Applying the Biopsychosocial-Spirituality Model to an Individual Case

Biopsychosocial Spiritual Assessment

Part I

Biological Dimension:

Regina is a 38-year-old Latina mother of two children. Her oldest daughter is Mary 9, and her youngest daughter is Amanda 7. Regina was born in Honduras and lived there until the age of 19. Then she moved to the United States. Regina currently suffers from high blood pressure but is able to maintain her illness with the Medicaid she and her children receive. She also suffers from very high volumes of stress. These illnesses could be a result of her mother’s genes being passed down to her. Regina’s mother died when she was only 12-year-old from what seemed to be a stroke. These symptoms Regina is experiencing could result in future bio functioning. Shortly after her mother’s death, her father began to drink heavily. This resulted in Regina being forced to grow up at such a young age. She became responsible for taking care of her two youngest siblings. I believe her illness can easily be managed. She already has access to health insurance. Doctors can provide the medicine and attention needed. High blood pressure and high volumes of stress can be reduced by relaxing and giving herself some alone time. She may need extra help with her children so she can begin to manage her time.

Psychological Dimension:

At a young age, Regina believed it was her responsibility to take on the mother role in her family. She began to cook, clean, and care for her younger siblings when she felt nobody else would. This trait followed her everywhere she went. When she moved to the United States, Regina became a nanny for her Aunt Gloria’s children ages 2 and 3. In return, she was able to room and board for as long as she needed to. But this stress also affected her negatively, because today she is a single mother of two children and has lost lots of patience with them. I believe she has spent most of her time taking care of others; and not having anyone to take care of her that the levels of stress she is facing is becoming overwhelming. She is in need of a break. Regina also believes her children should always get along with one another, this is very irrational thinking. Children especially at a young age, bump heads a lot. Regina has not adapted to spending day in and day out with her children like her husband did before he died. This thinking of hers is resulting in the impatience and lacking of motherhood she is facing in her current situation. Regina’s past experience raising her siblings, is causing her to believe her children are able to care for one another at a young age. Which I believe is the reason she leaves her children home alone, unsupervised.

The research on the impact of early nurturing helps me to understand Regina in many ways. For example, I believe if Regina wasn’t forced to grow up at such a young age she would have had more time to grow and develop at a reasonable pace. She would of never been in the position to have to take care of her family financially and lead her to struggle as her future went on. I also believe, Regina didn’t receive the education she needed early on to help her build a stable career. She was forced to drop out of school due to absences and helping her family. The love and support she should have had as a child was nonexistent. She watched her mother die, her father become an alcoholic, her aunts limited role in her life because of her own children, and the drug cartels threatening her if she didn’t sell drugs for them. My own knowledge of crisis and stress helps me understand Regina as well. When I am faced with a hard time, my emotions automatically become involved and the focus shifts. At the age of 20, my parents moved away and my sisters and I chose to stay. My youngest sibling after time became homeless and I began to look after her. It isn’t an easy task, but it did show me the amount of patience and love a person needs. Today, I have my own child and my youngest sister still isn’t in the best state. I can understand Regina’s amount of stress she is facing. She helped raise her siblings on her own and now today she is raising two children on her own. She is in need of help, and is doing all that she can to take care of her children. She doesn’t see the wrong in leaving her children unsupervised because in the end its all for her children. I believe she needs guidance, she needs help.

Spiritual Dimension:

Regina states she has been religious for most of her life. She has always taken her children Amanda and Mary to church on Sundays. They would spend half their day there. Regina believes in prayer and is very open to her faith in God. She believes in good and bad spirits and refuses to go anywhere where there are “bad” spirits. She explains she can feel their presence. Regina has an off the books cleaning business, and while cleaning a home she felt there was a ghost present. She no longer cleans the rooms in that house where she felt the spirits.

Based on the symbolic themes of spirituality, Regina is most relevant to the virtues of patience, forgiveness, hope, and faith. Throughout her struggles, she continues her faith with God and has hope and patience that things will get better. She has forgiven her family for putting her through such a tragic time, she grew from the experience and is still trying to overcome some things she never really had a chance to learn. Also, she has faced the relationship of cause and effect regarding poverty. Regina has struggled financially since a child. When she moved to the United States she had absolutely nothing so she began child care in return for a home. She later began cleaning homes to pay for her and her families studio apartment. Having very little money motivated her to begin working afternoons and early evenings.

Culture and the Physical Environment:

Regina’s culture is based solely on her social heritage/tradition. She has learned and adopted to repertory of thoughts and actions exhibited by her family. Growing up she watched her mother run an empanada business which influenced her to start her cleaning business. She seen her mother was hard working and helped her make and sell the empanadas. Once her mother died, she took her place as the families caregiver. Her family never allowed her to finish school due to the all the responsibilities they put on her, she now puts little effort to engage in her children’s education. I believe Regina has adapted good and bad traits onto her generation.

