Assignment Prompt & Instructions
– ## ClientOverview2ndPart-.docx
– ## Instructions-6thPart-EthicsConclusion.docx
– ## PolicyandSocialJustice3rdPart.docx
– InterventionEvaluation5thPart.docx
– EngagementAssessmentHBSETheory4thPart.docx
– IntegrativePaperOutline1stPart-.docx
**## ClientOverview2ndPart-.docx**
5
**Client Overview**
**Client Overview**
This paper describes the client who is receiving services at Center to Rise Wellness Spa Studio in Arlington, Texas, and his struggles with generalized anxiety disorder and alcohol dependency. They are treated with dual diagnosis within the Mental Health and Substance Misuse specialization, and the overview sets the context for this treatment.
**Practice Setting**
The client practice setting is Center to Rise Wellness Spa Studio, Arlington, Texas. The specialty of this therapy clinic is mental health and substance misuse interventions with individual therapy, group support, and holistic wellness services like mindfulness and stress management. The agency’s multidisciplinary team provides a recovery-supportive environment, especially for individuals with co-occurring disorders, by using evidence-based practices to treat complex needs (Center to Rise Wellness Spa Studio, 2023). It focuses on dual-diagnosis treatment, which meets the client’s needs in a community-based setting.
**Practice Situation**
This is a client who is a 35-year-old person who has generalized anxiety disorder and alcohol dependency, which hinder the client’s employment and social relationships. Their anxiety is persistent, uncontrollable worry that interferes with daily functioning and causes emotional distress. Alcohol use is used as a maladaptive coping mechanism, which worsens social isolation and occupational instability and thus perpetuates the cycle of dependency (SAMHSA, 2024). This dual diagnosis is a complicated practice situation that requires integrated therapeutic interventions to deal with both problems simultaneously. The client’s challenges point to the interplay between mental health and substance misuse and the need for tailored, evidence-based strategies for recovery and enhancing quality of life.
**Connection to Specialization**
The mental health and substance misuse specialization directly relates to the client’s co-occurring disorders. But their challenges illustrate the importance of integrated care models that address mental health and substance use at the same time. Dual-diagnosis treatment, as SAMHSA (2024) states, can be effective only when it is comprehensive and includes therapy, motivational strategies, and relapse prevention. The specialization’s concentration on handling intricate situations involving the combination of anxiety and alcohol dependency, as found in the client’s situation, emphasizes the need for evidence-based approaches, for example, motivational interviewing and cognitive behavioral therapy (Lee & Sherman, 2024). Specialized knowledge of the client and the care system can be used in this case to create client-centered interventions, advocate for equitable care, and work to dismantle systemic barriers to recovery.
**Social and Contextual Factors**
The client’s low socioeconomic status and limited access to resources in Arlington only exacerbate their challenges, which are symptomatic of broader systemic issues in the access to mental health care. Ware (2025) notes that rural and underserved communities often have barriers to integrated treatment, which in turn reduces the client’s ability to consistently engage in care. Other cultural factors, such as stigma associated with mental health and substance use issues, complicate help-seeking behaviors. Culturally adapted engagement strategies are used by social workers in order to build trust and make sure that interventions are resonating with the client’s background (Lee & Sherman, 2024). These factors indicate the need for treatment planning that addresses social determinants of health.
**Reason for Intervention Need**
This client is in need of intervention due to the prevalence of co-occurring disorders. According to SAMHSA (2024), an estimated 9.2 million U.S. adults suffer from both mental health and substance use disorders each year, highlighting the public health importance of dual-diagnosis treatment. The client is impaired and using alcohol to cope with this impairment, which indicates the need for immediate intervention to avoid further deterioration. Through the Mental Health and Substance Misuse specialization, the social worker will be able to help the client to work towards recovery while utilizing evidence-based practices in order to provide sustainable results.
**References**
Center to Rise Wellness Spa Studio. (2023). About us. Retrieved from
[https://centertorise.com/](https://centertorise.com/)
Lee, C. S., & Sherman, D. K. (2024). Integration of motivational interviewing and self-affirmation theory into a culturally adapted motivational interview: A case study.
_Clinical Case Studies, 23_(3), 212-229.
[https://doi.org/10.1177/15346501231222554](https://doi.org/10.1177/15346501231222554)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from
[https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf](https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf)
Ware, A. M. (2025). Medical social workers’ self-efficacy and perceptions of interdisciplinary collaboration managing patients with co-occurring chronic pain and opioid use disorder (Doctoral dissertation, Walden University).
[https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y](https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y)
**## Instructions-6thPart-EthicsConclusion.docx**
**Ethics & Conclusion Instructions** (6th & Final part of the integrative paper outline)
**INSTRUCTIONS**
**Micro Instructions for Ethics and Conclusion**
**NASW Code of Ethics**
Provide a general discussion of how the NASW Code of Ethics guides social work practice and how to be an ethical practitioner as it relates to this practice situation.
**Ethical Dilemma and/or Value Conflict**
Identify and describe one or more potential ethical and values dilemmas related to this practice situation. This should be different from the values and ethical dilemmas you considered in previous assignments in this course.
**Application of the Code of Ethics to Selected Case**
Apply the NASW Code of Ethics to this practice situation to resolve the ethical dilemma described.
**Next Steps for the Client and Agency**
Provide an overall conclusion that discusses the next steps for the client/agency at the conclusion of your work.
**Required – 2 pages for this section.**
(Please use the references that you mentioned in the outline for this section and you can also add additional references) Please also use subheadings as needed.
**Remember, this section of the paper should be written in 3rd person.**
**Refer to the rubric below for evaluation criteria.**
Please find attached the outline that was completed as the first part of this assignment and all the other parts that were completed for this assignment. The 1st outline will serve as the foundation for the remaining sections.
I’ve also attached the full assignment description and instructions, which detail the requirements for each section. These sections are due every two weeks, and I will be submitting a request for each part accordingly. You’ve already completed the Integrative Paper Outline, Client Overview, Policy and Justice & Engagement, Assessment & HBSE theory sections, Intervention and Evaluation. Now we’re on the 6th part.
Please continue to follow the structure established in the initial outline. Each section has specific page requirements, which I will clearly indicate when assigning them every two weeks.
Thank you again for all your help.
**_Full Description of Major Assessments and Examinations_**
The purpose of this paper is to demonstrate a comprehensive understanding of practice and theory in your area of specialization. Select a client, client system or target population from your graduate level social work Practicum. The selected client or client system should reflect your chosen specialization. For example, if you are a CAP student you should select an agency, community or other social intervention. If your specialization is mental health, you should chose an individual, family or small group with mental health and/or substance misuse issues and concerns. If your area of specialization is family and children, you should choose an individual, family or small group with issues and concerns related to family and children. The client system you choose for your paper should be a real case from your Practicum placement. If you have an issue or problem with selecting a case from your Practicum placement, please see or talk with your instructor. All exceptions must be approved by the instructor. In no circumstances are family members, friends, or characters from media to be used as the client system in the paper.
