SOAP Notes

S

The client presented with recently moving back home to live her parents, bringing along her boyfriend, and she states that the living environment is “crazy”.

 

O

The client has anxiety about her living situation. She has recently moved back home with her parents, wants to move out, but has no money to do so. She does not have a job and she is a student part time. Her parents are dysfunctional. Her mother has borderline personality disorder and her father is in denial of the situation and states that the mother is not mentally ill. When she moved back home one of the conditions with the parents was she must have a relationship with her mother. Her mom is verbally abusive. Her bf lives with her and her mother is pressuring her marry her boyfriend. She is not sure but she does not really feel she wants to marry the boyfriend and states he is too clingy. She claims that he is not physically abusive but sometimes makes her feel comfortable by making her do things she does not want to do. To cope she goes out with friends and drinks socially and feels her friends are her only stable support system. She denies the currently use of drugs, but does admit using drugs when she was younger. Even though she shared that there are no boundaries within this household, she is currently taking medication for depression, is unhappy and anxious, she states she has no problems sleeping.  

 

A

Cf is currently being medicated for depression. She has anxiety about her living situation living at home with her parents and bf.  Her mother has borderline personality disorder. Her mom is verbally abusive and has no boundaries. Dad never set boundaries and denies that the mother is ill. When she moved back home one of the conditions to live there was to have a relationship with her mother. Her mom is pressuring her to marry her boyfriend but she does not want to. Her bf can be too clingy. He is not abusive but sometimes she feels uncomfortable around him. She wants to move out to develop her independence but has no money to do so. She does not have a job and she is a student part time. She goes out with her friends and drinks socially to cope.

 

P

I recommend that cf receive some personal counseling to help develop strategies to cope with mother’s mental illness and dad’s passive behavior. She needs assistance locating better housing and with job searching to be able to make money to move out. She needs help developing financial independence and budgeting. She may want to consider tabling continuing her education at this time until some of her more pressing issues are addressed. She needs relationship counseling to be able to set boundaries and decide whether is she is going to continue or not with her present partner. She needs guidance with setting self-goals.

 

 

First impressions of Bridget:

Drug user accompanied by illegal activity, is promiscuous, and has a criminal record charged with a felon.

 

Why do you have these impressions?

Society’s rules and expectations

My own personal prejudges

Human service background

 

What is your more systematic judgment of Bridget?

Poor parental supervision while growing up

Raised in an alcoholic and eventually no father in the home and a mother with depression

Associates with a boyfriend who encourages and partners with the drug use and illegal activities

Poor self-esteem

Poor decision making

Criminal behavior

 

How did you first impression change and why?

The case study provided more information about how deeply involved she is in the drug society and criminal behavior and therefore gave me more insight into who she really is currently.

 

Do you think Bridget internally or externally is more influenced?

I believe that Bridget within herself and her environment both contribute to present situation. She actively choses to be with a boyfriend who seems to be an instigator of the her drug use because when she is not around him she seems to do better while living at home with her mother. However, the previous use of drugs many times can lead to relapses regardless of who the person is currently associating with at the time.

 

How does fundamental attribution error apply to our thoughts about Bridget?

Fundamental attribution error does contribute to my thoughts because some of her decision making is definitely contributing to her issues, however I am the type of person who has chosen not to make her type of decisions and feel that I have a better quality of live because of my decision making.

 

What social categories does Bridget belong?

Poor

Low education level

Needing of AA

Female

Age 22

Adult US citizen

Unemployed frequently

 

What social categories do you belong?

Middle class

College education

No need for AA

Female

Age 21

Adult US citizen

Employed in 2 part-time jobs and full time college

In what ways is Bridget in your in group or out group?

She would not be in my in-group. I do not support people who use drugs and not have a job; therefore I am aware that my assessment of her would be more critical.

 

Did you stereotype Bridget after reading the first 2 paragraphs, describe and did the stereotype remain?

Yes I did stereotype her as an addict and after reading more of her case it reinforced my impressions and assessment for what she needs to do to improve her life.