SOWK 431 Week 5 DB Forum 3 Example

Discussion Board Forum 3: Thread and Two Replies

SOWK 431 Social Work in Mental Health, Discussion Board Forum 3 (thread and two replies)

Thread by [Student Name]

The prompt, the client and the classmates' posts are composites standing in for the course's own forum; Scripture, the casebook, the manual and the journal articles are real and described from their published sources; the requirements follow Liberty's public course guide for SOWK 431.

Thread

Ava, a composite fifteen-year-old, is one of the fastest runners on her high school cross-country team. Her coach contacted the school social worker after noticing that she skipped team dinners, wore layers on warm days and had grown pale and tired. Her mother then reported that Ava has lost eighteen pounds since spring, cuts food into tiny pieces and becomes upset when the family eats out.

The DSM-5 lists three criteria for anorexia nervosa: energy intake restricted until weight is significantly low for age and health, a strong fear of gaining weight or behavior that keeps weight from rising and a disturbed experience of one's own weight or shape (American Psychiatric Association, 2013). Ava's weight is now well below the expected range for her age and height, she says she is terrified of getting slow and heavy and she insists she still needs to lose more. The DSM-5 dropped the earlier requirement of missed periods, so a clinician need not wait for that sign.

Urgency matters. Arcelus et al. (2011) pooled 36 studies and found that anorexia nervosa had the highest mortality rate among the eating disorders they examined, with a meaningful share of deaths due to suicide. For adolescents, evidence favors family-based treatment, in which parents take charge of meals to restore weight and then hand control back gradually. Lock et al. (2010) randomized adolescents to family-based treatment or individual adolescent-focused therapy and found significantly higher full remission rates with family-based treatment at follow-up.

Corcoran and Walsh (2014) urge workers to see families as resources, not causes. Ava's parents are frightened but united, and her sister is protective of her. Those are strengths that family-based treatment can mobilize. My plan would include an urgent medical evaluation, referral to a family-based treatment team and coordination with her coach about training while she recovers.

At what point should a school social worker involve parents if a teen asks to keep her eating private?

Reply to Sophia

Sophia, you worried that putting parents in charge of meals implies they caused the disorder. Family-based treatment actually takes the opposite stance: it treats the illness as no one's fault and enlists parents because they know their child best and are present at every meal. Lock et al. (2010) showed it can outperform individual therapy, which suggests parents are a powerful resource. A social worker can say this explicitly, relieving guilt so parents can act with confidence.

Reply to Isaac

Isaac, you cited 1 Samuel 16:7, where God tells Samuel that people judge by outward appearance but the Lord looks at the heart (English Standard Version Bible, 2001/2016). That verse could be powerful for a teen like Ava, whose illness tells her that her worth depends on her body. A Christian social worker might, if Ava welcomes it, help her name the qualities her friends and family value, such as loyalty and courage, which have nothing to do with weight or speed.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731. https://doi.org/10.1001/archgenpsychiatry.2011.74

Corcoran, J., & Walsh, J. (2014). Mental health in social work: A casebook on diagnosis and strengths-based assessment (2nd ed.). Pearson.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Lock, J., Le Grange, D., Agras, W. S., Moye, A., Bryson, S. W., & Jo, B. (2010). Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Archives of General Psychiatry, 67(10), 1025-1032. https://doi.org/10.1001/archgenpsychiatry.2010.128