(My specialization is Mental health)
**Integrative Paper Outline**
Use the template in the assignments module to complete the outline assignment. The template is set up so you can compose directly onto the document, save, and upload as your assignment submission.
**Client Situation. (Overview)**
Describe the client system. (e.g., individual, family, other small group, larger group, team, program, agency, organization or community) and the client’s situation that is the reason for your intervention. Include a discussion of how this client’s situation fits into your area of specialization. For example, if your area of specialization is mental health, describe how the client’s issues/concerns fit the definition of mental health, mental illness, and/or mental well-being.
Apply, synthesize and analyze knowledge, theory, and skills in relation to the client system.
**Engagement, Assessment, Human Behavior and the Social Environment**
Describe how you did engage the client in the assessment and intervention. What specific skills did you use to engage the client?
Describe your efforts to collect, organize and interpret information about the client. What are the client’s strengths and limitations?
Your assessment should include a discussion of relevant issues of age, class, color, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, sex, stigma, and/or sexual orientation as applicable to your client. Be sure that your discussion of diversity links well with the client and or client situation.
Discuss how the issues of social and economic justice and human and civil rights may relate to this specific practice situation.
Select and describe one or more of the most relevant HBSE theories that contribute to the client’s issues and concerns.
Briefly explain the theory and how this theory is relevant to your client’s area of concern/problem situation.
**Policy and Social Justice**
Select and describe one or more of the most relevant social policies relevant to the practice situation. This policy section refers to state and federal policies (laws, court decisions, or regulations), not agency policy. Be sure to cite the laws and policies correctly (as you should with all literature you reference).
Briefly explain the policy and how it is relevant to your client’s area of concern/problem situation.
Use a policy analysis model to analyze the effectiveness of the policy for the general client group you have chosen and then your client specifically. Include carefully referenced literature sources including books; peer-reviewed journal articles; research studies; government documents, reports and data; and web sites. While this is not expected in the space available to be a full policy analysis, you should draw on one of the policy analysis models with which you are familiar, and reference the model fully.
Based on your analysis, what would you advocate in terms of policy review, application, formulation, or revision?
**Intervention and Evaluation**
Present a mutually developed and agreed upon intervention strategy with specific goals and objectives. Provide a rationale for your selection.
Describe your intervention from beginning to end, including termination. How did you help the client prevent or resolve problems? How did you negotiate mediate and advocate for your client. Select and discuss at least 3 practice skills (micro/macro) used in your intervention with the client.
Write a critique of your work with the client. What did you do well in terms of the intervention? What could have been done to improve the outcomes with the client? How was the intervention empowering? How may it have been discriminatory or oppressive?
Provide a discussion of whether the intervention was developed from a theoretical practice model. If so, which practice theory? If not, what practice theory could have been used to facilitate better outcomes? Regardless, analyze and provide evidence- based knowledge about the theory-based intervention (used or proposed) and its effectiveness.
Select one of the methods used to evaluate change and improvement with clients/client systems (single subject, pretest/posttest or other). Provide a rationale for the evaluation method you selected. Describe the method and how you would facilitate using that method to collect data to assess change and improvement.
**Ethics and Conclusion**
Critically review your practice situation and intervention as an external observer and comment on the following:
Identify and describe one or more potential ethical and values issues related to this practice situation. Be sure to reference the NASW Code of Ethics in your discussion.
Discuss how this assignment raises issues of professional strengths and challenges. Formulate a plan for lifelong professional learning and continuing education.
NOTE: The final document should be between 20-25 double-spaced pages (not including references or a cover page) and in 12-point font. Your paper must adhere to APA style (6th edition).
## image1.png
**## PolicyandSocialJustice3rdPart.docx**
1
**Policy and Social Justice**
**Policy and Social Justice**
This section is an analysis of how a federal social policy can be applied to treat a 35-year-old client with generalized anxiety disorder and alcohol dependency in Center to Rise Wellness Spa Studio in Arlington, Texas. It is aligned with the mental health and substance misuse specialization through the policy analysis and recommendations, exploration of the social justice and ethical considerations, and rigorous policy analysis.
**Policy Selected**
The Affordable Care Act (ACA), which was implemented in 2010, is a federal policy that requires insurance coverage of mental and substance use disorder services to be on par with physical health services (CMS, 2023). This policy is essential to the client, who is a 35-year-old patient under dual-diagnosis treatment at Center to Rise Wellness Spa Studio in Arlington, Texas. The ACA allows one to access integrated care, including evidence-based interventions, including cognitive behavioral therapy (CBT) and motivational interviews, which can alleviate the client of occupational and social impairments due to the presence of persistent anxiety and alcohol dependency. Nevertheless, the policy is limited in its application by the fact that it faces implementation difficulties in rural settings such as certain areas in Arlington (shortage of providers and poor healthcare infrastructure), and, therefore, its effectiveness is limited to low-income clients (Patel & Jones, 2023). Such barriers contribute towards the inability of the client to get consistent care, which makes it hard to recover. The focus on mental health parity provided by the ACA is critical to helping the client receive the treatment he or she needs, yet there are improvements that need to be made in order to support the detailed needs of the client and enhance his or her overall quality of life.
**Policy Analysis Model**
The Karger and Stoesz (2021) policy analysis model allows examining the ACA through the prism of access, equity, and affordability and provides a solid framework to examine its effect on clients with co-occurring disorders. Mental health and substance use services are also more accessible under the ACA, but the absence of providers in rural areas critically restricts the ability to provide the client with timely care, causing delays in treatment that only worsen the symptoms (Ware, 2025). Inconsistency in Medicaid expansion among the states is a violation of equity, which disproportionately harms the low-income and minority groups, such as the client, who experiences systemic factors that restrict long-term treatment involvement (Nam et al., 2021). Although the affordability has been enhanced due to the low out-of-pocket expenses, it is still a major issue, as deductibles and copays are too high and bring financial pressure on the client due to their low socioeconomic status (Priester et al., 2022). This discussion shows the improvements made by the ACA on expanding coverage and the key systemic obstacles that reduce its effectiveness to address the complex needs of the client, which require strategic measures to increase its effectiveness.
