a. SOCIAL HISTORY/BIOPSYCHOSOCIAL (due March 16)
b. SERVICE PLAN (due April 16, 2026)
a & b: 1. Student is to conduct a series of interviews (5+) with an adult individual with a long term vulnerabilities
(i.e. the elderly, individuals with developmental, physical and/or mental disabilities or illness, dependent or
abused children, alcoholic or substance abusers). Explain to him/her the purpose of this college assignment and
obtain written permission to conduct interviews and speak with family members/service providers through a
disclosure form you create. This form should inform the individual the purpose of the interview, that all identifying
information will be changed for confidentiality, signed by the individual, student and dated. Do not submit the
form to the Instructor, since it will have the individuals name. Students can choose a classmate, co-worker,
neighbor, client in an agency) Do not choose family, close friend or a minor. If possible, student is to consult the
individuals family, friends, support systems/service providers. After completing the interviews, summarize and
organize relevant facts.
2. Gather all relevant information, from the interviews to write a: a. Social History (aka Biopsychosocial) b.
Service Plan.
Utilize the text as well as the following instructions. Each assignment is due on different dates.
a. SOCIAL HISTORY/BIOPSYCHOSOCIAL Note on page one that all identifying information has been changed for
confidentiality.
1. Presenting Problem One paragraph for a-c
a. Source of referral
b. Reason for case management assessment and intervention, current problem(s), diagnosis.
c. Demographics: Client age, ethnicity, race, religion, birthplace, marital status, living situation, location,
employment status, etc.
2. Complete an extensive history of the client in all of the following:
Areas:
A. Psychiatric (Mental Illness)
B. Psychological (Intellectual Disability)
C. Family (issues, abuse)
D. Medical (diseases, exams, prevention, meds)
E. Social/Interpersonal (support systems, hobbies, etc)
F. Education/Vocational (special ed, GED, college, skills, etc)
G. Housing (Independent, daily skills, etc)
H. Legal (divorce, ACS, bankruptcy, warrants, immigration, etc)
I. Substance Abuse (use, abuse, dependency)
J. Employment (termination, seeking, resume, skills, etc)
K. Finances (debt, budgets, etc) -Write a brief summary of the history (1-2 paragraphs) -Complete the five Axis
(DSM) -Sign Your Name/Title
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