Using Simulations to Promote Social Justice in Clinical Practice

Individual/InternalSystemic/Structural/ExternalMedical ModelBiopsychosocial model

1. People have poor health because they’ve made unhealthychoices. It’s a question of individual responsibility.2.Problems lie in personal inadequacies and remedies liebeyond personal power. (Roy, 2007).3. Health disparities (to the extent they are acknowledged)may be unfortunate but not necessarily unfair.4. There’s little that can be done.(Unnatural Causes tool kit)

InternalExternal*--------------------------------------------------------*IndividualSystemicChoiceBiologyEnvironmentPolicy

PsychoanalyticAdlerianExistentialPerson-CenteredGestaltBehaviorPostmodernFamily SystemsRealityFeministsCognitiveBehavioral

AgencyExamining the relationship betweenconditions outside the body and healthGroup therapy and empowerment (Roy,2007)• Problem solving groups• Community support, skill learning unlearningpowerlessness-learning power sharing

(Comas-Diaz, 2007)

Common findings (systemic and personal)• Public housing (overcrowded, unhealthy livingconditions)• Substandard schools• Limited health care• Victim of sexual abuse (rape, molestation)• Sex workers• Addicted to multiple substances (alcohol and cocaine)• Familial loss (gang violence, poor health)• Health problems(asthma, hypertension, hepatitis)• General history of multiple traumas• Separated from children and partners

List 5 important issues that may hinderLinda’s successful treatment andreintegration back into society.What issues will most impact your plan oftreatment?What other important information mightyou ask for?

STRUCTURAL CONCERNSINDIVIDUAL CONCERNS(MENTAL AND PHYSICAL)No health insuranceTransportationFoodHousing issues• Lived near factory• Multiple residents in smallliving quarters• Poor structural featuresAccess to (mental) health care• Waiting time forPsychiatristsEmployment• FELONY CHARGE• LIMITED EDUCATION Previous drug use Experience of trauma Death of loved one Familial issues Development issues Anxiety Asthma

Majorityof herneeds

CognitiveEmotional IntelligenceExperientialHow it applies to the simulationHow it has informed my work with theladies from Grace House

My experience at Grace House

PAI trends• Negative Self Images, Warm, Depression, Stress,Anxiety TAT trends• Personally identifies with several cards. Mentionssystems and institutions (poor housing, jails,hospitals) Early Memories• Also mentions poor and overcrowded housing Intelligence Tests• Higher scores on novel tasks, lower scores on verbaltasks

Warm and engagingResilientAdaptiveStrong social skills

Video Clips

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