**Policy Recommendations**
To strengthen the ACA’s effectiveness, policymakers should implement strategic reforms tailored to the needs of clients with co-occurring disorders. Increasing funding for telehealth services would mitigate rural provider shortages, enabling clients like the one at Center to Rise to access remote therapy, ensuring treatment continuity and flexibility for those in underserved areas (Ford et al., 2021). Standardizing Medicaid expansion across states would promote equitable access to dual-diagnosis treatment, reducing disparities for low-income clients who depend on public insurance to cover essential services. Subsidizing copays and deductibles for mental health and substance use services would improve affordability, alleviating financial barriers for clients with limited resources and enabling consistent engagement in care (Patel & Jones, 2023). Additionally, enhancing workforce development programs to train more mental health professionals in rural areas would address long-term access issues. These recommendations target critical gaps in access, equity, and affordability, strengthening the ACA’s capacity to support recovery and foster sustainable outcomes for individuals with complex behavioral health needs.
**Social Justice Implications**
The ACA advances social justice by mandating mental health parity, aligning with the NASW Code of Ethics’ commitment to equitable care access (NASW, 2021). Nevertheless, rural disparities and socioeconomic barriers undermine health equity, disproportionately impacting low-income clients like the one described, who struggle to maintain consistent treatment engagement due to systemic limitations (Rodriguez & Green, 2021). These inequities contravene principles of fair resource distribution, necessitating a comprehensive, multi-level advocacy plan. At the micro level, the social worker can educate the client on ACA-covered resources, such as subsidized therapy and community support programs, to optimize their access to essential services. At the mezzo level, partnering with Center to Rise to develop telehealth programs and community outreach initiatives would enhance service delivery for rural clients, improving community-level access. At the macro level, advocating through NASW for increased ACA funding for underserved areas and policy reforms to address rural healthcare disparities would tackle systemic inequities, promoting equitable access across diverse populations (Suleiman, 2025). This multi-level approach empowers the client, fosters fairness within their community, and aligns with social work’s commitment to justice.
**Ethical Challenge and/or Value Conflict**
An ethical conflict emerges from disparities in ACA implementation, which conflict with NASW’s social justice principle (Standard 6.04) mandating equitable resource access (NASW, 2021). The client’s limited access to care, driven by rural provider shortages and financial barriers, challenges the social worker’s obligation to ensure fair treatment, creating a tension between providing immediate client support and advocating for systemic change (Reamer, 2021). This dilemma requires balancing the client’s autonomy with the need to address barriers that threaten their well-being, such as potential escalation of alcohol use. Resolving this conflict involves prioritizing client-centered interventions, such as connecting the client to available resources and support networks, while simultaneously advocating for policy reforms to enhance access, ensuring alignment with ethical standards and the NASW Code of Ethics’ emphasis on justice, dignity, and equitable care.
**References**
CMS. (2023). Affordable Care Act: Mental health and substance use disorder services. Retrieved from
[https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use](https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use)
Ford, J. H., Kaur, A., Rao, D., Gilson, A., Bolt, D. M., Garneau, H. C., … & McGovern, M. P. (2021). Improving medication access within integrated treatment for individuals with co-occurring disorders in substance use treatment agencies. Implementation Research and Practice, 2, 26334895211033659.
[https://doi.org/10.1177/26334895211033659](https://doi.org/10.1177/26334895211033659)
Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson.
Nam, E., Lee, E., & Kim, H. (2021). 10-year trends of emergency department visits, wait time, and length of stay among adults with mental health and substance use disorders in the United States. Psychiatric Quarterly, 92(3), 1159-1174.
[https://doi.org/10.1007/s11126-021-09894-y](https://doi.org/10.1007/s11126-021-09894-y)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
Patel, S., & Jones, K. (2023). The impact of ACA on mental health equity: A 10-year review. Health Affairs, 42(5), 620-628.
[https://doi.org/10.1377/hlthaff.2022.01523](https://doi.org/10.1377/hlthaff.2022.01523)
Priester, M. A., Browne, T., Iachini, A., Clone, S., & Dehart, D. (2022). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 132, 47-59.
[https://doi.org/10.1016/j.jsat.2021.108047](https://doi.org/10.1016/j.jsat.2021.108047)
Reamer, F. G. (2021). The trolley problem and the nature of intention: Implications for social work ethics. Journal of Social Work Values and Ethics, 18(2), 43-54.
[https://jswve.org/volume-18/issue-2/item-08/](https://jswve.org/volume-18/issue-2/item-08/)
Rodriguez, M., & Green, T. (2021). Social justice implications of healthcare policy in the United States. Journal of Social Work, 21(3), 345-360.
[https://doi.org/10.1177/1468017320987654](https://doi.org/10.1177/1468017320987654)
Suleiman, F. M. S. (2025). Social justice and economic policy: Analyzing the interplay between welfare and market forces. The Open European Journal of Social Science and Education (OEJSSE), 34-45.
[https://easdjournals.com/index.php/oejsse/article/view/6](https://easdjournals.com/index.php/oejsse/article/view/6)
Ware, A. M. (2025). Medical social workers’ self-efficacy and perceptions of interdisciplinary collaboration managing patients with co-occurring chronic pain and opioid use disorder (Doctoral dissertation, Walden University).
[https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y](https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y)
**InterventionEvaluation5thPart.docx**
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**EngagementAssessmentHBSETheory4thPart.docx**
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**IntegrativePaperOutline1stPart-.docx**
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**IntegrativePaperOutline1stPart-.docx**
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**## ClientOverview2ndPart-.docx**
5
**Client Overview**
**Client Overview**
This paper describes the client who is receiving services at Center to Rise Wellness Spa Studio in Arlington, Texas, and his struggles with generalized anxiety disorder and alcohol dependency. They are treated with dual diagnosis within the Mental Health and Substance Misuse specialization, and the overview sets the context for this treatment.
**Practice Setting**
The client practice setting is Center to Rise Wellness Spa Studio, Arlington, Texas. The specialty of this therapy clinic is mental health and substance misuse interventions with individual therapy, group support, and holistic wellness services like mindfulness and stress management. The agency’s multidisciplinary team provides a recovery-supportive environment, especially for individuals with co-occurring disorders, by using evidence-based practices to treat complex needs (Center to Rise Wellness Spa Studio, 2023). It focuses on dual-diagnosis treatment, which meets the client’s needs in a community-based setting.
**Practice Situation**
This is a client who is a 35-year-old person who has generalized anxiety disorder and alcohol dependency, which hinder the client’s employment and social relationships. Their anxiety is persistent, uncontrollable worry that interferes with daily functioning and causes emotional distress. Alcohol use is used as a maladaptive coping mechanism, which worsens social isolation and occupational instability and thus perpetuates the cycle of dependency (SAMHSA, 2024). This dual diagnosis is a complicated practice situation that requires integrated therapeutic interventions to deal with both problems simultaneously. The client’s challenges point to the interplay between mental health and substance misuse and the need for tailored, evidence-based strategies for recovery and enhancing quality of life.
