SOC-449 Week 1 Intake Form Analysis Worksheet Assignment
Access and complete the “Intake Form Analysis Worksheet.”
While APA style is not required for the body of this assessment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a scoring guide. Please review a scoring guide prior to beginning the assignment to become familiar with the expectations for successful completion.
Students are required to submit this assignment to LopesWrite.
Turn in the completed assignment to the folder at the end of Topic 1.
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SOC-449 Intake Interview Form Analysis Assignment
Knowing how to analyze an intake form is essential in social work. The intake form provides the information social workers will use to determine possible identified problems. This assignment will help you learn this concept.
Read the intake form and then use it to answer the prompts below:
Name of Client: Martin McNowhere
Age: 35 DOB: 7-4-1982 Date: __________________
Marital Status: (circle) Single Married Separated Divorced
Email: M.McNowhere@yoohoo.net
Address: 89 E. Idunno Drive Apt 1100 NYC, NY 56789
Phone: (928)555-2222
Work Status: (Circle all that apply)
- Currently employed as An assistant Principal
- Looking for employment as ______University professor____________________________________
- Involved with local government agency to find employment
- Going to college at NYU_______________________
- Obtaining vocational training at_________________________________
Any formal diagnoses: None.
Any medications (dose and frequency): None_______________
After reading the above intake form, use the information to answer the following prompts:
- Explain the presenting problem and other possible identified problems of the client. (40-50 words)
- Identify any cultural personal biases that might arise during the interview. (40-50 words)
- What are the primary concerns of the client? (40-50 words)
- Describe any personal or family coping capacities, skills, values, motivations of the client. (40-50 words)
- List some of the strengths and weaknesses of the client: (30-40 words)
- Identify systems in this client’s life that shape his life circumstances: (40-50 words)
- As the social worker assigned this client, how would you use this information to build a rapport with the client? (40-50 words)
- Explain whether there are any social phenomena (behavior that influences or is influenced by the client) in this case (30-40 words):
- List some possible measurable client goals you would suggest to the client:
Course: SOC-449 Direct Practice
School: Grand Canyon University
- : 25/08/2019
- : 60
