the client? What
steps did you take to avoid practicing from a place of
stereotypes, biases, and assumptions? What did you do to
become culturally competent, sensitive, and responsive with
your client? Give one example where you demonstrated cultural
humility.
· Briefly describe any missteps you had in contracting and goal-
setting for intervention. How did you recover?
· Specifically, describe the contract and goals that you have
developed or are developing to address the problem-for-work
you identified. In particular, comment on the nature of the
contract established (verbal, written, implicit, explicit) and the
rationale for your choice. Write 1 – 3 goals for your client
using the S.M.A.R.T. format. SMART refers to specific,
measureable (time, frequency, duration, or intensity/magnitude),
attainable, relevant, and time-bound.
· Evaluate the quality of your goals. How specific are your
goals? Measurable? Did you develop them with the client?
How will you know when the client has achieved each goal?
What will you use to measure the success of each goal?
· Identify 2 social work values presented in the NASW Code of
Ethics that are relevant to any stage of the helping process (e.g.
engagement, assessment, planning/contracting, implementation,

6. evaluation, termination, and follow-up) with the client. Discuss
how your work with the client demonstrates the chosen ethical
standards.
Client System Analysis
Select a client system for beginning problem analysis. This can
be an individual, couple, family, small treatment group, or
community task group. Limited contact—i.e. 1-2 encounters
with the client system—is acceptable and expected, since this is
your first semester in your field placement.
Engagement
Client description and engagement: Briefly describe your client
system (about 2 pages). Date of interview, name, address, age,
gender, ethnicity, religion, marital status and history, referral
source, etc. Caution: Remember confidentiality: Do not use the
client's real name and disguise any other identifying
information.
a. Source of data: Include the individual(s) who provided
information and reason for the report. What brought the person
to treatment at this time? (A person does not come to treatment
because they have been depressed for nine months. They come
to treatment because they have reached the end of their rope.
What was that precipitating event?). Hint: Write this from the
client's perspective, e.g., "Mr. Jones reports that" or "Sammy
state that"...to maintain objectivity and report the source of
information.
b. Client History: Include chronological developmental history
including all major events from prenatal to present. Include
information on: Medical and psychiatric history; intellectual
and emotional functioning; education; employment status and
patterns (including military); economic functioning; home and
neighborhood environment; drug or alcohol usage, including
assessment of addiction risk or history; relationship, intimacy,
and sexuality issues; history of violence, legal issues; religion;

7. recreation; etc.
c. Family History: Include chronological history of family and
brief descriptive information about family members. Include
three generations of family, including the client's own
generation. Hint: Keeping information about each person in
the family in one section or paragraph allows the reader to
develop a picture of each family member.
d. Current Situation: Including physical functioning and health
practices; intellectual, spiritual, and emotional functioning;
current significant relationships, including spouse, significant
others, friends, extended family, support systems; problem-
solving capacity; financial situation; legal involvements;
housing and transportation; use of community services. Draw
and complete an eco-map. If possible complete the eco-map
with the client and describe the process.
Assessment
e. Describe the problem-for-work of your client system. Include
an analysis of the problem as the client sees it, as defined by
significant other systems involved, and as you see it.
1. Presenting Problem: How does the client define the problem?
When did the problem begin and how often is it currently
occurring? How long does the problem last? What happen right
before and after the problem? Where does the problem occur
physically? Why is this problem happening to the client at this
time? When was the problem not happening, or happening
differently?
2. Coping Strategies: What has the client used in the past to
address, reduce, manage, or resolve the problem? Why is the
client having difficulty with the problem at this time? What is
the outcome the client wants with the problem? What is
preventing the client from using former coping strategies? What
is the capacity of the client to employ previous coping
strategies?
f. Strengths (1/2 page): Discuss the prosocial behaviors,
positive attitudes or thoughts, strengths, resources, access of
services and motivation of the client, which you discovered

8. during the process of problem identification and assessment.
Describe how at least one of these prosocial behaviors, positive
attitudes or thoughts, strengths, resources, access of services,
and/or motivation of the client could be pivotal in the
development of an intervention plan.
g. Interplay of presenting problem and coping (1/2 page):
Briefly discuss how the presenting problem and coping
strategies effect the client’s daily life, the purposes they
(presenting problem and coping strategies) serve, and the ways
they operate in the client’s intrapersonal, interpersonal, or
environmental experience.
i. Provide at least 2 plausible hypotheses for the etiological
factors (underlying or root causes) of the problem and/or the
sustain factors (features maintaining the problem). A
hypothesis is a tentative explanation about the cause and nature
of the presenting problems, including both etiological and
sustaining factors.
ii. Make sure that your hypotheses reflect at least two of the
three levels: intrapersonal (within the client’s mind e.g. self-
talk), interpersonal (between different people), or
environmental (outside, but impinging upon the person).
h. Practice theory application (1-2 pages): Using 2 outside (i.e.,
non-textbook) sources, refer to practice theory, such as
cognitive-behavioral, humanistic, trauma-informed practice, to
guide your understanding of the client’s problem. Review
scholarly literature on practice theories and select the best
theory that identifies the etiological and sustaining factors of
the underlying dynamics, causal roots, or explanatory
mechanisms contributing to the client’s problem. Use the theory
and evidence provided by the client to develop your case plan.
Contracting and Planning for Intervention
i. Describe the process of moving from problem identification
to contracting and goal setting with your client system.
j. Evaluate the status of your relationship with the client. How
will you maintain (or if needed) improve it?

9. k. Describe diversity and cultural differences (race/ethnicity,
class, education, gender, sex, socioeconomic status, religion)
that exists between you and the client system. How did you
address diversity and cultural differences within your
relationship with the client? What effects will these differences
have on your relationship with the client? What were your
stereotypes, biases, and assumptions about the client? What
steps did you take to avoid practicing from a place of
stereotypes, biases, and assumptions? What did you do to
become culturally competent, sensitive, and responsive with
your client? Give one example where you demonstrated cultural
humility.
l. Briefly describe any missteps you had in contracting and
goal-setting for intervention. How did or would you recover?
m. Specifically, describe the contract and goals that you have
developed or are developing to address the problem-for-work
you identified. In particular, comment on the nature of the
contract established (verbal, written, implicit, explicit) and the
rationale for your choice. Write 1 – 3 goals for your client
using the S.M.A.R.T. format. SMART refers to specific,
measureable (time, frequency, duration, or intensity/magnitude),
attainable, relevant, and time-bound.
n. Evaluate the quality of your goals. How specific are your
goals? Measurable? Did you develop them with the client?
How will you know when the client has achieved each goal?
What will you use to measure the success of each goal?
o. Identify 2 social work values presented in the NASW Code of
Ethics that are relevant to any stage of the helping process (e.g.
engagement, assessment, planning/contracting, implementation,
evaluation, termination, and follow-up) with the client. Discuss
how your work with the client demonstrates the chosen ethical
standards.