**Connection to Specialization**
The mental health and substance misuse specialization directly relates to the client’s co-occurring disorders. But their challenges illustrate the importance of integrated care models that address mental health and substance use at the same time. Dual-diagnosis treatment, as SAMHSA (2024) states, can be effective only when it is comprehensive and includes therapy, motivational strategies, and relapse prevention. The specialization’s concentration on handling intricate situations involving the combination of anxiety and alcohol dependency, as found in the client’s situation, emphasizes the need for evidence-based approaches, for example, motivational interviewing and cognitive behavioral therapy (Lee & Sherman, 2024). Specialized knowledge of the client and the care system can be used in this case to create client-centered interventions, advocate for equitable care, and work to dismantle systemic barriers to recovery.
**Social and Contextual Factors**
The client’s low socioeconomic status and limited access to resources in Arlington only exacerbate their challenges, which are symptomatic of broader systemic issues in the access to mental health care. Ware (2025) notes that rural and underserved communities often have barriers to integrated treatment, which in turn reduces the client’s ability to consistently engage in care. Other cultural factors, such as stigma associated with mental health and substance use issues, complicate help-seeking behaviors. Culturally adapted engagement strategies are used by social workers in order to build trust and make sure that interventions are resonating with the client’s background (Lee & Sherman, 2024). These factors indicate the need for treatment planning that addresses social determinants of health.
**Reason for Intervention Need**
This client is in need of intervention due to the prevalence of co-occurring disorders. According to SAMHSA (2024), an estimated 9.2 million U.S. adults suffer from both mental health and substance use disorders each year, highlighting the public health importance of dual-diagnosis treatment. The client is impaired and using alcohol to cope with this impairment, which indicates the need for immediate intervention to avoid further deterioration. Through the Mental Health and Substance Misuse specialization, the social worker will be able to help the client to work towards recovery while utilizing evidence-based practices in order to provide sustainable results.
**References**
Center to Rise Wellness Spa Studio. (2023). About us. Retrieved from
[https://centertorise.com/](https://centertorise.com/)
Lee, C. S., & Sherman, D. K. (2024). Integration of motivational interviewing and self-affirmation theory into a culturally adapted motivational interview: A case study.
_Clinical Case Studies, 23_(3), 212-229.
[https://doi.org/10.1177/15346501231222554](https://doi.org/10.1177/15346501231222554)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from
[https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf](https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf)
Ware, A. M. (2025). Medical social workers’ self-efficacy and perceptions of interdisciplinary collaboration managing patients with co-occurring chronic pain and opioid use disorder (Doctoral dissertation, Walden University).
[https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y](https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y)
**## Instructions-6thPart-EthicsConclusion.docx**
**Ethics & Conclusion Instructions** (6th & Final part of the integrative paper outline)
**INSTRUCTIONS**
**Micro Instructions for Ethics and Conclusion**
**NASW Code of Ethics**
Provide a general discussion of how the NASW Code of Ethics guides social work practice and how to be an ethical practitioner as it relates to this practice situation.
**Ethical Dilemma and/or Value Conflict**
Identify and describe one or more potential ethical and values dilemmas related to this practice situation. This should be different from the values and ethical dilemmas you considered in previous assignments in this course.
**Application of the Code of Ethics to Selected Case**
Apply the NASW Code of Ethics to this practice situation to resolve the ethical dilemma described.
**Next Steps for the Client and Agency**
Provide an overall conclusion that discusses the next steps for the client/agency at the conclusion of your work.
**Required – 2 pages for this section.**
(Please use the references that you mentioned in the outline for this section and you can also add additional references) Please also use subheadings as needed.
**Remember, this section of the paper should be written in 3rd person.**
**Refer to the rubric below for evaluation criteria.**
Please find attached the outline that was completed as the first part of this assignment and all the other parts that were completed for this assignment. The 1st outline will serve as the foundation for the remaining sections.
I’ve also attached the full assignment description and instructions, which detail the requirements for each section. These sections are due every two weeks, and I will be submitting a request for each part accordingly. You’ve already completed the Integrative Paper Outline, Client Overview, Policy and Justice & Engagement, Assessment & HBSE theory sections, Intervention and Evaluation. Now we’re on the 6th part.
Please continue to follow the structure established in the initial outline. Each section has specific page requirements, which I will clearly indicate when assigning them every two weeks.
Thank you again for all your help.
**_Full Description of Major Assessments and Examinations_**
The purpose of this paper is to demonstrate a comprehensive understanding of practice and theory in your area of specialization. Select a client, client system or target population from your graduate level social work Practicum. The selected client or client system should reflect your chosen specialization. For example, if you are a CAP student you should select an agency, community or other social intervention. If your specialization is mental health, you should chose an individual, family or small group with mental health and/or substance misuse issues and concerns. If your area of specialization is family and children, you should choose an individual, family or small group with issues and concerns related to family and children. The client system you choose for your paper should be a real case from your Practicum placement. If you have an issue or problem with selecting a case from your Practicum placement, please see or talk with your instructor. All exceptions must be approved by the instructor. In no circumstances are family members, friends, or characters from media to be used as the client system in the paper.
(My specialization is Mental health)
**Integrative Paper Outline**
Use the template in the assignments module to complete the outline assignment. The template is set up so you can compose directly onto the document, save, and upload as your assignment submission.
**Client Situation. (Overview)**
Describe the client system. (e.g., individual, family, other small group, larger group, team, program, agency, organization or community) and the client’s situation that is the reason for your intervention. Include a discussion of how this client’s situation fits into your area of specialization. For example, if your area of specialization is mental health, describe how the client’s issues/concerns fit the definition of mental health, mental illness, and/or mental well-being.
Apply, synthesize and analyze knowledge, theory, and skills in relation to the client system.
**Engagement, Assessment, Human Behavior and the Social Environment**
Describe how you did engage the client in the assessment and intervention. What specific skills did you use to engage the client?
Describe your efforts to collect, organize and interpret information about the client. What are the client’s strengths and limitations?
Your assessment should include a discussion of relevant issues of age, class, color, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, sex, stigma, and/or sexual orientation as applicable to your client. Be sure that your discussion of diversity links well with the client and or client situation.
Discuss how the issues of social and economic justice and human and civil rights may relate to this specific practice situation.
Select and describe one or more of the most relevant HBSE theories that contribute to the client’s issues and concerns.
Briefly explain the theory and how this theory is relevant to your client’s area of concern/problem situation.
**Policy and Social Justice**
Select and describe one or more of the most relevant social policies relevant to the practice situation. This policy section refers to state and federal policies (laws, court decisions, or regulations), not agency policy. Be sure to cite the laws and policies correctly (as you should with all literature you reference).
Briefly explain the policy and how it is relevant to your client’s area of concern/problem situation.
Use a policy analysis model to analyze the effectiveness of the policy for the general client group you have chosen and then your client specifically. Include carefully referenced literature sources including books; peer-reviewed journal articles; research studies; government documents, reports and data; and web sites. While this is not expected in the space available to be a full policy analysis, you should draw on one of the policy analysis models with which you are familiar, and reference the model fully.