Two ways to describe Regina and her families culture is defined under Postmodern Culture. For example, the stability and change of their family living is unpredictable and chaotic. Regina faces many tragedies and is unable to become stable. When she moved out of her Aunt Gloria’s apartment into her own, she had two children in a studio apartment and limited money. She was unable to move to a bigger place. Her husband did not work, which put more weight on Regina’s shoulder. He later died of stomach cancer and left her with their two children and struggling. Her family from generation to generation is faced with unpredictable and life ruining situations. It is beginning to become impossible for the future generation to be successful and rise out of poverty. Another example is, their role of rationality. Regina and her family question the limits of rationality. I feel like they do not believe in any of their wrong doing. When Regina’s worker stole from a good customer and was confronted, Regina became angry and defensive. She should have addressed the situation in a different way and I believe the relationship with the woman would of never been sacrificed. Also, “She believes that it should be easier to raise the girls; that they should be able to take better care of themselves and not bother her.” This is complete irrational thinking. Her daughters are children; they are unable to fend for themselves nor should anyone have to at such a young age. With the experience Regina faced, she should be able to understand that it isn’t an easy task and want better for her children. Understand the way Regina thinks helps me to understand Regina and her behavior. Her behavior comes from her past generation. She is following behind what she seen and what she learned. She isn’t trying to better than they were, she is remaining in the same state of mind.

Some examples of Regina’s relationship between her and her physical environment include crowding and activity. Since Regina moved into the U.S. she has been living in cramped areas. Beginning with her Aunts apartment with her, her aunt, her two children, Regina’s husband, and their one child. She then moved into a studio apartment with her husband and two children. She also faces perceived intensity of ongoing behavior within an environment. Regina continues to leave her children home alone, and refuses to use school resources. Her neighbor informs her on after school programs that are provided and she never enrolled the girls until after child welfare was involved.

Social Structure and Social Institutions:

A social system consists of bonds and relationships among one person and a group. Throughout Regina’s life she has strong and weak bonds between many different social systems. As a child she was a part of her mother’s empanadas business, she would help her mother cook and sell them. At the age of 12, her mother passed away. Her and her father’s relationship was weak, he became a heavy alcoholic which caused Regina to have to take care of her two younger siblings. When Regina finally was able to leave Honduras and move to the United States, years later she joined a non-profit refugee program. This program helped Regina through the process to become a legal alien. Her family is the strongest social system she is a part of. Since a young age, she has nothing but her family. Beginning with her aunts who helped her grow up and gave her places to stay. Ending with her deceased husband and her two daughters she now raises on her own. Regina and her husband Juan hit it off immediately and soon got married. They began living with one another and had two children together. Juan died of stomach cancer. Regina’s children are a part of an elementary school community. Amanda who is her youngest daughter is in the second grade and she is having a hard time concentrating. Her aide, teachers, and principle were very worried about her and her sister. Her bond with the school isn’t very strong because of the fact she is a very shy child. Regina also has a very strong and stable relationship with her work and workers. She runs an off the book cleaning business and seems to have great business. Also, Regina and her children are a part of a religious community. They attend church on a weekly basis and are very involved in their faith for God. Regina now has a relationship with a family social worker since child welfare has begun an investigation of the allegations of child neglect.

I believed Regina faced a number of social inequalities. On that stood out most was the idea that she receives Medicaid for herself and her children but does not receive any other financial assistance. Regina could have avoided leaving her children unsupervised while she worked if she was able to have access to child care through social services. She is a single mother of two young girls, and is financially struggling. Her finances are in the system due to her free health care so a worker should have offered other assistance. The jobs of social workers to help those who are in poverty rise up and do better. Regina was a part of a non-profit refugee program gaining citizenship, and I believe they used that as a barrier to keep her from receiving the assistance she needs.

Part II-

Regina’s biological, psychological, spiritual, social, and physical systems interact with and influence one another. Regina’s biological factors explains her psychological state of mind. She has always been a caregiver and has had loads of stress weighed onto her since a very young age. Today, her psychological state is affected by who and what she has been exposed to. Mentally she believes she in control of everything which include care giving and even financials. Her amount of stress is a contributing factor in her high blood pressure. She never has a moment to herself to manage what it is going on around her. Her psychological state has resulted in her spiritual mind set. She has faith in her God, and she also has involved her children in her faith as well. They go to church every Sunday and pray. I believe she has faith and hope in herself. She believes everything is going to get better, she won’t be struggling forever. With all of this going on, she does still have a social life. She is not too involved in her children’s lives, she believes they shouldn’t need her help and should know how to take care of their selves. She is very unhappy raising them alone. Her husband was the one who would spend all day with the children while she went out and worked and paid the bills. She now has little to no patience, she thinks they are bad and has on occasions hit them. Their relationships with each other aren’t very strong. But, she does consistently go to work and have relationships with her co-workers. Her off the books cleaning company isn’t enough to provide a larger home for her and her children so she is stuck living in a studio apartment. Her financials are causing her to continue to be in crowded living areas. From living with family, to her current situation. Regina has been limited to environmental systems and resources. She isn’t able to move around freely, she has to be sure she knows where her children are, she can’t afford her own transportation. The social welfare system hasn’t given her the needs she should receive which limits her families’ available resources. She is in denial that she needs help from anyone. Her neighbors tried to encourage her to enroll her daughters in after school programs while she is working so they would not be home and unsupervised. Regina has ignored her request up until child services began investigating her.

As you can see, Regina has not had an easy life and I do not believe she intentionally meant to “neglect” her children. She has faced a lot of tragic occurrences in her life and just needs some guidance. She has always gone above and beyond for her family, and does whatever has to be done to make sure they will be okay. I do believe she needs therapy, and help understanding leaving her children unsupervised home alone is a crime and considered child neglect. Regina should not put her children through what she been through; it isn’t something a normal child goes through in life. Her psychological state should be examined for the sake of her two daughters.