Based on your analysis, what would you advocate in terms of policy review, application, formulation, or revision?
**Intervention and Evaluation**
Present a mutually developed and agreed upon intervention strategy with specific goals and objectives. Provide a rationale for your selection.
Describe your intervention from beginning to end, including termination. How did you help the client prevent or resolve problems? How did you negotiate mediate and advocate for your client. Select and discuss at least 3 practice skills (micro/macro) used in your intervention with the client.
Write a critique of your work with the client. What did you do well in terms of the intervention? What could have been done to improve the outcomes with the client? How was the intervention empowering? How may it have been discriminatory or oppressive?
Provide a discussion of whether the intervention was developed from a theoretical practice model. If so, which practice theory? If not, what practice theory could have been used to facilitate better outcomes? Regardless, analyze and provide evidence- based knowledge about the theory-based intervention (used or proposed) and its effectiveness.
Select one of the methods used to evaluate change and improvement with clients/client systems (single subject, pretest/posttest or other). Provide a rationale for the evaluation method you selected. Describe the method and how you would facilitate using that method to collect data to assess change and improvement.
**Ethics and Conclusion**
Critically review your practice situation and intervention as an external observer and comment on the following:
Identify and describe one or more potential ethical and values issues related to this practice situation. Be sure to reference the NASW Code of Ethics in your discussion.
Discuss how this assignment raises issues of professional strengths and challenges. Formulate a plan for lifelong professional learning and continuing education.
NOTE: The final document should be between 20-25 double-spaced pages (not including references or a cover page) and in 12-point font. Your paper must adhere to APA style (6th edition).
## image1.png
**## PolicyandSocialJustice3rdPart.docx**
1
**Policy and Social Justice**
**Policy and Social Justice**
This section is an analysis of how a federal social policy can be applied to treat a 35-year-old client with generalized anxiety disorder and alcohol dependency in Center to Rise Wellness Spa Studio in Arlington, Texas. It is aligned with the mental health and substance misuse specialization through the policy analysis and recommendations, exploration of the social justice and ethical considerations, and rigorous policy analysis.
**Policy Selected**
The Affordable Care Act (ACA), which was implemented in 2010, is a federal policy that requires insurance coverage of mental and substance use disorder services to be on par with physical health services (CMS, 2023). This policy is essential to the client, who is a 35-year-old patient under dual-diagnosis treatment at Center to Rise Wellness Spa Studio in Arlington, Texas. The ACA allows one to access integrated care, including evidence-based interventions, including cognitive behavioral therapy (CBT) and motivational interviews, which can alleviate the client of occupational and social impairments due to the presence of persistent anxiety and alcohol dependency. Nevertheless, the policy is limited in its application by the fact that it faces implementation difficulties in rural settings such as certain areas in Arlington (shortage of providers and poor healthcare infrastructure), and, therefore, its effectiveness is limited to low-income clients (Patel & Jones, 2023). Such barriers contribute towards the inability of the client to get consistent care, which makes it hard to recover. The focus on mental health parity provided by the ACA is critical to helping the client receive the treatment he or she needs, yet there are improvements that need to be made in order to support the detailed needs of the client and enhance his or her overall quality of life.
**Policy Analysis Model**
The Karger and Stoesz (2021) policy analysis model allows examining the ACA through the prism of access, equity, and affordability and provides a solid framework to examine its effect on clients with co-occurring disorders. Mental health and substance use services are also more accessible under the ACA, but the absence of providers in rural areas critically restricts the ability to provide the client with timely care, causing delays in treatment that only worsen the symptoms (Ware, 2025). Inconsistency in Medicaid expansion among the states is a violation of equity, which disproportionately harms the low-income and minority groups, such as the client, who experiences systemic factors that restrict long-term treatment involvement (Nam et al., 2021). Although the affordability has been enhanced due to the low out-of-pocket expenses, it is still a major issue, as deductibles and copays are too high and bring financial pressure on the client due to their low socioeconomic status (Priester et al., 2022). This discussion shows the improvements made by the ACA on expanding coverage and the key systemic obstacles that reduce its effectiveness to address the complex needs of the client, which require strategic measures to increase its effectiveness.
**Policy Recommendations**
To strengthen the ACA’s effectiveness, policymakers should implement strategic reforms tailored to the needs of clients with co-occurring disorders. Increasing funding for telehealth services would mitigate rural provider shortages, enabling clients like the one at Center to Rise to access remote therapy, ensuring treatment continuity and flexibility for those in underserved areas (Ford et al., 2021). Standardizing Medicaid expansion across states would promote equitable access to dual-diagnosis treatment, reducing disparities for low-income clients who depend on public insurance to cover essential services. Subsidizing copays and deductibles for mental health and substance use services would improve affordability, alleviating financial barriers for clients with limited resources and enabling consistent engagement in care (Patel & Jones, 2023). Additionally, enhancing workforce development programs to train more mental health professionals in rural areas would address long-term access issues. These recommendations target critical gaps in access, equity, and affordability, strengthening the ACA’s capacity to support recovery and foster sustainable outcomes for individuals with complex behavioral health needs.
**Social Justice Implications**
The ACA advances social justice by mandating mental health parity, aligning with the NASW Code of Ethics’ commitment to equitable care access (NASW, 2021). Nevertheless, rural disparities and socioeconomic barriers undermine health equity, disproportionately impacting low-income clients like the one described, who struggle to maintain consistent treatment engagement due to systemic limitations (Rodriguez & Green, 2021). These inequities contravene principles of fair resource distribution, necessitating a comprehensive, multi-level advocacy plan. At the micro level, the social worker can educate the client on ACA-covered resources, such as subsidized therapy and community support programs, to optimize their access to essential services. At the mezzo level, partnering with Center to Rise to develop telehealth programs and community outreach initiatives would enhance service delivery for rural clients, improving community-level access. At the macro level, advocating through NASW for increased ACA funding for underserved areas and policy reforms to address rural healthcare disparities would tackle systemic inequities, promoting equitable access across diverse populations (Suleiman, 2025). This multi-level approach empowers the client, fosters fairness within their community, and aligns with social work’s commitment to justice.
**Ethical Challenge and/or Value Conflict**
An ethical conflict emerges from disparities in ACA implementation, which conflict with NASW’s social justice principle (Standard 6.04) mandating equitable resource access (NASW, 2021). The client’s limited access to care, driven by rural provider shortages and financial barriers, challenges the social worker’s obligation to ensure fair treatment, creating a tension between providing immediate client support and advocating for systemic change (Reamer, 2021). This dilemma requires balancing the client’s autonomy with the need to address barriers that threaten their well-being, such as potential escalation of alcohol use. Resolving this conflict involves prioritizing client-centered interventions, such as connecting the client to available resources and support networks, while simultaneously advocating for policy reforms to enhance access, ensuring alignment with ethical standards and the NASW Code of Ethics’ emphasis on justice, dignity, and equitable care.
**References**
CMS. (2023). Affordable Care Act: Mental health and substance use disorder services. Retrieved from
[https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use](https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use)
Ford, J. H., Kaur, A., Rao, D., Gilson, A., Bolt, D. M., Garneau, H. C., … & McGovern, M. P. (2021). Improving medication access within integrated treatment for individuals with co-occurring disorders in substance use treatment agencies. Implementation Research and Practice, 2, 26334895211033659.
[https://doi.org/10.1177/26334895211033659](https://doi.org/10.1177/26334895211033659)
Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson.
Nam, E., Lee, E., & Kim, H. (2021). 10-year trends of emergency department visits, wait time, and length of stay among adults with mental health and substance use disorders in the United States. Psychiatric Quarterly, 92(3), 1159-1174.
[https://doi.org/10.1007/s11126-021-09894-y](https://doi.org/10.1007/s11126-021-09894-y)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
Patel, S., & Jones, K. (2023). The impact of ACA on mental health equity: A 10-year review. Health Affairs, 42(5), 620-628.
[https://doi.org/10.1377/hlthaff.2022.01523](https://doi.org/10.1377/hlthaff.2022.01523)
Priester, M. A., Browne, T., Iachini, A., Clone, S., & Dehart, D. (2022). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 132, 47-59.
[https://doi.org/10.1016/j.jsat.2021.108047](https://doi.org/10.1016/j.jsat.2021.108047)
Reamer, F. G. (2021). The trolley problem and the nature of intention: Implications for social work ethics. Journal of Social Work Values and Ethics, 18(2), 43-54.
[https://jswve.org/volume-18/issue-2/item-08/](https://jswve.org/volume-18/issue-2/item-08/)
Rodriguez, M., & Green, T. (2021). Social justice implications of healthcare policy in the United States. Journal of Social Work, 21(3), 345-360.
[https://doi.org/10.1177/1468017320987654](https://doi.org/10.1177/1468017320987654)
Suleiman, F. M. S. (2025). Social justice and economic policy: Analyzing the interplay between welfare and market forces. The Open European Journal of Social Science and Education (OEJSSE), 34-45.
[https://easdjournals.com/index.php/oejsse/article/view/6](https://easdjournals.com/index.php/oejsse/article/view/6)
Ware, A. M. (2025). Medical social workers’ self-efficacy and perceptions of interdisciplinary collaboration managing patients with co-occurring chronic pain and opioid use disorder (Doctoral dissertation, Walden University).
[https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y](https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y)
**InterventionEvaluation5thPart.docx**
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**EngagementAssessmentHBSETheory4thPart.docx**
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**IntegrativePaperOutline1stPart-.docx**
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**## ClientOverview2ndPart-.docx**
5
**Client Overview**
**Client Overview**
This paper describes the client who is receiving services at Center to Rise Wellness Spa Studio in Arlington, Texas, and his struggles with generalized anxiety disorder and alcohol dependency. They are treated with dual diagnosis within the Mental Health and Substance Misuse specialization, and the overview sets the context for this treatment.
**Practice Setting**
The client practice setting is Center to Rise Wellness Spa Studio, Arlington, Texas. The specialty of this therapy clinic is mental health and substance misuse interventions with individual therapy, group support, and holistic wellness services like mindfulness and stress management. The agency’s multidisciplinary team provides a recovery-supportive environment, especially for individuals with co-occurring disorders, by using evidence-based practices to treat complex needs (Center to Rise Wellness Spa Studio, 2023). It focuses on dual-diagnosis treatment, which meets the client’s needs in a community-based setting.
**Practice Situation**
This is a client who is a 35-year-old person who has generalized anxiety disorder and alcohol dependency, which hinder the client’s employment and social relationships. Their anxiety is persistent, uncontrollable worry that interferes with daily functioning and causes emotional distress. Alcohol use is used as a maladaptive coping mechanism, which worsens social isolation and occupational instability and thus perpetuates the cycle of dependency (SAMHSA, 2024). This dual diagnosis is a complicated practice situation that requires integrated therapeutic interventions to deal with both problems simultaneously. The client’s challenges point to the interplay between mental health and substance misuse and the need for tailored, evidence-based strategies for recovery and enhancing quality of life.
**Connection to Specialization**
The mental health and substance misuse specialization directly relates to the client’s co-occurring disorders. But their challenges illustrate the importance of integrated care models that address mental health and substance use at the same time. Dual-diagnosis treatment, as SAMHSA (2024) states, can be effective only when it is comprehensive and includes therapy, motivational strategies, and relapse prevention. The specialization’s concentration on handling intricate situations involving the combination of anxiety and alcohol dependency, as found in the client’s situation, emphasizes the need for evidence-based approaches, for example, motivational interviewing and cognitive behavioral therapy (Lee & Sherman, 2024). Specialized knowledge of the client and the care system can be used in this case to create client-centered interventions, advocate for equitable care, and work to dismantle systemic barriers to recovery.
**Social and Contextual Factors**
The client’s low socioeconomic status and limited access to resources in Arlington only exacerbate their challenges, which are symptomatic of broader systemic issues in the access to mental health care. Ware (2025) notes that rural and underserved communities often have barriers to integrated treatment, which in turn reduces the client’s ability to consistently engage in care. Other cultural factors, such as stigma associated with mental health and substance use issues, complicate help-seeking behaviors. Culturally adapted engagement strategies are used by social workers in order to build trust and make sure that interventions are resonating with the client’s background (Lee & Sherman, 2024). These factors indicate the need for treatment planning that addresses social determinants of health.
**Reason for Intervention Need**
This client is in need of intervention due to the prevalence of co-occurring disorders. According to SAMHSA (2024), an estimated 9.2 million U.S. adults suffer from both mental health and substance use disorders each year, highlighting the public health importance of dual-diagnosis treatment. The client is impaired and using alcohol to cope with this impairment, which indicates the need for immediate intervention to avoid further deterioration. Through the Mental Health and Substance Misuse specialization, the social worker will be able to help the client to work towards recovery while utilizing evidence-based practices in order to provide sustainable results.
**References**
Center to Rise Wellness Spa Studio. (2023). About us. Retrieved from
[https://centertorise.com/](https://centertorise.com/)
Lee, C. S., & Sherman, D. K. (2024). Integration of motivational interviewing and self-affirmation theory into a culturally adapted motivational interview: A case study.
_Clinical Case Studies, 23_(3), 212-229.
[https://doi.org/10.1177/15346501231222554](https://doi.org/10.1177/15346501231222554)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
SAMHSA. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Retrieved from
[https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf](https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf)
Ware, A. M. (2025). Medical social workers’ self-efficacy and perceptions of interdisciplinary collaboration managing patients with co-occurring chronic pain and opioid use disorder (Doctoral dissertation, Walden University).
[https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y](https://www.proquest.com/openview/f19a4afafbfbe08636ba47757d36939b/1?pq-origsite=gscholar&cbl=18750&diss=y)
**## Instructions-6thPart-EthicsConclusion.docx**
**Ethics & Conclusion Instructions** (6th & Final part of the integrative paper outline)
**INSTRUCTIONS**
**Micro Instructions for Ethics and Conclusion**
**NASW Code of Ethics**
Provide a general discussion of how the NASW Code of Ethics guides social work practice and how to be an ethical practitioner as it relates to this practice situation.
**Ethical Dilemma and/or Value Conflict**
Identify and describe one or more potential ethical and values dilemmas related to this practice situation. This should be different from the values and ethical dilemmas you considered in previous assignments in this course.
**Application of the Code of Ethics to Selected Case**
Apply the NASW Code of Ethics to this practice situation to resolve the ethical dilemma described.
**Next Steps for the Client and Agency**
Provide an overall conclusion that discusses the next steps for the client/agency at the conclusion of your work.
**Required – 2 pages for this section.**
(Please use the references that you mentioned in the outline for this section and you can also add additional references) Please also use subheadings as needed.
**Remember, this section of the paper should be written in 3rd person.**
**Refer to the rubric below for evaluation criteria.**
Please find attached the outline that was completed as the first part of this assignment and all the other parts that were completed for this assignment. The 1st outline will serve as the foundation for the remaining sections.
I’ve also attached the full assignment description and instructions, which detail the requirements for each section. These sections are due every two weeks, and I will be submitting a request for each part accordingly. You’ve already completed the Integrative Paper Outline, Client Overview, Policy and Justice & Engagement, Assessment & HBSE theory sections, Intervention and Evaluation. Now we’re on the 6th part.
Please continue to follow the structure established in the initial outline. Each section has specific page requirements, which I will clearly indicate when assigning them every two weeks.
Thank you again for all your help.
**_Full Description of Major Assessments and Examinations_**
The purpose of this paper is to demonstrate a comprehensive understanding of practice and theory in your area of specialization. Select a client, client system or target population from your graduate level social work Practicum. The selected client or client system should reflect your chosen specialization. For example, if you are a CAP student you should select an agency, community or other social intervention. If your specialization is mental health, you should chose an individual, family or small group with mental health and/or substance misuse issues and concerns. If your area of specialization is family and children, you should choose an individual, family or small group with issues and concerns related to family and children. The client system you choose for your paper should be a real case from your Practicum placement. If you have an issue or problem with selecting a case from your Practicum placement, please see or talk with your instructor. All exceptions must be approved by the instructor. In no circumstances are family members, friends, or characters from media to be used as the client system in the paper.
(My specialization is Mental health)
**Integrative Paper Outline**
Use the template in the assignments module to complete the outline assignment. The template is set up so you can compose directly onto the document, save, and upload as your assignment submission.
**Client Situation. (Overview)**
Describe the client system. (e.g., individual, family, other small group, larger group, team, program, agency, organization or community) and the client’s situation that is the reason for your intervention. Include a discussion of how this client’s situation fits into your area of specialization. For example, if your area of specialization is mental health, describe how the client’s issues/concerns fit the definition of mental health, mental illness, and/or mental well-being.
Apply, synthesize and analyze knowledge, theory, and skills in relation to the client system.
**Engagement, Assessment, Human Behavior and the Social Environment**
Describe how you did engage the client in the assessment and intervention. What specific skills did you use to engage the client?
Describe your efforts to collect, organize and interpret information about the client. What are the client’s strengths and limitations?
Your assessment should include a discussion of relevant issues of age, class, color, disability, ethnicity, family structure, gender, marital status, national origin, race, religion, sex, stigma, and/or sexual orientation as applicable to your client. Be sure that your discussion of diversity links well with the client and or client situation.
Discuss how the issues of social and economic justice and human and civil rights may relate to this specific practice situation.
Select and describe one or more of the most relevant HBSE theories that contribute to the client’s issues and concerns.
Briefly explain the theory and how this theory is relevant to your client’s area of concern/problem situation.
**Policy and Social Justice**
Select and describe one or more of the most relevant social policies relevant to the practice situation. This policy section refers to state and federal policies (laws, court decisions, or regulations), not agency policy. Be sure to cite the laws and policies correctly (as you should with all literature you reference).
Briefly explain the policy and how it is relevant to your client’s area of concern/problem situation.
Use a policy analysis model to analyze the effectiveness of the policy for the general client group you have chosen and then your client specifically. Include carefully referenced literature sources including books; peer-reviewed journal articles; research studies; government documents, reports and data; and web sites. While this is not expected in the space available to be a full policy analysis, you should draw on one of the policy analysis models with which you are familiar, and reference the model fully.
Based on your analysis, what would you advocate in terms of policy review, application, formulation, or revision?
**Intervention and Evaluation**
Present a mutually developed and agreed upon intervention strategy with specific goals and objectives. Provide a rationale for your selection.
Describe your intervention from beginning to end, including termination. How did you help the client prevent or resolve problems? How did you negotiate mediate and advocate for your client. Select and discuss at least 3 practice skills (micro/macro) used in your intervention with the client.
Write a critique of your work with the client. What did you do well in terms of the intervention? What could have been done to improve the outcomes with the client? How was the intervention empowering? How may it have been discriminatory or oppressive?
Provide a discussion of whether the intervention was developed from a theoretical practice model. If so, which practice theory? If not, what practice theory could have been used to facilitate better outcomes? Regardless, analyze and provide evidence- based knowledge about the theory-based intervention (used or proposed) and its effectiveness.
Select one of the methods used to evaluate change and improvement with clients/client systems (single subject, pretest/posttest or other). Provide a rationale for the evaluation method you selected. Describe the method and how you would facilitate using that method to collect data to assess change and improvement.
**Ethics and Conclusion**
Critically review your practice situation and intervention as an external observer and comment on the following:
Identify and describe one or more potential ethical and values issues related to this practice situation. Be sure to reference the NASW Code of Ethics in your discussion.
Discuss how this assignment raises issues of professional strengths and challenges. Formulate a plan for lifelong professional learning and continuing education.
NOTE: The final document should be between 20-25 double-spaced pages (not including references or a cover page) and in 12-point font. Your paper must adhere to APA style (6th edition).
## image1.png
**## PolicyandSocialJustice3rdPart.docx**
1
**Policy and Social Justice**
**Policy and Social Justice**
This section is an analysis of how a federal social policy can be applied to treat a 35-year-old client with generalized anxiety disorder and alcohol dependency in Center to Rise Wellness Spa Studio in Arlington, Texas. It is aligned with the mental health and substance misuse specialization through the policy analysis and recommendations, exploration of the social justice and ethical considerations, and rigorous policy analysis.
**Policy Selected**
The Affordable Care Act (ACA), which was implemented in 2010, is a federal policy that requires insurance coverage of mental and substance use disorder services to be on par with physical health services (CMS, 2023). This policy is essential to the client, who is a 35-year-old patient under dual-diagnosis treatment at Center to Rise Wellness Spa Studio in Arlington, Texas. The ACA allows one to access integrated care, including evidence-based interventions, including cognitive behavioral therapy (CBT) and motivational interviews, which can alleviate the client of occupational and social impairments due to the presence of persistent anxiety and alcohol dependency. Nevertheless, the policy is limited in its application by the fact that it faces implementation difficulties in rural settings such as certain areas in Arlington (shortage of providers and poor healthcare infrastructure), and, therefore, its effectiveness is limited to low-income clients (Patel & Jones, 2023). Such barriers contribute towards the inability of the client to get consistent care, which makes it hard to recover. The focus on mental health parity provided by the ACA is critical to helping the client receive the treatment he or she needs, yet there are improvements that need to be made in order to support the detailed needs of the client and enhance his or her overall quality of life.
**Policy Analysis Model**
The Karger and Stoesz (2021) policy analysis model allows examining the ACA through the prism of access, equity, and affordability and provides a solid framework to examine its effect on clients with co-occurring disorders. Mental health and substance use services are also more accessible under the ACA, but the absence of providers in rural areas critically restricts the ability to provide the client with timely care, causing delays in treatment that only worsen the symptoms (Ware, 2025). Inconsistency in Medicaid expansion among the states is a violation of equity, which disproportionately harms the low-income and minority groups, such as the client, who experiences systemic factors that restrict long-term treatment involvement (Nam et al., 2021). Although the affordability has been enhanced due to the low out-of-pocket expenses, it is still a major issue, as deductibles and copays are too high and bring financial pressure on the client due to their low socioeconomic status (Priester et al., 2022). This discussion shows the improvements made by the ACA on expanding coverage and the key systemic obstacles that reduce its effectiveness to address the complex needs of the client, which require strategic measures to increase its effectiveness.
**Policy Recommendations**
To strengthen the ACA’s effectiveness, policymakers should implement strategic reforms tailored to the needs of clients with co-occurring disorders. Increasing funding for telehealth services would mitigate rural provider shortages, enabling clients like the one at Center to Rise to access remote therapy, ensuring treatment continuity and flexibility for those in underserved areas (Ford et al., 2021). Standardizing Medicaid expansion across states would promote equitable access to dual-diagnosis treatment, reducing disparities for low-income clients who depend on public insurance to cover essential services. Subsidizing copays and deductibles for mental health and substance use services would improve affordability, alleviating financial barriers for clients with limited resources and enabling consistent engagement in care (Patel & Jones, 2023). Additionally, enhancing workforce development programs to train more mental health professionals in rural areas would address long-term access issues. These recommendations target critical gaps in access, equity, and affordability, strengthening the ACA’s capacity to support recovery and foster sustainable outcomes for individuals with complex behavioral health needs.
**Social Justice Implications**
The ACA advances social justice by mandating mental health parity, aligning with the NASW Code of Ethics’ commitment to equitable care access (NASW, 2021). Nevertheless, rural disparities and socioeconomic barriers undermine health equity, disproportionately impacting low-income clients like the one described, who struggle to maintain consistent treatment engagement due to systemic limitations (Rodriguez & Green, 2021). These inequities contravene principles of fair resource distribution, necessitating a comprehensive, multi-level advocacy plan. At the micro level, the social worker can educate the client on ACA-covered resources, such as subsidized therapy and community support programs, to optimize their access to essential services. At the mezzo level, partnering with Center to Rise to develop telehealth programs and community outreach initiatives would enhance service delivery for rural clients, improving community-level access. At the macro level, advocating through NASW for increased ACA funding for underserved areas and policy reforms to address rural healthcare disparities would tackle systemic inequities, promoting equitable access across diverse populations (Suleiman, 2025). This multi-level approach empowers the client, fosters fairness within their community, and aligns with social work’s commitment to justice.
**Ethical Challenge and/or Value Conflict**
An ethical conflict emerges from disparities in ACA implementation, which conflict with NASW’s social justice principle (Standard 6.04) mandating equitable resource access (NASW, 2021). The client’s limited access to care, driven by rural provider shortages and financial barriers, challenges the social worker’s obligation to ensure fair treatment, creating a tension between providing immediate client support and advocating for systemic change (Reamer, 2021). This dilemma requires balancing the client’s autonomy with the need to address barriers that threaten their well-being, such as potential escalation of alcohol use. Resolving this conflict involves prioritizing client-centered interventions, such as connecting the client to available resources and support networks, while simultaneously advocating for policy reforms to enhance access, ensuring alignment with ethical standards and the NASW Code of Ethics’ emphasis on justice, dignity, and equitable care.
**References**
CMS. (2023). Affordable Care Act: Mental health and substance use disorder services. Retrieved from
[https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use](https://www.cms.gov/marketplace/private-health-insurance/mental-health-substance-use)
Ford, J. H., Kaur, A., Rao, D., Gilson, A., Bolt, D. M., Garneau, H. C., … & McGovern, M. P. (2021). Improving medication access within integrated treatment for individuals with co-occurring disorders in substance use treatment agencies. Implementation Research and Practice, 2, 26334895211033659.
[https://doi.org/10.1177/26334895211033659](https://doi.org/10.1177/26334895211033659)
Karger, H. J., & Stoesz, D. (2021). American social welfare policy: A pluralist approach. Pearson.
Nam, E., Lee, E., & Kim, H. (2021). 10-year trends of emergency department visits, wait time, and length of stay among adults with mental health and substance use disorders in the United States. Psychiatric Quarterly, 92(3), 1159-1174.
[https://doi.org/10.1007/s11126-021-09894-y](https://doi.org/10.1007/s11126-021-09894-y)
NASW. (2021). Code of ethics of the National Association of Social Workers. Retrieved from
[https://www.socialworkers.org/About/Ethics/Code-of-Ethics](https://www.socialworkers.org/About/Ethics/Code-of-Ethics)
Patel, S., & Jones, K. (2023). The impact of ACA on mental health equity: A 10-year review. Health Affairs, 42(5), 620-628.
[https://doi.org/10.1377/hlthaff.2022.01523](https://doi.org/10.1377/hlthaff.2022.01523)
Priester, M. A., Browne, T., Iachini, A., Clone, S., & Dehart, D. (2022). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 132, 47-59.
[https://doi.org/10.1016/j.jsat.2021.108047](https://doi.org/10.1016/j.jsat.2021.108047)
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